The GALE
ENCYCLOPEDIA of
ALTERNATIVE
MEDICINE
SECOND EDITION
The GALE
ENCYCLOPEDIA of
Alternative
Medicine
SECOND EDITION
VOLUME
1
A-C
JACQUELINE L. LONGE, PROJECT EDITOR
THOMSON
GALE
Detroit • New York • San Francisco • San Diego • New Haven, Conn. • Waterville, Maine • London • Munich
THOMSON
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GALE
The Gale Encyclopedia of Alternative Medicine, Second Edition
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Jacqueline L. Longe
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LIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA
The Gale encyclopedia of alternative medicine / Jacqueline L. Longe,
project editor.-- 2nd ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 0-7876-7424-9 (set hardcover : alk. paper) - ISBN 0-7876-7425-7 (v. 1 : alk.
paper) ~ ISBN 0-7876-7426-5 (v. 2 : alk. paper) - ISBN 0-7876-7427-3 (v. 3 : alk.
paper) -- ISBN 0-7876-7428-1 (v. 4 : alk. paper)
1. Alternative medicine— Encyclopedias.
[DNLM: 1. Complementary Therapies— Encyclopedias-English. 2. Internal
Medicine—
Encyclopedias-English. WB 13 G1507 2005] I. Title: Encyclopedia of
alternative medicine. II. Longe, Jacqueline L.
R733.G34 2005
61 5.5'03— dc22
2004022502
This title is also available as an e-book
ISBN 7876-9396-0 (set)
Contact your Gale sales representative for ordering information
ISBN 0-7876-7424-9(set)
0-7876-7425-7 (Vol. 1)
0-7876-7426-5 (Vol. 2)
0-7876-7427-3 (Vol. 3)
0-7876-7428-1 (Vol. 4)
Printed in the United States of America
1098765432 1
CONTENTS
List of Entries vii
About the Encyclopedia xvii
Advisory Board xix
Contributors xxi
Entries
Volume 1: A-C 1
Volume 2: D-K 523
Volume 3: L-R 1029
Volume 4: S-Z 1523
Organizations 2199
Glossary 2225
General Index 2293
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
V
LIST OF ENTRIES
Apis
Bates method
1 A
Apitherapy
Bayberry
Abscess
Appendicitis
Bedsores
Acidophilus
Applied kinesiology
Bedwetting
Acne
Apricot seed
Bee pollen
Aconite
Arginine
Behavioral optometry
Acupressure
Arnica
Behavioral therapy
Acupuncture
Aromatherapy
Belladonna
Ademetionine
Arrowroot
Beta-hydroxy
Adie’s pupil
Arsenicum album
Beta-methylbutyric acid
African pygeum
Art therapy
Beta carotene
Agastache
Ashwaganda
Betaine hydrochloride
Aging
Asthma
Bhakti yoga
AIDS
Astigmatism
Bilberry
Alcoholism
Aston-Patterning
Binge eating disorder
Alexander technique
Astragalus
Biofeedback
Alfalfa
Atherosclerosis
Bioflavonoids
Alisma
Athlete’s foot
Biota
Allergies
Atkins diet
Biotin
Allium cepa
Atractylodes (white)
Bipolar disorder
Aloe
Attention-deficit hyperactivity dis-
Bird flu
Alpha-hydroxy
order
Bites and stings
Alzheimer’s disease
Aucklandia
Bitter melon
Amino acids
Auditory integration training
Bitters
Andrographis
Aura therapy
Black cohosh
Androstenedione
Auriculotherapy
Black currant seed oil
Anemarrhena
Autism
Black haw
Anemia
Ayurvedic medicine
Black walnut
Angelica root
Black cumin seed extract
Angina
Bladder cancer
Anise
1 B
Bladder infection
Ankylosing spondylitis
Blessed thistle
Anorexia nervosa
Bad breath
Blisters
Anthroposophical medicine
Balm of Gilead
Blood poisoning
Antioxidants
Barberry
Blood clots
Anxiety
Barley grass
Bloodroot
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
VII
List of Entries
Blue cohosh
Body odor
Boils
Bone spurs
Bonemeal
Boneset
Borage oil
Boron
Boswellia
Botanical medicine
Breast cancer
Breastfeeding problems
Breath therapy
Breema
Brewer’s yeast
Bromelain
Bronchitis
Bruises
Bruxism
Bryonia
Buchu
Buckthorn
Bugleweed
Bulimia nervosa
Bunions
Burdock root
Burns
Bursitis
Butcher’s broom
Buteyko
1C
Cadmium poisoning
Caffeine
Calcarea carbonica
Calcium
Calendula
Cancer
Cancer treatments, biological
Candidiasis
Canker sores
Cantharis
Carnitine
Carotenoids
Carpal tunnel syndrome
Cartilage supplements
Castor oil
Cat’s claw
Cataracts
Catnip
Cayce systems
Cayenne
Celiac disease
Cell therapy
Cell salt therapy
Cellulite
Cerebral vascular insufficiency
Cerebral palsy
Cervical dysplasia
Chakra balancing
Chamomile
Charcoal, activated
Chasteberry tree
Chelated minerals
Chelation therapy
Chemical poisoning
Cherry bark
Chickenpox
Chickweed
Chicory
Childbirth
Childhood nutrition
Chills
Chinese massage
Chinese system of food cures
Chinese thoroughwax
Chinese yam
Chinese foxglove root
Chiropractic
Chlamydia
Chlorella
Cholesterol
Chondroitin
Christian Science healing
Chromium
Chronic fatigue syndrome
Chrysanthemum flower
Chymotrypsin
Cicada
Cinnamon bark
Cirrhosis
Cnidium seeds
Codonopsis root
Coenzyme Q 1()
Coix
Cold sores
Coleus
Colic
Colloidal silver
Colonic irrigation
Color therapy
Colorectal cancer
Colostrum
Coltsfoot
Comfrey
Common cold
Conjunctivitis
Constipation
Contact dermatitis
Copper
Coptis
Cordyceps
Corns and calluses
Cornsilk
Cornus
Corydalis
Cotton root bark
Cough
Cradle cap
Cramp bark
Cranberry
Craniosacral therapy
Creatine
Crohn’s disease
Croup
Crystal healing
Cupping
Curanderismo
Cuscuta
Cuts and scratches
Cymatic therapy
Cyperus
D
Damiana
Dance therapy
Dandelion
Dandruff
VIII
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Deglycyrrhizanated licorice
Evening primrose oil
Gelsemium
Dementia
Evodia fruit
Genital herpes
Depression
Exercise
Genital warts
Dermatitis
Eyebright
Gentiana
Detoxification
Geriatric massage
Devil’s claw
Gerson therapy
DHEA
Ginger
Diabetes mellitus
F
Ginkgo biloba
Diamond diet
Facial massage
Ginseng, American
Diaper rash
Fasting
Ginseng, Korean
Diarrhea
Fatigue
Ginseng, Siberian
Diathermy
Feldenkrais
Glaucoma
Diets
Feng shui
Glucosamine
Digestive enzymes
Fennel
Glutamine
Diverticulitis
Fenugreek
Glutathione
Dizziness
Ferrum phosphoricum
Goldenrod
Dolomite
Fever
Goldenseal
Dong quai
Feverfew
Gonorrhea
Dry mouth
Fibrocystic breast disease
Gotu kola
Dyslexia
Fibromyalgia
Gout
Dysmenorrhea
Fish oil
Grains-of-paradise fruit
5-HTP
Grape skin
Flaxseed
Grape seed extract
Flower remedies
Grapefruit seed extract
E
Fo ti
Green tea
Ear infection
Folic acid
Guggul
Earache
Food poisoning
Guided imagery
Echinacea
Foxglove
Gulf War syndrome
Eczema
Fractures
Gum disease
Edema
French green clay
Gymnema
Elder
Fritillaria
Electroacupuncture
Frostbite and frostnip
Elimination diet
Fungal infections
H
Emphysema
Endometriosis
Flair loss
Energy medicine
Flangover
Environmental therapy
G
Flatha yoga
Enzyme therapy
Gallstones
Hawthorn
Ephedra
Gamma-linoleic acid
Hay fever
Epididymitis
Gangrene
Headache
Epilepsy
Ganoderma
Hearing loss
Epimedium
Gardenia
Heart disease
Essential fatty acids
Garlic
Heart attack
Essential oils
Gas
Heartburn
Essiac tea
Gastritis
Heavy metal poisoning
Eucalyptus
Gastrodia
Heel spurs
Eucommia bark
Gastroenteritis
Hellerwork
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
IX
List of Entries
List of Entries
Hemorrhoids
Hepar sulphuris
Hepatitis
Herbalism, Western
Herbalism, traditional Chinese
Herniated disk
Hiatal hernia
Hibiscus
Hiccups
High sensitivity C reactive protein
test
High-fiber diet
Hives
Hodgkin’s disease
Holistic dentistry
Holistic medicine
Homeopathy
Homeopathy, acute prescribing
Homeopathy, constitutional pre-
scribing
Honeysuckle
Hops
Horehound
Horse chestnut
Horsetail
Hot flashes
Humor therapy
Huna
Hydrotherapy
Hypercortisolemia
Hyperopia
Hyperparathyroidism
Hypertension
Hyperthermia
Hyperthyroidism
Hypnotherapy
Hypoglycemia
Hypothyroidism
Hyssop
I I
Iceland moss
Ignatia
Immuno-augmentation therapy
Impetigo
Impotence
Indigestion
Infant massage
Infections
Infertility
Inflammatory bowel disease
Influenza
Ingrown nail
Insomnia
Insulin resistance
Iodine
Ipecac
Ipriflavone
Iridology
Iron
Irritable bowel syndrome
Ischemia
Itching
IJ
Jaundice
Jet lag
Jock itch
Jojoba oil
Journal therapy
Juice therapies
Juniper
Juvenile rheumatoid arthritis
K
Kali bichromicum
Kampo medicine
Kaposi’s sarcoma
Kava kava
Kegel exercises
Kelley-Gonzalez diet
Kelp
Kidney stones
Kidney infections
Kirlian photography
Knee pain
Kneipp wellness
Kola nut
Kombucha
Kudzu
I L
Labyrinth walking
Lachesis
Lacto-ovo vegetarianism
Laryngitis
Lavender
Lazy eye
Lead poisoning
Learning disorders
Lecithin
Ledum
Lemon balm
Lemongrass
Leukemia
Lice infestation
Licorice
Light therapy
Linoleic acid
Livingston- Wheeler therapy
Lobelia
Lomatium
Lomilomi
Lou Gehrig’s disease
Low back pain
Lung cancer
Lutein
Lycium fruit
Lycopene
Lycopodium
Lyme disease
Lymphatic drainage
Lysimachia
Lysine
M
Macrobiotic diet
Macular degeneration
Magnesium
Magnetic therapy
Magnolia
Maitake
Malaria
Malignant lymphoma
Manganese
X
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Marijuana
Marsh mallow
Martial arts
Massage therapy
McDougall diet
Measles
Meditation
Mediterranean diet
Medium-chain triglycerides
Melatonin
Memory loss
Meniere’s disease
Meningitis
Menopause
Menstruation
Mercurius vivus
Mesoglycan
Metabolic therapies
Methionine
Mexican yam
Migraine headache
Milk thistle
Mind/Body medicine
Mistletoe
Mononucleosis
Morning sickness
Motherwort
Motion sickness
Movement therapy
Moxibustion
MSM
Mugwort leaf
Mullein
Multiple chemical sensitivity
Multiple sclerosis
Mumps
Muscle spasms and cramps
Music therapy
Myopia
Myotherapy
Myrrh
N
Narcolepsy
Native American medicine
Natrum muriaticum
Natural hygiene diet
Natural hormone replacement ther-
apy
Naturopathic medicine
Nausea
Neck pain
Neem
Nettle
Neural therapy
Neuralgia
Neurolinguistic programming
Niacin
Night blindness
Noni
Nosebleeds
Notoginseng root
Nutmeg
Nutrition
Nux vomica
o
Oak
Obesity
Obsessive-compulsive disorder
Omega-3 fatty acids
Omega-6 fatty acids
Ophiopogon
Oregano essential oil
Ornish diet
Ortho-bionomy
Orthomolecular medicine
Osha
Osteoarthritis
Osteopathy
Osteoporosis
Ovarian cancer
Ovarian cysts
Oxygen/Ozone therapy
P
Pain
Paleolithic diet
Panchakarma
Pancreatitis
Panic disorder
Pantothenic acid
Parasitic infections
Parkinson’s disease
Parsley
Passionflower
Past-life therapy
Pau d'arco
Pelvic inflammatory disease
Pennyroyal
Peppermint
Peripheral neuropathy
Periwinkle
Pet therapy
Phlebitis
Phobias
Phosphorus
Pilates
Pinched nerve
Pine bark extract
Pinellia
Pityriasis rosea
Placebo effect
Plantain
Pleurisy
Pneumonia
Polarity therapy
Postpartum depression
Post-traumatic stress disorder
Potassium
Pranic healing
Prayer and spirituality
Pregnancy
Pregnancy massage
Premenstrual syndrome
Prickly heat
Prickly pear cactus
Pritikin diet
Probiotics
Prolotherapy
Prostate enlargement
Prostate cancer
Psoriasis
Psychoneuroimmunology
Psychophysiology
Psychosomatic medicine
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
XI
List of Entries
List of Entries
Psychotherapy
Psyllium
Pulsatilla
Pulse diagnosis
Pyridoxine
Q
Qigong
Quan yin
R
Rabies
Radiation injuries
Radiesthesia
Radionics
Rashes
Raspberry
Raynaud’s syndrome
Red cedar
Red clover
Red yeast rice extract
Reflexology
Reiki
Reishi mushroom
Relaxation
Rescue Remedy
Restless leg syndrome
Retinal detachment
Retinopathy
Rheumatic fever
Rheumatoid arthritis
Rhinitis
Rhubarb root
Rhus toxicodendron
Riboflavin
Rolfing
Rosacea
Rose hip
Rosemary
Rosen method
Royal jelly
Rubella
Rubenfeld synergy
Russian massage
Ruta
I s
Safflower flower
Saffron
Sage
Saliva sample testing
Sargassum seaweed
Sassafras
Saw palmetto
Scabies
Scallion
Scarlet fever
Schisandra
Schizophrenia
Sciatica
Scoliosis
Seasonal affective disorder
Selenium
Senior nutrition
Senna
Sensory deprivation
Sensory integration disorder
Sepia
Sesame oil
Sexual dysfunction
Shamanism
Sheep sorrel
Shiatsu
Shiitake mushroom
Shin splints
Shingles
Shintaido
Sick building syndrome
Sickle cell anemia
Silica
Sinus infection
Sjogren’s syndrome
Skin cancer
Skullcap
Sleep apnea
Sleep disorders
Slippery elm
Smoking
Sneezing
Snoring
Sodium
Somatics
Sore throat
Sound therapy
South Beach diet
Soy protein
Spearmint
Spinal manipulative therapy
Spirulina
Sports massage
Sprains and strains
Squawvine
St. John’s wort
Staphylococcal infections
Sties
Stomachaches
Stone massage
Strep throat
Stress
Stroke
Substance abuse and dependence
Sulfur
Suma
Sun’s soup
Sunburn
Swedish massage
Sweet clover
Swimmer’s ear
Syntonic optometry
Syphilis
Systemic lupus erythematoses
IT
T’ai chi
Tangerine peel
Tea tree oil
Teenage nutrition
Teething problems
Temporomandibular joint syn-
drome
Tendinitis
Tennis elbow
Tetanus
Thai massage
XII
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Therapeutic touch
Uterine cancer
Wheezing
Thiamine
Uterine fibroids
White peony root
Thuja
Uva ursi
White willow
Thunder God vine
Whooping cough
Thyme
Wigmore diet
Tibetan medicine
Wild cherry
Tinnitus
V
Wild oat
Tonsillitis
Vaginitis
Wild yam
Toothache
Valerian
Wintergreen
Tourette syndrome
Vanadium
Witch hazel
Toxic shock syndrome
Varicose veins
Worms
Traditional African medicine
Veganism
Wormwood
Traditional Chinese medicine
Vegetarianism
Wounds
Trager psychophysical integration
Venom immunotherapy
Tremors
Vitamin A
Trepanation
Vitamin B complex
Trichomoniasis
Vitamin B ] ,
■ Y
Trigger point therapy
Vitamin C
Yarrow
Triphala
Vitamin D
Yeast infection
Tuberculosis
Vitamin E
Yellow dock
Turmeric
Vitamin K
Yerba santa
Vomiting
Yoga
Yohimbe
Yucca
u
—
Ulcers, digestive
w
Unani-tibbi
Warts
"7
Urinary incontinence
Wasabi
Z
Urine therapy
Wheat grass therapy
Zinc
Usnea
Wheat germ
Zone diet
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
XIII
List of Entries
PLEASE READ - IMPORTANT INFORMATION
The Gale Encyclopedia of Alternative Medicine is a
medical reference product designed to inform and edu-
cate readers about a wide variety of complementary ther-
apies and herbal remedies and treatments for prevalent
conditions and diseases. Thomson Gale believes the
product to be comprehensive, but not necessarily defini-
tive. It is intended to supplement, not replace, consulta-
tion with a physician or other healthcare practitioner.
While Thomson Gale has made substantial efforts to pro-
vide information that is accurate, comprehensive, and
up-to-date, Thomson Gale makes no representations or
warranties of any kind, including without limitation,
warranties of merchantability or fitness for a particular
purpose, nor does it guarantee the accuracy, comprehen-
siveness, or timeliness of the information contained in
this product. Readers should be aware that the universe
of complementary medical knowledge is constantly
growing and changing, and that differences of medical
opinion exist among authorities. They are also advised to
seek professional diagnosis and treatment for any med-
ical condition, and to discuss information obtained from
this book with their healthcare provider.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
XV
ABOUT THE ENCYCLOPEDIA
The Gale Encyclopedia of Alternative Medicine
(GEAM) is a one-stop source for alternative medical in-
formation that covers complementary therapies, herbs
and remedies, and common medical diseases and condi-
tions. It avoids medical jargon, making it easier for the
layperson to use. The Gale Encyclopedia of Alternative
Medicine presents authoritative, balanced information
and is more comprehensive than single-volume family
medical guides.
Scope
Over 800 full-length articles are included in The
Gale Encyclopedia of Alternative Medicine. Many
prominent figures are highlighted as sidebar biographies
that accompany the therapy entries. Articles follow a
standardized format that provides information at a
glance. Rubrics include:
Therapies
• Origins
• Benefits
• Description
• Preparations
• Precautions
• Side effects
• Research & general acceptance
• Resources
• Key terms
Herbs/remedies
• General use
• Preparations
• Precautions
• Side effects
• Interactions
• Resources
• Key terms
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Diseases/conditions
• Definition
• Description
• Causes & symptoms
• Diagnosis
• Treatment
• Allopathic treatment
• Expected results
• Prevention
• Resources
• Key terms
Inclusion criteria
A preliminary list of therapies, herbs, remedies, dis-
eases, and conditions was compiled from a wide variety
of sources, including professional medical guides and
textbooks, as well as consumer guides and encyclope-
dias. The advisory board, made up of three medical and
alternative healthcare experts, evaluated the topics and
made suggestions for inclusion. Final selection of topics
to include was made by the medical advisors in conjunc-
tion with Thomson Gale editors.
About the Contributors
The essays were compiled by experienced medical
writers, including alternative healthcare practitioners and
educators, pharmacists, nurses, and other complementary
healthcare professionals. GEAM medical advisors re-
viewed over 95% of the completed essays to insure that
they are appropriate, up-to-date, and medically accurate.
How to Use this Book
The Gale Encyclopedia of Alternative Medicine has
been designed with ready reference in mind:
• Straight alphabetical arrangement allows users
to locate information quickly.
XVII
About the Encyclopedia
• Bold faced terms function as print hyperlinks that
point the reader to related entries in the encyclo-
pedia.
• A list of key terms is provided where appropriate
to define unfamiliar words or concepts used with-
in the context of the essay. Additional terms may
be found in the glossary.
• Cross-references placed throughout the encyclo-
pedia direct readers to where information on sub-
jects without their own entries can be found. Syn-
onyms are also cross-referenced.
• A Resources section directs users to sources of
further complementary medical information.
• An appendix of alternative medical organizations
is arranged by type of therapy and includes valu-
able contact information.
• A comprehensive general index allows users to
easily target detailed aspects of any topic, includ-
ing Latin names.
Graphics
The Gale Encyclopedia of Alternative Medicine is
enhanced with over 450 images, including photos, ta-
bles, and customized line drawings. Each volume con-
tains a color insert of 64 important herbs, remedies, and
supplements.
XVIII
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
ADVISORY BOARD
An advisory board made up of prominent individuals from complementary medical
communities provided invaluable assistance in the formulation of this encyclopedia.
They defined the scope of coverage and reviewed individual entries for accuracy and
accessibility. We would therefore like to express our appreciation to them:
Mirka Knaster, PhD
author, editor, consultant in Eastern and Western body-mind disciplines and spiritual traditions
Oakland, CA
Lisa Meserole, MS, ND
President, Botanical Medicine Academy
One Sky Medicine Clinic
Seattle, WA
Katherine E. Nelson, ND
Naturopathic Physician
Naples, FL
Jamison Starbuck, JD, ND
Naturopathic Family Physician
Former president, American Association of Naturopathic Physicians
Member, Homeopathic Academy of Naturopathic Physicians
Missoula, MT
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
XIX
CONTRIBUTORS
Margaret Alic, PhD
Medical Writer
Eastsound, WA
Greg Annussek
Medical Writer
American Society of Journalists and Authors
New York, NY
Barbara Boughton
Health and Medical Writer
El Cerrito, CA
Ruth Ann Prag Carter
Freelance Writer
Farmington Hills, MI
Linda Chrisman
Massage Therapist and Educator
Medical Writer
Oakland, CA
Gloria Cooksey, CNE
Medical Writer
Sacramento, CA
Amy Cooper, MA, MSI
Medical Writer
Vermillion, SD
Sharon Crawford
Writer, Editor, Researcher
American Medical Writers Association
Periodical Writers Association of Canada and the Editors’
Association of Canada
Toronto, ONT Canada
Sandra Bain Cushman
Massage Therapist
Alexander Technique Practitioner and Educator
Charlottesville, VA
Tish Davidson, MA
Medical Writer
Fremont, CA
Lori DeMilto, MJ
Medical Writer
Sicklerville, NJ
Doug Dupler, MA
Medical Writer
Boulder, CO
Paula Ford-Martin, PhD
Medical Writer
Warwick, RI
Rebecca J. Frey, PhD
Medical Writer
New Haven, CT
Lisa Frick
Medical Writer
Columbia, MO
Kathleen Goss
Medical Writer
Darwin, CA
Elliot Greene, MA
former president, American Massage Therapy Association
Massage Therapist
Silver Spring, MD
Peter Gregutt
Medical Writer
Asheville, NC
Clare Hanrahan
Medical Writer
Asheville, NC
David Helwig
Medical Writer
London, ONT Canada
Beth A. Kapes
Medical Writer, Editor
Bay Village, OH
Katherine Kim
Medical Writer
Oakland, CA
Erika Lenz
Medical Writer
Lafayette, CO
Lorraine Lica, PhD
Medical Writer
San Diego, CA
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
XXI
Contributors
Whitney Lowe, LMT
Orthopedic Massage Education & Research Institute
Massage Therapy Educator
Bend, OR
Mary McNulty
Freelance Writer
St.Charles, IL
Kathy Shepard Stolley, PhD
Medical Writer
Virginia Beach, VA
Judith Sims, MS
Science Writer
Logan, UT
Katherine E. Nelson, ND
Naturopathic physician
Naples, FL
Patricia Skinner
Medical Writer
Amman, Jordan
Teresa Odle
Medical Writer
Ute Park, NM
Genevieve Slomski, PhD
Medical Writer
New Britain, CT
Jodi Ohlsen Read
Medical Writer
Carver, MN
Jane E. Spear
Medical Writer
Canton, OH
Carole Osborne-Sheets
Massage Therapist and Educator
Medical Writer
Poway, CA
Lee Ann Paradise
Freelance Writer
Lubbock, TX
Liz Swain
Medical Writer
San Diego, CA
Judith Turner, DVM
Medical Writer
Sandy, UT
Patience Paradox
Medical Writer
Bainbridge Island, WA
Samuel Uretsky, PharmD
Medical Writer
Wantagh, NY
Belinda Rowland, PhD
Medical Writer
Voorheesville, NY
Ken R. Wells
Science Writer
Laguna Hills, CA
Joan M. Schonbeck, RN
Medical Writer
Marlborough, MA
Angela Woodward
Science Writer
Madison, WI
Gabriele Schubert, MS
Medical Writer
San Diego, CA
Kathleen Wright, RN
Medical Writer
Delrnar, DE
Kim Sharp, M Ln
Medical Writer
Houston, TX
Jennifer L. Wurges
Medical Writer
Rochester Hills, MI
XXII
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
A
Abdominal pain see Stomachaches
Abscess
Definition
An abscess is a place of accumulation of the creamy
white, yellow, or greenish fluid, known as pus, surround-
ed by reddened tissue. It is the result of the body’s in-
flammatory response to a foreign body or a bacterial,
viral, parasitic, or fungal infection. An abscess usually
dries out and resolves when it is drained of pus. The
most common parts of the body affected by abscesses
are the face, armpits, arms and legs, rectum, sebaceous
glands (oil glands), and the breast during lactation.
Description
Most abscesses are septic, which means they are the
result of an infection. Abscesses occur when white blood
cells ( WBCs) gather in response to an infection. They pro-
duce oxidants (for example, superoxide radical) and en-
zymes to digest the invading bacteria, viruses, parasites, or
fungi. The infective agents are then broken down by the
WBCs into small pieces that can be transported through
the bloodstream and eliminated from the body. Unfortu-
nately, the enzymes may also digest part of the body’s tis-
sues along with the infective agents. The resulting liquid
of this digestion is pus, which contains the remains of the
infective agents, tissue, white blood cells, and enzymes.
A sterile abscess is one that is not produced by an
infection. It is caused by irritants, such as foreign bodies
or injected drugs, and medications that have not been to-
tally absorbed. Sterile abscesses quite often heal into
hardened scar tissue.
Common types of abscesses:
• Boils and carbuncles. Sebaceous glands and superficial
skin are the places usually infected.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• Dental abscess. An abscess that develops along the root
of a tooth.
• Pilonidal abscess. People who have a birth defect in-
volving a tiny opening in the skin just above the anus
may have fecal bacteria enter this opening, causing an
infection and a subsequent abscess.
• Retropharyngeal, parapharyngeal, peritonsillar abscess.
As a result of throat infections like strep throat and
tonsillitis, bacteria invade the deeper tissues of the
throat and cause a parapharyngeal or peritonsillar ab-
scess. A retropharyngeal abscess is a result of some-
thing usually blood-borne, and not from a direct spread
of tonsillitis. These abscesses can compromise swal-
lowing and even breathing.
• Lung abscess. During or after pneumonia, an abscess
can develop as a complication.
• Liver abscess. Bacteria, parasites, or amoeba from the
intestines can spread through the blood to the liver and
cause abscesses.
• Psoas abscess. An abscess can develop in the psoas
muscles, when an infection spreads from the appendix,
the large intestine, or the fallopian tubes.
• Butin abscess. Any blood-borne feeding off bacteria
that stimulate pus production (pyogenic organisms).
Can cause abscesses in possibly many sites.
Causes & symptoms
Many different agents cause abscesses. The most
common are the pyogenic, or pus-forming bacteria, such
as Staphylococcus aureus, which is nearly always the
cause of abscesses directly under the skin. Abscesses are
usually caused by organisms that normally inhabit near-
by structures or that infect them. For example, abscesses
around the anus may be caused by any of the numerous
bacteria found within the large intestine. Brain abscesses
and liver abscesses are caused by the bacteria, amoeba,
and fungi that are able to travel there through circulation.
1
Abscess
An amoebic abscess caused by Entameoba histolytica.
(Phototake NYC. Reproduced by permission.)
Symptoms of an abscess are the general signs of in-
flammation. Symptoms that identify superficial abscess-
es include heat, redness, swelling, and pain over the af-
fected area. Abscesses in other places may produce only
generalized symptoms, such as fever and discomfort. A
sterile abscess may present as painful lump deep under
the site of an injection. A severe infection may bring on
fever, fatigue, weight loss, and chills. Recurrent abscess-
es may indicate undiscovered allergies or decreased im-
mune functioning.
Diagnosis
A general physical examination and a detailed pa-
tient history are used to diagnose an abscess. Recent or
chronic disease or dysfunction in an organ suggests it
may be the site of an abscess. Pain and tenderness on
physical examination are common findings. There may
also be a leakage of pus from a sinus tract connected to
an abscess deep in the body tissue.
Treatment
Bentonite clay packs with a small amount of gold-
enseal powder (Hydrastis canandensis ) can be placed on
the site of a superficial abscess and used to draw out the
infection. Tea tree oil ( Melaleuca spp.) and garlic (Alli-
um sativa) directly applied to abscesses may also help to
clear them.
Applications of a hot compress to the skin over the
abscess will hasten the draining or the reabsorption of
the abscess. Contrast hydrotherapy, using alternating
hot and cold compresses, can also be used. Additionally,
localized warm/hot soaks three to five times daily fre-
quently brings an abscess to heal.
Homeopathic remedies that can be taken to help di-
minish abscess formation include belladonna, silica,
2
Hepar sulphuris, and calendula. Also, acupuncture
may be recommended to help treat pain caused by an ab-
scess. In addition, vitamins A and C, beta-carotene, zinc,
liquid chlorophyll, and garlic are useful as supportive
daily nutrients to help clear up abscesses.
Allopathic treatment
Often, the pus of an abscess must be drained by a
physician. Ordinarily, the body will handle the remain-
ing infection. Sometimes antibiotics are prescribed. The
doctor may often put a piece of cloth or rubber, called a
drain, in the cavity of the abscess to prevent it from clos-
ing until all the pus has drained.
Expected results
Once the abscess is properly drained, it should clear
up in a few days. Any underlying diseases will determine
the overall outcome of the condition. Recurrent abscesses,
especially those on the skin, return due to either defec-
tive/altered immunity, or staph overgrowth, where there is
high bacterial colonization on the skin. The patient should
consult a physician for treatment with which to wash the
skin areas, and treatment to eradicate colonization.
If the abscess ruptures into neighboring areas or if
the infectious agent spills into the bloodstream, serious
consequences are likely. Abscesses in and around the
nasal sinuses, face, ears, and scalp may spread the infec-
tion into the brain. Abscesses in the abdominal cavity,
such as in the liver, may rupture into that cavity. Blood
poisoning, or septicemia, is an infection that has spilled
into the bloodstream and then spreads throughout the
body. These are emergency situations where the patient
needs to be seen by a physician as soon as possible.
It is important to take note that abscesses in the
hand may be more serious than they might appear. Due
to the intricate structure and the overriding importance
of the hand, any hand infection must be treated prompt-
ly and competently.
Prevention
Infections that are treated early with heat, if superfi-
cial, or antibiotics, if deeper, will often resolve without
the formation of an abscess. It is even better to avoid in-
fections altogether by promptly cleaning and irrigating
open injuries, particularly bites and puncture wounds.
Resources
BOOKS
Bennett, J. Claude and Fred Plum, ed. Cecil Textbook of Medi-
cine. Philadelphia: W. B. Saunders Co., 1996.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Bentonite clay — A green clay of aluminum silicate
containing magnesium and trace minerals. The
clay has the ability to attract and hold to its sur-
face agents of infection from a wound.
Enzyme — A protein that can increase the rate of
chemical reactions.
Sinus tract — A channel connecting a body part
with the skin outside.
Duke, James A., et at. The Green Pharmacy. Pennsylvania: Ro-
dale, 1997.
Isselbacher, Kurt, et at, ed. Harrison’s Principles of Internal
Medicine. New York: McGraw-Hill, 1997.
Tierney, Jr., Lawrence M., et al, ed. Current Medical Diagnosis
and Treatment. Connecticut: Appleton & Lange, 1996.
OTHER
AlternativeMedicine.com. <http://www.alternativemedicine.
com/> (December 28, 2000).
Patience Paradox
Absinthe see Wormwood
Aches and pains see Pain
Acidophilus
Description
Lactobacillus acidophilus , commonly referred to
simply as acidophilus, is a friendly inhabitant of the gas-
trointestinal (GI) tract. It, as well as some related strains
of bacteria, is known as a probiotic. Probiotic organisms
secrete enzymes that support healthy digestion. They
keep the flora of the intestines and vagina balanced, and
compete with some pathogenic organisms. When the pro-
biotic population of the body is severely decreased, as
can occur with treatment by many antibiotics, yeasts and
harmful bacteria may take over and cause illness. Normal
and healthy amounts of acidophilus can also be decreased
by chronic diarrhea, stress, infections, and poor diet.
The species of Lactobacilli that inhabit the GI tract
cause an increase of acidity. The bacteria do this by pro-
ducing lactic acid from milk sugar (lactose). The in-
creased acidity may promote the absorption of calcium,
as well as of some other minerals. Lowered pH also dis-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
courages the growth of many pathogenic species of bac-
teria and yeasts. The hydrogen peroxide produced by the
acidophilus also helps to suppress pathogens.
Acidophilus may function in the production of some
of the B vitamins, such as niacin, pyridoxine, biotin,
and folic acid.
General use
Yeast infections
Acidophilus may be used to reduce susceptibility to
vaginal yeast infections, which are quite common.
Symptoms including itching, burning, inflammation,
and discharge occur due to an overgrowth of the yeast
Candida albicans , which is part of the normal vaginal
flora. Some women are more prone to yeast infections
than others. Antibiotics destroy the normal probiotic
flora, and may lead to yeast infections. High sugar levels
are another predisposing factor. Diabetics, who tend to
have high blood sugar, and persons who consume a
processed diet that is high in sugar have more frequent
problems with yeast as well. The hormonal states created
by pregnancy or the use of oral contraceptives also con-
tribute to yeast infections. IUD users can also have an in-
creased rate of infection. In rare cases, Candida is sexu-
ally transmitted, and both partners may require treatment
in order to control repeated overgrowth. Anyone who has
AIDS or any other condition causing immunosuppres-
sion has increased susceptibility to Candida and other
types of infections too. Acidophilus is one of the organ-
isms that competes with Candida and decreases its popu-
lation. Many studies have shown that oral and topical use
(by douching) of acidophilus are effective to prevent and
treat this condition.
Systemic candidiasis, or yeast hypersensitivity syn-
drome, is a condition that is not recognized by many al-
lopaths. It is acknowledged by some practitioners of al-
ternative and complementary medicine as a problem
with broad-ranging consequences. This theory holds that
some people have an allergic reaction to the yeast and/or
its toxins, and that they can experience serious symp-
toms when the organism multiplies in the body to an ab-
normal degree. Fatigue, diarrhea, constipation, muscle
pain, thrush, itching, mood changes, endocrine dysfunc-
tion, headaches, and tingling or numbness of the extrem-
ities are some of the symptoms that are reportedly asso-
ciated with systemic candidiasis. A weak immune sys-
tem may be more prone to allowing yeast to multiply,
and large numbers of yeast can act to further suppress
the immune function. Acidophilus, in combination with
such nutritional supplements as essential fatty acids, is
often recommended for the prevention and treatment of
this syndrome.
3
Acidophilus
Acidophilus
Gastrointestinal disorders
Irritable bowel syndrome (IBS) is a functional dis-
turbance of the lower intestine that can cause bloating,
cramping, abdominal pain, diarrhea, constipation, and
painful bowel movements. This condition is also known
as spastic colon. One small study of the use of aci-
dophilus to treat IBS showed more improvement in the
treated group than in those who took a placebo. This is
not conclusive evidence, but in view of the safety of the
treatment and the scarcity of effective alternatives, aci-
dophilus may be worth trying.
Traveler’s diarrhea is sometimes suffered by peo-
ple who consume contaminated food or water in other
countries. Some evidence shows that regular use of
acidophilus and other probiotics may prevent this con-
dition.
High cholesterol levels
Recent evidence suggests that consuming Lacto-
bacillus acidophilus LI can be effective in lowering
blood cholesterol. The February 1999 issue of the
Journal of the American College of Nutrition reports on
two studies done at the University of Kentucky. Sub-
jects who consumed the yogurt containing L. aci-
dophilus LI had cholesterol levels drop by 2.4% in one
study and 3.2% in the other. Although the percentages
are small, the effect on the risk of heart disease could
be significant.
Immune response
A study published in the December 1998 issue of
the Brazilian Journal of Medical and Biological Re-
search found that acidophilus induced a nonspecific
immune response in experimental mice. Acidophilus is
sometimes recommended as an immune booster for
people, although the effect has not yet been document-
ed in humans.
Other uses
Acidophilus may possibly be helpful in the treat-
ment of canker sores, fever blisters, hives, and adoles-
cent acne. Its use has also been suggested as a preventa-
tive for colon cancer.
Preparations
Acidophilus is taken by mouth. It is available as
powder, liquid, tablets, or capsules, and is also present
in some types of milk, kefir, yogurt, and some cheeses.
Frozen yogurt does not contain live probiotics. Check
product labels to see whether live organisms are present.
The bacteria are killed by pasteurization. Probiotic
4
KEY TERMS
Candidiasis — Any of a variety of infections caused
by fungi of the genus Candida.
Probiotic — Any strain of bacteria that lives in the
human gut and is considered a "friendly" bacteri-
um. Probiotics secrete enzymes that help to keep
the digestive system balanced, and compete with
some pathogenic organisms. Acidophilus is one of
the best-known probiotics.
Traveler's diarrhea — Diarrhea caused by ingesting
local bacteria to which one's digestive system has
not yet adapted.
products are most potent when kept refrigerated. The
potency of a given preparation is usually expressed as
the number of organisms per capsule. A usual dose of
acidophilus is 1-10 billion organisms, divided into three
doses per day.
Precautions
People who are lactose-intolerant may also not tol-
erate acidophilus.
Side effects
The initial use of acidophilus may cause an increase
in intestinal gas, which decreases with continued use of
the product.
Interactions
Taking acidophilus in conjunction with some antibi-
otics, including ampicillin (Amcill, Ampicin) and amox-
icillin (Amoxil, Novamoxin), can prevent the diarrhea
that is sometimes caused by their use.
Resources
BOOKS
Bratman, Steven, and David Kroll. Natural Health Bible.
Rocklin, CA: Prima Publishing, 1999.
Jellin, Jeff, Forrest Batz, and Kathy Hitchens. Pharmacist’ s let-
ter/Prescriber’s Letter Natural Medicines Comprehensive
Database. California: Therapeutic Research Faculty,
1999.
Lininger, Skye. The Natural Pharmacy. Rocklin, CA: Prima
Health, 1998.
Judith Turner
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Acne
Definition
Acne is a common inflammatory skin disease char-
acterized by pimples on the face, chest, and back. It oc-
curs when the pores of the skin become clogged with oil,
dead skin cells, and/or bacteria.
Description
Acne vulgaris, the medical term for common acne,
is the most common skin disease. It affects nearly 17
million people in the United States. While acne can arise
at any age, it usually begins at puberty and worsens dur-
ing adolescence. Nearly 85% of people develop acne
some time between the ages of 12 and 25 years old. Up
to 20% of women develop mild acne. It is also found in
some newborns.
The sebaceous glands lie just beneath the skin’s
surface. They produce sebum, an oily secretion that
helps to preserve the flexibility of the hair and moistur-
izes the skin. These glands and the hair follicles within
which they are found are called sebaceous follicles.
These follicles open onto the skin through pores that
allow the sebum to reach the hair shaft and the skin. In
certain situations, the glands excrete excess sebum and
it cannot be cleared from the pores efficiently. This
happens, for instance, at puberty when increased levels
of the androgen hormones cause overproduction of
sebum. In addition, cells lining the follicle are shed too
quickly and begin to clump together. The excess sebum
combines with the dead cells and forms a plug, or
comedo (also called comedones), that blocks the pore,
which is not usually seen. When the follicle begins to
bulge and show up as a small whitish bump mostly
under the skin, it is called a whitehead. If the comedo
opens up, the top surface of the plug darkens, and it is
referred to as a blackhead.
Infection results when a plugged follicle is invaded
by Propionibacterium acnes, a bacteria that normally
lives on the skin, and possibly other microorganisms.
The bacteria produce chemicals and enzymes that bring
on inflammation. Pimples are the result of infected
blackheads or whiteheads that rupture, releasing sebum,
bacteria, dead skin, and white blood cells onto the sur-
rounding tissues. Inflamed pimples near the skin’s sur-
face are called papules; they are red and raised, and may
be quite tender to the touch. The papules may become
filled with pus, and are then called pustules. If the folli-
cle continues to enlarge rather than rupture, it forms a
closed sac, called a cyst, which can be felt as a lump
under the skin. Large hard swellings deep within the skin
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Acne vulgaris affecting a woman’s face. Acne is the general
name given to a skin disorder in which the sebaceous
glands become inflamed. (Photograph by Biophoto Associ-
ates, Photo Researchers, Inc. Reproduced by permission.)
are called nodules. Both nodules and cysts may cause
pain and scarring.
Causes & symptoms
The exact cause of acne is mostly unknown. Some-
times when acne in women is due to excess male hor-
mone production, it is diagnosed by an onset of the con-
dition in adulthood; excessive growth of hair, especially
in places not usual on a female, called hirsuitism; irregu-
lar menstrual cycles; and premenstrual flare-ups of acne.
A 2001 study demonstrated that menstrual cycle does af-
fect acne. Surprisingly, the study revealed that 53% of
women over age 33 experienced a higher premenstrual
acne rate than women under age 20.
Many alternative practitioners assert that acne is
often related to a condition of toxicity in the intestines or
liver. This may be due to the presence of bacteria such as
Clostridia spp. and Yersinia enterocolitica, a low-fiber
5
Acne
diet; a lack of friendly gut flora such as Lactobacillus
spp.; an intestinal overgrowth of Candida albicans; and
food allergies.
The interaction between the body’s hormones, skin
protein, skin secretions, and bacteria determines the
course of acne. Several other factors have also been
shown to affect the condition:
• Age. Teenagers are more likely than anyone to develop
acne.
• Gender. Boys have more severe acne and develop it
more often than girls.
• Disease. Hormonal disorders can complicate acne in
girls.
• Heredity. Individuals with a family history of acne have
greater susceptibility to the condition.
• Hormonal changes. Acne can flare up before menstru-
ation, during pregnancy, and menopause.
• Diet. Although they are not the primary cause of acne,
certain foods may bring on flare-ups or make the con-
dition worse.
• Drugs. Acne can be a side effect of antibiotics, oral
contraceptives, and anabolic steroids.
• Personal hygiene. Use of abrasive soaps, hard scrub-
bing of the face, or handling pimples will often make
them worse.
• Cosmetics. Oil-based makeup and hair sprays worsen
acne.
• Environment. Exposure to oils and greases, polluted
air, and sweating in hot weather can all aggravate acne.
• Stress. Emotional stress may contribute to acne.
• Friction. Continual pressure or rubbing on the skin by
such things as bicycle helmets, backpacks, or tight
clothing, as well as hard scrubbing of the skin, can
worsen acne.
The most common sites of acne are the face, chest,
shoulders, and back, since these are the parts of the body
where the most sebaceous follicles are found. In
teenagers, acne is often found on the forehead, nose, and
chin. As people get older, it tends to appear towards the
outer part of the face. Adult women may have acne on
their chins and around their mouths. The elderly often de-
velop whiteheads and blackheads on the upper cheeks and
skin around the eyes. Inflamed lesions may cause redness,
pain, tenderness, itching, or swelling in affected areas.
Diagnosis
Acne has a characteristic appearance and is, there-
fore, not difficult to diagnose. A complete medical histo-
6
ry should be taken, including questions about skin care,
diet, factors that improve or worsen the condition, med-
ication use, and prior treatment. Physical examination
includes the face, upper neck, chest, shoulders, back, and
other affected areas. Under good lighting, the doctor can
determine what types and how many blemishes are pre-
sent, whether they are inflamed, whether they are deep
or superficial, and whether there is scarring or skin dis-
coloration. Blood tests are done when the patient appears
to have hormonal or other medical problems. Stool tests
can be helpful in determining whether there is a bacterial
or yeast overgrowth contributing to the condition. Food
allergy testing should also be considered.
Treatment
Alternative treatments for acne focus on proper
cleansing to keep the skin oil-free; intermittent fasting;
eating a good diet; an elimination diet where the indi-
vidual avoids alcohol, dairy products, smoking,
caffeine, sugar, processed foods, and foods high in io-
dine, a mineral which appears to contribute to acne.
Supplementation with herbs that are blood cleansers
or blood purifiers is recommended. These herbs
strengthen the action of the liver and the kidneys, help-
ing with detoxification and excretion. Dandelion root
tincture (Taraxacum officinale) is recommended. Others
include burdock root ( Arctium lappa), also known as
gobo, and can be purchased fresh at health food grocers
or in Asian markets. It can be used either raw or cooked
in salads, stir-fries, or other vegetable dishes. Burdock
root tincture can also be used. Red clover ( Trifolium
pratense) makes a pleasant tea that can be consumed
throughout the day. Milk thistle seed (Silybum mari-
anum) can either be taken in tincture form or the seeds
can be ground up and eaten in combination with hot ce-
real, granola, or other foods.
Other herbs useful in the treatment of acne include
Echinacea spp. and goldenseal (Hydrastis canadensis).
Goldenseal is particularly helpful in clearing up underly-
ing conditions of intestinal toxicity. Herbal remedies
used in traditional Chinese medicine (TCM) for acne
include cnidium seed, ( Cnidium monnieri), and honey-
suckle flower ( Lonicera japonica). Supplementation nu-
trients, such as essential fatty acids (EFAs), vitamin B
complex, zinc, vitamin A or beta-carotene, and chromi-
um are also recommended.
Bowel toxicity may contribute to acne flare-ups, and
should be addressed. Lactobacillus acidophilus and Lac-
tobacillus bulgaricus should be taken in yogurt or in
capsules to maintain a healthy balance of intestinal flora.
Goldenseal can be used to kill toxic bacteria. Allergic
foods should be identified and removed from the diet.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Dietary fiber, such as oats and wheat bran, beans, fruits
and vegetables and their skins, and psyllium seed,
should be increased in the diet. The fiber will absorb tox-
ins and carry them through the colon to be excreted.
In addition, those with acne may want to participate
in movement therapy, such as yoga or t’ai chi, or begin
an exercise regimen. The person may also consider
stress reduction or meditation.
Allopathic treatment
Acne treatment consists of reducing sebum and ker-
atin production, encouraging the shedding of dead skin
cells to help unclog the pores, and killing or limiting
bacteria. Treatment choice depends upon whether the
acne is mild, moderate, or severe. Complicated cases are
referred to a dermatologist, or an endocrinologist, who
treats diseases of the glands and the hormones. Counsel-
ing may be necessary to clear up misconceptions about
the condition and to offer support regarding the negative
effect of acne on the physical appearance.
Topical drugs
Treatment for mild acne consists of reducing the
formation of new comedones with over-the-counter acne
medications containing benzoyl peroxide (e.g., Clearasil,
Fostex), salicylic acid (Stridex), sulfur (Therac lotion),
resorcinol (Acnomel cream). Treatment with stronger
medications requires a doctor’s supervision. Such med-
ications include comedolytics, which are agents that
loosen hard plugs and open pores. Adapalene (Differin),
the vitamin A acid tretinoin (Retin-A), and concentrated
versions of salicylic acid, resorcinol, and sulfur are in
this group. Topical antibiotics, such as erythromycin,
clindamycin (Cleocin-T), and meclocycline (Meclan),
may be added to the treatment regimen. Drugs that act as
both comedolytics and antibiotics, such as benzoyl per-
oxide, azelaic acid (Azelex), or benzoyl peroxide plus
erythromycin (Benzamycin), are also used.
After washing with a mild soap, the acne medica-
tions are applied alone or in combination, once or twice
a day over the entire affected area of skin. It may take
many months to years to control the condition with these
medications. Possible side effects include mild redness,
peeling, irritation, dryness, and an increased sensitivity
to sunlight that requires use of a sunscreen.
Oral drugs
When acne is severe and the lesions are deep, oral
antibiotics may be taken daily to reduce the spread of
bacteria. Tetracycline is the medication most often used.
Minocycline, however, may be more preferable because
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
it has fewer side effects. Erythromycin and doxycycline
are also used, and they also have side effects, including
dizziness, photosensitivity, gastrointestinal problems,
and darkening of the skin. Other possible side effects in-
clude allergic reactions, yeast infections, dizziness,
tooth discoloration, and folliculitis. It is necessary for
antibiotics to be used for up to three months to clear up
the condition.
Isotretinoin (Accutane) can be used in cases of very
severe acne, or if antibiotic therapy proves unsuccessful.
It may clear up resistant cysts and nodules in up to 90%
of people and prevent scarring. Some do require a sec-
ond course of treatment before this happens, however.
Although the medication can be quite helpful, women
who might become pregnant should use it with care.
Isotretinoin can cause birth defects up to a month after it
has stopped being used. Therefore, strict attention is paid
to pregnancy tests and contraceptive requirements for
women of child-bearing age who take this medication.
The course of treatment with isotretinoin lasts about
four to five months. If dosage is kept low, a longer
course of therapy is needed. Isotretinoin is a strong med-
ication. Side effects are very common, mostly dryness of
the eyes, genital mucosa, and lips. Other effects may in-
clude increases in cholesterol, tryglicerides, and abnor-
mal liver enzymes. Blood tests taken each month should
be monitored during the course of treatment to ensure
that the medication is not causing serious harm.
Anti-androgens, drugs that inhibit androgen produc-
tion, are used to treat women who are unresponsive to
other therapies. Oral contraceptives such as norgesti-
mate/ethinyl estradiol (Ortho-Tri-Cyclen) have been
shown to improve acne. In late 2001, a clinical trial
demonstrated that ultra low-dose birth control pills
(Alesse) prove as effective in treating acne as do pills
with higher doses of estrogen. Improvement may take up
to four months.
Other drugs, such as spironolactone and corticos-
teroids, may be used to reduce hormone activity in the
adrenal glands, reducing production of sebum. This is
the treatment of choice for an extremely severe, but rare
type of acne called acne fulminans, found mostly in ado-
lescent males. Acne conglobata, a more common form of
severe inflammation, is characterized by numerous,
deep, inflammatory nodules that heal with scarring. It is
treated with oral isotretinoin and corticosteroids.
Other types of treatment
Several surgical or medical treatments are available
to alleviate acne or the resulting scars:
• Comedone extraction. The comedo is removed from
the pore with a special tool.
7
Acne
Aconite
• Chemical peels. Glycolic acid is applied to peel off the
top layer of skin to reduce scarring.
• Dermabrasion. The affected skin is frozen with a chem-
ical spray, and removed by brushing or planing.
• Punch grafting. Deep scars are excised and the area re-
paired with small skin grafts.
• Intralesional injection. Corticosteroids are injected di-
rectly into inflamed pimples.
• Collagen injection. Shallow scars are elevated by colla-
gen protein injections.
• Laser treatments. Two types of laser treatments are proving
effective in treating acne scars. Laser-treated skin heals in
three to 10 days, depending on the treatment chosen.
Expected results
Most dermatologists now use a combination of ther-
apies to treat acne, depending on the individual. Results
of specific treatments will vary. Acne is not a serious
health threat. The most troubling aspects of this condi-
tion are the negative cosmetic effects and potential for
permanent scarring. Some people, especially teenagers,
become emotionally upset about their condition, and this
may contribute to social or emotional problems.
Acne is not considered curable, although it can be
controlled by proper treatment, with improvement possi-
bly taking many months. Acne tends to reappear when
treatment stops, but it often spontaneously improves over
time. Inflammatory acne may leave scars that require
further treatment.
Prevention
There are no sure ways to prevent acne, but the fol-
lowing steps may be taken to minimize flare-ups:
• Gentle washing of affected areas once or twice every day.
• Avoidance of abrasive cleansers.
• Limited use of makeup and moisturizers; with avoid-
ance of oil-based brands altogether.
• Oily hair should be shampooed often and worn up,
away from the face.
• A healthy, well-balanced diet should be eaten. Fresh
fruits and vegetables should be stressed, and foods that
seem to trigger flare-ups should be avoided.
• The face can be washed gently, twice daily with a soap
compounded of sulfur. Calendula officinalis, or other
substances that are useful against acne.
• Affected areas should not be handled excessively. Pim-
ples should not be squeezed or prodded, as this may con-
tribute to scarring, as well as spreading the acne lesions.
8
KEY TERMS
Androgens — Male sex hormones that are linked
with the development of acne.
Comedo — A hard plug composed of sebum and
dead skin cells.
Follicles — Structures where pimples form. They
are found within the skin and house the oil glands
and hair.
Isotretinoin — A drug that decreases sebum pro-
duction and dries up acne pimples.
Sebum — An oily skin moisturizer produced by se-
baceous glands.
• Emotional stress should be kept in check.
Resources
BOOKS
Murray, Michael, and Joseph Pizzorno. Encyclopedia of Natur-
al Medicine. 2nd ed. California: Prima Publishing, 1998.
Tierney Jr., Lawrence M., et at, eds. Current Medical Diagno-
sis and Treatment 2003 . 42nd ed. Connecticut: Appleton
& Lange, 2002.
PERIODICALS
“Combination Therapies Offer New Management Options for
Acne.” Medical Devices and Surgical Technology Week
(December 9, 2001): 13.
“Monthly Hormonal Changes in Menstrual Cyclel Affect
Flare-ups.” Health and Medicine Week (December 31,
2001): 4.
“Ultra Low-Dose Estrogen Birth Control Pill is Effective Treat-
ment.” Women's Health Weekly (October 4, 2001).
OTHER
Merck & Co., Inc. The Merck Manual Online. December 28,
2000 [cited October 2002]. <http://www.merck.com>.
Patience Paradox
Acne rosacea see Rosacea
Aconite
Description
Aconite is the common name for any of 100 or more
related species in the Aconitum genus. Two of the
species, Aconitum napellus and Aconitum carmichaeli
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
are used medicinally. The more popular remedy, Aconi-
tum napellus, is a plant that grows in mountainous re-
gions of Central Asia, Russia, Europe, and Great Britain.
This perennial plant from the Ranunculaceae family
grows to a height of 3 ft (1 m) and has dark green, glossy
leaves and dark blue flowers.
Other names for aconite are wolf’s bane, monks-
hood, blue rocket, and friar’s cap. Wolf’s bane is a direct
translation of the Greek word Lycotonum. The Greeks
left the plant as poisonous bait for wolves or anointed ar-
rows with the juice of the herb in order to kill wolves.
The plant was nicknamed monkshood and friar’s cap be-
cause of the shape of the flowers.
The plant in its fresh form is highly poisonous. The
poison comes from the toxic alkaloid aconitine. Aconi-
tine is found in the whole plant but is mainly concentrat-
ed in the root. Symptoms of poisoning include tingling,
numbness of the tongue and mouth, nausea and vomit-
ing, labored breathing, a weak and irregular pulse, and
cold, clammy skin. Even the smallest amounts of aconi-
tine inside the mouth cause burning, tingling, and numb-
ness. As little as 2 mg of aconitine can cause death in as
little as 4 hours, which may be one reason why aconite is
often chosen by people attempting suicide by poison.
The Australian government has declared all species of
aconite “unfit for human consumption.”
General use
Western herbology
Herbalists have used aconite as a medicine for hun-
dreds of years. However, in ancient times the herb was
known more for its power to kill rather than heal; it was
often used in ancient Rome to commit murders.
The herb acts as a diuretic (a substance that pro-
motes urination) and diaphoretic (a substance that causes
sweating). Tinctures are taken internally to slow fevers,
pneumonia, laryngitis, and acute tonsillitis. Liniments
or ointments made from the herb are applied externally
to relieve the pain of neuralgia and rheumatism.
Traditional Chinese medicine
Aconitum carmichaeli is used in traditional Chi-
nese medicine. It is called Fu Zi (sometimes Fu Tzu) in
Mandarin; in other parts of China and in Hong Kong it is
known as chuan won ton.. This herb is used to treat
rheumatism, bruises, arthritis, acute hypothermia, diar-
rhea, and impotence. The herb is very hot and has a
sweet, spicy taste.
The main function of Fu Zi is to warm the interior. It
also works to restore collapsed yang, warm Kidney fire,
warm the Kidney and Spleen, drive out the cold, warm
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
the meridians, and relieve pain. Fu Zi is also used by tra-
ditional Chinese herbalists in conditions marked by defi-
cient Kidney and Spleen yang or in conditions with early
morning diarrhea or lack of appetite.
Aconitum carmichaeli also contains the toxic alka-
loid aconitine. After cooking the herb, the alkaloid is
converted to aconine, which is not as toxic.
This herb is poisonous. When it is properly prepared
as recommended by a Chinese medicine practitioner,
there are rarely any adverse effects. Chinese pharmacies
do not sell raw, untreated aconite, as the plant should be
dried and then brewed for long periods of time. There
have been, however, cases of aconite poisoning reported
in Asian countries, including some that ended in the pa-
tient’s death from heart arrhythmias. It appears that most
of these cases are due either to the herbalist’s prescribing
a larger dose of aconite than is needed, or to the patient’s
attempting to prepare the remedy at home.
Homeopathy
Homeopaths prescribe aconite for conditions that
come on suddenly as a result of grief, fear, anger, shock,
or exposure to cold, dry wind. It is also recommended for
people troubled by suicidal thoughts. The remedy is short-
acting and is indicated at the onset of acute conditions
such as croup, colds, cough, bronchitis, eye and ear in-
fections, headaches, and rheumatism. This remedy is one
of the best for measles, arthritis, and pneumonia when all
of the symptoms are present. Aconite is also useful at the
beginning of a fever, in early stages of inflammation, and
following shock caused by an injury or surgery.
Preparations
Aconite is available as a homeopathic remedy or in
dried bulk form, as an ointment or liniment, and as a
tincture. Pharmacies, health food stores, and Chinese
herbal stores carry the various preparations. They are
also available as prescribed by a herbalist, homeopathic
doctor, or Chinese medicine practitioner.
The whole plant is used in Western herbal medicine.
The leaves and flowers are cut when the flowers are in
blossom in June. The roots are collected after the stem
has died off, usually in August. The root is dried before
use while the leaves, stems, and flowers are used fresh.
The homeopathic preparation of aconite is created in
the following manner. The whole plant — but not the
root — is collected when the flowers are in full bloom and
pounded to a pulp. The juice from the pulp is pressed
and mixed with alcohol. The mixture is then strained and
diluted. The final homeopathic remedy is created after
the diluted mixture is repeatedly succussed (pounded
9
Aconite
Aconite
against a hard surface to break down and mix the sub-
stance). The remedy is available at health-food and drug
stores in various potencies in the form of tinctures,
tablets, and pellets.
In traditional Chinese medicine, the aconite root is
generally used in small amounts in combination with
other herbs.
Precautions
If symptoms do not improve after the recommended
time period, consult your homeopath or other healthcare
practitioner.
Do not exceed the recommended dosage.
Use Aconitum carmichaeli only under supervision
of a Chinese medical practitioner.
Aconite is poisonous and should not be consumed in
its raw state. Persons who gather wild plants to eat
should be very careful in identifying what they are gath-
ering; cases have been reported of aconite poisoning in
people who thought they were gathering “mountain
chicory.”
Women who are pregnant, trying to get pregnant, or
who are breast-feeding should not use Aconitum car-
michaeli.
Side effects
Symptoms of poisoning by the fresh aconite plant
include tingling, numbness of the tongue and mouth,
nausea, vomiting, labored breathing, a weak and irregu-
lar pulse, and cold, clammy skin. In cases of severe poi-
soning, aconite can produce extreme symptoms that in-
clude severe pain, convulsions, paralysis, confusion,
seizures, and heart failure. The only established treat-
ment for aconite poisoning is supportive; that is, there is
no antidote.
Most liniments or lotions made with aconite for ex-
ternal use contain a 1.3% concentration of the herb. Use
of these preparations must be limited to unbroken skin,
as aconite can be absorbed through the skin and cause
toxic symptoms. If a skin reaction occurs, use of the lini-
ment must be discontinued immediately.
Interactions
When taking any homeopathic remedy, do not use
peppermint products, coffee, or alcohol. These products
will make the remedy ineffective.
Aconitum carmichaeli should not be used in those
having a deficiency of yin, or coolness, or with signs of
heat such as fever, redness, and agitation.
10
KEY TERMS
Aconitine — A toxic alkaloid contained in aconite.
As little as 2 mg taken internally may be fatal.
Antidote — A medication or remedy given to coun-
teract the effects of a poison.
Diaphoretic — A substance that causes sweating.
Diuretic — A substance that promotes urination.
Succussion — A process integral to the creation of
a homeopathic remedy in which a solution is re-
peatedly struck against a firm surface. This is per-
formed to thoroughly mix the substance and mag-
nify its healing properties.
Toxicology — The branch of medical pharmacolo-
gy dealing with the detection, effects, and anti-
dotes of poisons.
Resources
BOOKS
Cummings, Stephen, M.D., and Dana Ullman. Everybody' s
Guide to Homeopathic Medicines. New York: Putnam,
1997.
Kent, James Tyler. Lectures on Materia Medica. Delhi, India:
B. Jain Publishers, 1996.
Reid, Daniel. Chinese Herbal Medicine. Boston, MA: Shamb-
hala, 1996.
PERIODICALS
Chan, T. Y. "Incidence of Herb-Induced Aconitine Poisoning in
Hong Kong: Impact of Publicity Measures to Promote
Awareness Among the Herbalists and the Public.” Drug
Safety 25 (2002): 823-828.
Elliott, S. P. “A Case of Fatal Poisoning with the Aconite Plant:
Quantitative Analysis in Biological Fluid.” Science and
Justice 42 (April-June 2002): 111-115.
Gaibazzi, N., G. P. Gelmini, G. Montresor, et al. “Case Study
of Accidental Aconite Poisoning.” [in Italian] Italian
Heart Journal 3 (August 2002): 874-877.
ORGANIZATIONS
American Academy of Clinical Toxicology. Ill East Park
Drive, P. O. Box 8820, Harrisburg, PA 17105. (717) 558-
7750. <http://www.clintox.org>.
National Center for Homeopathy. 801 N. Fairfax St., Suite 306,
Alexandria, VA 22314. (703) 548-7790.
Jennifer Wurges
Rebecca J. Frey, PhD
Acquired Immunodeficiency syndrome see
AIDS
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Acupressure
Definition
Acupressure is a form of touch therapy that utilizes
the principles of acupuncture and Chinese medicine. In
acupressure, the same points on the body are used as in
acupuncture, but are stimulated with finger pressure in-
stead of with the insertion of needles. Acupressure is
used to relieve a variety of symptoms and pain.
Origins
One of the oldest text of Chinese medicine is the
Huang Di, The Yellow Emperor’s Classic of Internal
Medicine, which may be at least 2,000 years old. Chinese
medicine has developed acupuncture, acupressure, herbal
remedies, diet, exercise, lifestyle changes, and other
remedies as part of its healing methods. Nearly all of the
forms of Oriental medicine that are used in the West
today, including acupuncture, acupressure, shiatsu, and
Chinese herbal medicine, have their roots in Chinese
medicine. One legend has it that acupuncture and acu-
pressure evolved as early Chinese healers studied the
puncture wounds of Chinese warriors, noting that certain
points on the body created interesting results when stimu-
lated. The oldest known text specifically on acupuncture
points, the Systematic Classic of Acupuncture , dates back
to 282 a.d. Acupressure is the non-invasive form of
acupuncture, as Chinese physicians determined that stim-
ulating points on the body with massage and pressure
could be effective for treating certain problems.
Outside of Asian- American communities, Chinese
medicine remained virtually unknown in the United
States until the 1970s, when Richard Nixon became the
first U.S. president to visit China. On Nixon’s trip, jour-
nalists were amazed to observe major operations being
performed on patients without the use of anesthetics. In-
stead, wide-awake patients were being operated on, with
only acupuncture needles inserted into them to control
pain. At that time, a famous columnist for the New York
Times, James Reston, had to undergo surgery and elected
to use acupuncture for anesthesia. Later, he wrote some
convincing stories on its effectiveness. Despite being ne-
glected by mainstream medicine and the American Med-
ical Association (AMA), acupuncture and Chinese medi-
cine became a central to alternative medicine practition-
ers in the United States. Today, there are millions of pa-
tients who attest to its effectiveness, and nearly 9,000
practitioners in all 50 states.
Acupressure is practiced as a treatment by Chinese
medicine practitioners and acupuncturists, as well as by
massage therapists. Most massage schools in American
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
include acupressure techniques as part of their bodywork
programs. Shiatsu massage is very closely related to acu-
pressure, working with the same points on the body and
the same general principles, although it was developed
over centuries in Japan rather than in China. Reflexology
is a form of bodywork based on acupressure concepts.
Jin Shin Do is a bodywork technique with an increasing
number of practitioners in America that combines acu-
pressure and shiatsu principles with qigong, Reichian
theory, and meditation.
Benefits
Acupressure massage performed by a therapist can
be very effective both as prevention and as a treatment
for many health conditions, including headaches, general
aches and pains, colds and flu, arthritis, allergies, asth-
ma, nervous tension, menstrual cramps, sinus problems,
sprains, tennis elbow, and toothaches, among others.
Unlike acupuncture which requires a visit to a profes-
sional, acupressure can be performed by a layperson.
Acupressure techniques are fairly easy to learn, and have
been used to provide quick, cost-free, and effective relief
from many symptoms. Acupressure points can also be
stimulated to increase energy and feelings of well-being,
reduce stress, stimulate the immune system, and allevi-
ate sexual dysfunction.
Description
Acupressure and Chinese medicine
Chinese medicine views the body as a small part of
the universe, subject to laws and principles of harmony
and balance. Chinese medicine does not make as sharp a
destinction as Western medicine does between mind and
body. The Chinese system believes that emotions and
mental states are every bit as influential on disease as
purely physical mechanisms, and considers factors like
work, environment, and relationships as fundamental to a
patient’s health. Chinese medicine also uses very different
symbols and ideas to discuss the body and health. While
Western medicine typically describes health as mainly
physical processes composed of chemical equations and
reactions, the Chinese use ideas like yin and yang, chi, and
the organ system to describe health and the body.
Everything in the universe has properties of yin and
yang. Yin is associated with cold, female, passive, down-
ward, inward, dark, wet. Yang can be described as hot,
male, active, upward, outward, light, dry, and so on.
Nothing is either completely yin or yang. These two
principles always interact and affect each other, although
the body and its organs can become imbalanced by hav-
ing either too much or too little of either.
11
Acupressure
Acupressure
Therapist working acupressure points on a woman’s shoulder. (Photo Researchers, Inc. Reproduced by permission.)
Chi (pronounced chee, also spelled qi or ki in Japan-
ese shiatsu) is the fundamental life energy. It is found in
food, air, water, and sunlight, and it travels through the
body in channels called meridians. There are 12 major
meridians in the body that transport chi, corresponding
to the 12 main organs categorized by Chinese medicine.
Disease is viewed as an imbalance of the organs and
chi in the body. Chinese medicine has developed intri-
cate systems of how organs are related to physical and
mental symptoms, and it has devised corresponding
treatments using the meridian and pressure point net-
works that are classified and numbered. The goal of acu-
pressure, and acupuncture, is to stimulate and unblock
the circulation of chi, by activating very specific points,
called pressure points or acupoints. Acupressure seeks to
stimulate the points on the chi meridians that pass close
to the skin, as these are easiest to unblock and manipu-
late with finger pressure.
Acupressure can be used as part of a Chinese physi-
cian’s prescription, as a session of massage therapy, or
as a self-treatment for common aches and illnesses. A
Chinese medicine practitioner examines a patient very
thoroughly, looking at physical, mental and emotional ac-
12
tivity, taking the pulse usually at the wrists, examining
the tongue and complexion, and observing the patient’s
demeanor and attitude, to get a complete diagnosis of
which organs and meridian points are out of balance.
When the imbalance is located, the physician will recom-
mend specific pressure points for acupuncture or acupres-
sure. If acupressure is recommended, the patient might
opt for a series of treatments from a massage therapist.
In massage therapy, acupressurists will evaluate a
patient’s symptoms and overall health, but a massage
therapist’s diagnostic training isn’t as extensive as a Chi-
nese physician’s. In a massage therapy treatment, a per-
son usually lies down on a table or mat, with thin cloth-
ing on. The acupressurist will gently feel and palpate the
abdomen and other parts of the body to determine energy
imbalances. Then, the therapist will work with different
meridians throughout the body, depending on which or-
gans are imbalanced in the abdomen. The therapist will
use different types of finger movements and pressure on
different acupoints, depending on whether the chi needs
to be increased or dispersed at different points. The ther-
apist observes and guides the energy flow through the
patient’s body throughout the session. Sometimes, spe-
cial herbs ( Artemesia vulgaris or moxa) may be placed
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
on a point to warm it, a process called moxibustion. A
session of acupressure is generally a very pleasant expe-
rience, and some people experience great benefit imme-
diately. For more chronic conditions, several sessions
may be necessary to relieve and improve conditions.
Acupressure massage usually costs from $30-70 per
hour session. A visit to a Chinese medicine physician or
acupuncturist can be more expensive, comparable to a
visit to an allopathic physician if the practitioner is an
MD. Insurance reimbursement varies widely, and con-
sumers should be aware if their policies cover alternative
treatment, acupuncture, or massage therapy.
Self-treatment
Acupressure is easy to learn, and there are many
good books that illustrate the position of acupoints and
meridians on the body. It is also very versatile, as it can
be done anywhere, and it’s a good form of treatment for
spouses and partners to give to each other and for parents
to perform on children for minor conditions.
While giving self-treatment or performing acupres-
sure on another, a mental attitude of calmness and atten-
tion is important, as one person’s energy can be used to
help another’s. Loose, thin clothing is recommended.
There are three general techniques for stimulating a pres-
sure point.
• Tonifying is meant to strengthen weak chi, and is done
by pressing the thumb or finger into an acupoint with a
firm, steady pressure, holding it for up to two minutes.
• Dispersing is meant to move stagnant or blocked chi,
and the finger or thumb is moved in a circular motion
or slightly in and out of the point for two minutes.
• Calming the chi in a pressure point utilizes the palm to
cover the point and gently stroke the area for about two
minutes.
There are many pressure points that are easily found
and memorized to treat common ailments from
headaches to colds.
• For headaches, toothaches, sinus problems, and pain in
the upper body, the “LI4” point is recommended. It is
located in the web between the thumb and index finger,
on the back of the hand. Using the thumb and index fin-
ger of the other hand, apply a pinching pressure until
the point is felt, and hold it for two minutes. Pregnant
women should never press this point.
• To calm the nerves and stimulate digestion, find the
“CV12” point that is four thumb widths above the
navel in the center of the abdomen. Calm the point with
the palm, using gentle stroking for several minutes.
Press on point governing vessel 24.5, the top of the bridge
of the nose, lightly for two minutes to relieve hay fever
symptoms. Press on lung 10, the center of the thumb pad,
for one minute to alleviate a sore throat. To ease heartburn,
apply pressure to stomach 36, four finger-widths below the
kneecap outside the shinbone. Use on both legs. (Illustra-
tion by Electronic Illustrators Group. The Gale Group.)
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
13
Acupressure
Acupressure
Press on point pericardium 6 for one minute on each arm to
relieve general nausea. Press on stomach 3, at the bottom
of the cheekbones, to relieve a sinus headache. Squeezing
the webbed area between your forefinger and thumb, large
intestine 4, may also help relieve sinus pain. (Illustration by
Electronic Illustrators Group. The Gale Group.)
• To stimulate the immune system, find the “TH5” point
on the back of the forearm two thumb widths above the
wrist. Use a dispersing technique, or circular pressure
with the thumb or finger, for two minutes on each arm.
• For headaches, sinus congestion, and tension, locate
the “GB20” points at the base of the skull in the back
of the head, just behind the bones in back of the ears.
Disperse these points for two minutes with the fingers
or thumbs. Also find the “yintang” point, which is in
the middle of the forehead between the eyebrows. Dis-
perse it with gentle pressure for two minutes to clear
the mind and to relieve headaches.
Precautions
Acupressure is a safe technique, but it is not meant
to replace professional health care. A physician should
always be consulted when there are doubts about med-
ical conditions. If a condition is chronic, a professional
should be consulted; purely symptomatic treatment
can exacerbate chronic conditions. Acupressure should
not be applied to open wounds, or where there is
swelling and inflammation. Areas of scar tissue, blis-
ters, boils, rashes, or varicose veins should be avoid-
ed. Finally, certain acupressure points should not be
stimulated on people with high or low blood pressure
and on pregnant women.
Research & general acceptance
In general, Chinese medicine has been slow to gain
acceptance in the West, mainly because it rests on ideas
very foreign to the scientific model. For instance, West-
ern scientists have trouble with the idea of chi, the invisi-
ble energy of the body, and the idea that pressing on cer-
tain points can alleviate certain conditions seems some-
times too simple for scientists to believe.
Western scientists, in trying to account for the action
of acupressure, have theorized that chi is actually part of
the neuroendocrine system of the body. Celebrated or-
thopedic surgeon Robert O. Becker, who was twice nom-
inated for the Nobel Prize, wrote a book on the subject
called Cross Currents: The Promise of Electromedicine ;
The Perils of Electropollution. By using precise electri-
cal measuring devices, Becker and his colleagues
showed that the body has a complex web of electromag-
netic energy, and that traditional acupressure meridians
and points contained amounts of energy that non-acu-
pressure points did not.
The mechanisms of acupuncture and acupressure re-
main difficult to document in terms of the biochemical
processes involved; numerous testimonials are the pri-
mary evidence backing up the effectiveness of acupres-
14
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
sure and acupuncture. However, a body of research is
growing that verifies the effectiveness in acupressure and
acupuncture techniques in treating many problems and
in controlling pain.
Training & certification
There are two routes to becoming trained in the skill
of acupressure. The first is training in traditional
acupuncture and Chinese medicine, which has many
schools and certifying bodies around the country. The
majority of acupressure practitioners are trained as certi-
fied massage therapists, either as acupressure or shiatsu
specialists.
The Acupressure Institute provides certification and
resources for acupressure practitioners. Address: 1533
Shattuck Ave., Berkeley, CA 94709, (800) 442-2232 or
(510) 845-1059, http://www.acupressure.com.
The American Oriental Bodywork Therapy Associa-
tion (AOBTA) certifies acupressure practitioners and has
over 1,400 members. It also provides a list of schools and
training programs. Address: 1010 Haddonfield-Berlin
Road, Suite 408, Voorhees, NJ 08043, phone (856) 782-
1616, email: office@aobta.org. ttp://222. aobta.org
The Jin Shin Do Foundation for Body/Mind Acu-
pressure is an international network of teachers and prac-
titioners. Address: RO. Box 416, Idyllwild, CA 92549.
phone: (909) 659-5707
The largest organization that certifies massage ther-
apists, with over 40,000 members worldwide, is the
American Massage Therapy Association. It also has a
member directory and lists of training programs. Web-
site: www.amtamassage.org.
Resources
BOOKS
Jarmey, Chris and John Tindall. Acupressure for Common Ail-
ments. London: Gaia, 1991.
Kakptchuk, Ted. The Web That Has No Weaver: Understanding
Chinese Medicine. New York: Congdon and Weed, 1983.
Warren, Frank Z., MD. Freedom From Pain Through Acupres-
sure. New York: Fell, 1976.
PERIODICALS
Massage Therapy Journal. 820 Davis Street, Suite 100,
Evanston, IL 60201-4444.
OTHER
American Association of Oriental Medicine, http://www.aaom.
org/ (December 28, 2000).
National Acupuncture and Oriental Medicine Alliance, http://
www.acuall.org/ (December 28, 2000).
Douglas Dupler
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Acupoint — A pressure point stimulated in acu-
pressure.
Chi — Basic life energy.
Meridian — A channel through which chi travels in
the body.
Moxibustion — An acupuncture technique that
burns the herb moxa or mugwort.
Shiatsu — Japanese form of acupressure massage.
Yin/yang — Universal characteristics used to de-
scribe aspects of the natural world.
Acupuncture
Definition
Acupuncture is one of the main forms of treatment in
traditional Chinese medicine. It involves the use of sharp,
thin needles that are inserted in the body at very specific
points. This process is believed to adjust and alter the
body’s energy flow into healthier patterns, and is used to
treat a wide variety of illnesses and health conditions.
Origins
The original text of Chinese medicine is the Nei
Ching, The Yellow Emperor’s Classic of Internal Medi-
cine , which is estimated to be at least 2,500 years old.
Thousands of books since then have been written on the
subject of Chinese healing, and its basic philosophies
spread long ago to other Asian civilizations. Nearly all of
the forms of Oriental medicine which are used in the
West today, including acupuncture, shiatsu, acupressure
massage, and macrobiotics, are part of or have their roots
in Chinese medicine. Legend has it that acupuncture de-
veloped when early Chinese physicians observed unpre-
dicted effects of puncture wounds in Chinese warriors.
The oldest known text on acupuncture, the Systematic
Classic of Acupuncture , dates back to 282 a.d. Although
acupuncture is its best known technique, Chinese medi-
cine traditionally utilizes herbal remedies, dietary thera-
py, lifestyle changes and other means to treat patients.
In the early 1900s, only a few Western physicians
who had visited China were fascinated by acupuncture,
but outside of Asian- American communities it remained
virtually unknown until the 1970s, when Richard Nixon
became the first U.S. president to visit China. On Nixon's
trip, journalists were amazed to observe major operations
15
Acupuncture
Acupuncture
Woman undergoing facial acupuncture. (Photograph by Yoav Levy. Phototake NYC. Reproduced by permission.)
being performed on patients without the use of anesthet-
ics. Instead, wide-awake patients were being operated on
with only acupuncture needles inserted into them to con-
trol pain. During that time, a famous columnist for the
New York Times, James Reston, had to undergo surgery
and elected to use acupuncture instead of pain medication,
and he wrote some convincing stories on its effectiveness.
Today acupuncture is being practiced in all 50 states
by more than 9,000 practitioners, with about 4,000 MDs
including it in their practices. Acupuncture has shown no-
table success in treating many conditions, and more than
15 million Americans have used it as a therapy. Acupunc-
ture, however, remains largely unsupported by the med-
ical establishment. The American Medical Association
has been resistant to researching it, as it is based on con-
cepts very different from the Western scientific model.
Several forms of acupuncture are being used today
in America. Japanese acupuncture uses extremely thin
needles and does not incorporate herbal medicine in its
practice. Auricular acupuncture uses acupuncture points
only on the ear, which are believed to stimulate and bal-
ance internal organs. In France, where acupuncture is
very popular and more accepted by the medical estab-
lishment, neurologist Paul Nogier developed a system of
16
acupuncture based on neuroendocrine theory rather than
on traditional Chinese concepts, which is gaining some
use in America.
Benefits
The World Health Organization (WHO) recom-
mends acupuncture as an effective treatment for over
forty medical problems, including allergies, respiratory
conditions, gastrointestinal disorders, gynecological
problems, nervous conditions, and disorders of the eyes,
nose and throat, and childhood illnesses, among others.
Acupuncture has been used in the treatment of alco-
holism and substance abuse. In 2002, a center in Maine
received a unique grant to study acupuncture treatment
for substance abuse. Although recognizing that acupunc-
ture had been used before for helping those with abuse,
this study sought to show that ear acupuncture’s effects
on relaxation response helped those abusing drugs and
alcohol better deal with the anxiety and life circum-
stances thought to lead them to substance abuse.
Acupuncture is an effective and low-cost treatment
for headaches and chronic pain, associated with prob-
lems like back injuries and arthritis. It has also been used
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Traditional Chinese medicine teachings state that channels of energy flow throughout the body, and that disease is caused
by too much or to little flow of energy along these channels. Points along the channels, called meridians, are manipulated in
acupuncture. In the illustration, points are shown on the bladder (BL), conception vessel (CV), gall bladder (GB), governing
vessel (GV), heart (HE), kidney (Kl) large intestine (LI), liver (LV), lung (LU), pericardium (PE), small intestine (SI), spleen (SP),
stomach (ST), and triple warmer (TW) meridians. (Illustration by Electronic Illustrators Group. The Gale Group.)
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
17
Acupuncture
Acupuncture
to supplement invasive Western treatments like
chemotherapy and surgery. Acupuncture is generally
most effective when used as prevention or before a
health condition becomes acute, but it has been used to
help patients suffering from cancer and AIDS. In 2002,
the National Institutes of health announced that pain
from certain musculoskeletal conditions like fibromyal-
gia could be helped by acupuncture. Acupuncture is lim-
ited in treating conditions or traumas that require surgery
or emergency care (such as for broken bones).
Description
Basic ideas of Chinese medicine
Chinese medicine views the body as a small part of the
universe, and subject to universal laws and principles of har-
mony and balance. Chinese medicine does not draw a sharp
line, as Western medicine does, between mind and body.
The Chinese system believes that emotions and mental states
are every bit as influential on disease as purely physical
mechanisms, and considers factors like work, environment,
lifestyle, and relationships as fundamental to the overall pic-
ture of a patient’s health. Chinese medicine also uses very
different symbols and ideas to discuss the body and health.
While Western medicine typically describes health in terms
of measurable physical processes made up of chemical reac-
tions, the Chinese use ideas like yin and yang, chi, the organ
system, and the five elements to describe health and the
body. To understand the ideas behind acupuncture, it is
worthwhile to introduce some of these basic terms.
YIN AND YANG. According to Chinese philosophy,
the universe and the body can be described by two sepa-
rate but complementary principles, that of yin and yang.
For example, in temperature, yin is cold and yang is hot.
In gender, yin is female and yang is male. In activity, yin
is passive and yang is active. In light, yin is dark and
yang is bright; in direction yin is inward and downward
and yang is outward and up, and so on. Nothing is ever
completely yin or yang, but a combination of the two.
These two principles are always interacting, opposing,
and influencing each other. The goal of Chinese medi-
cine is not to eliminate either yin or yang, but to allow
the two to balance each other and exist harmoniously to-
gether. For instance, if a person suffers from symptoms
of high blood pressure, the Chinese system would say
that the heart organ might have too much yang, and
would recommend methods either to reduce the yang or
to increase the yin of the heart, depending on the other
symptoms and organs in the body. Thus, acupuncture
therapies seek to either increase or reduce yang, or in-
crease or reduce yin in particular regions of the body.
CHI. Another fundamental concept of Chinese medi-
cine is that of chi (pronounced chee. also spelled qi ). Chi
18
is the fundamental life energy of the universe. It is invisi-
ble and is found in the environment in the air, water, food
and sunlight. In the body, it is the invisible vital force that
creates and animates life. We are all born with inherited
amounts of chi, and we also get acquired chi from the
food we eat and the air we breathe. The level and quality
of a person’s chi also depends on the state of physical,
mental and emotional balance. Chi travels through the
body along channels called meridians.
THE ORGAN SYSTEM. In the Chinese system, there
are twelve main organs: the lung, large intestine, stom-
ach, spleen, heart, small intestine, urinary bladder, kid-
ney, liver, gallbladder, pericardium, and the “triple
warmer,” which represents the entire torso region. Each
organ has chi energy associated with it, and each organ
interacts with particular emotions on the mental level. As
there are twelve organs, there are twelve types of chi
which can move through the body, and these move
through twelve main channels or meridians. Chinese
doctors connect symptoms to organs. That is, symptoms
are caused by yin/yang imbalances in one or more or-
gans, or by an unhealthy flow of chi to or from one organ
to another. Each organ has a different profile of symp-
toms it can manifest.
THE FIVE ELEMENTS. Another basis of Chinese theo-
ry is that the world and body are made up of five main
elements: wood, fire, earth, metal, and water. These ele-
ments are all interconnected, and each element either
generates or controls another element. For instance,
water controls fire and earth generates metal. Each organ
is associated with one of the five elements. The Chinese
system uses elements and organs to describe and treat
conditions. For instance, the kidney is associated with
water and the heart is associated with fire, and the two
organs are related as water and fire are related. If the kid-
ney is weak, then there might be a corresponding fire
problem in the heart, so treatment might be made by
acupuncture or herbs to cool the heart system and/or in-
crease energy in the kidney system.
The Chinese have developed an intricate system of
how organs and elements are related to physical and men-
tal symptoms, and the above example is a very simple one.
Although this system sounds suspect to Western scientists,
some interesting parallels have been observed. For in-
stance, Western medicine has observed that with severe
heart problems, kidney failure often follows, but it still
does not know exactly why. In Chinese medicine, this con-
nection between the two organs has long been established.
MEDICAL PROBLEMS AND ACUPUNCTURE. In Chi-
nese medicine, disease as seen as imbalances in the
organ system or chi meridians, and the goal of any reme-
dy or treatment is to assist the body in reestablishing its
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
innate harmony. Disease can be caused by internal fac-
tors like emotions, external factors like the environment
and weather, and other factors like injuries, trauma, diet,
and germs. However, infection is seen not as primarily a
problem with germs and viruses, but as a weakness in
the energy of the body that is allowing a sickness to
occur. In Chinese medicine, no two illnesses are ever the
same, as each body has its own characteristics of symp-
toms and balance. Acupuncture is used to open or adjust
the flow of chi throughout the organ system, which will
strengthen the body and prompt it to heal itself.
A VISIT TO THE ACUPUNCTURIST. The first thing an
acupuncturist will do is get a thorough idea of a patient’s
medical history and symptoms, both physical and emo-
tional. This is done with a long questionnaire and inter-
view. Then the acupuncturist will examine the patient to
find further symptoms, looking closely at the tongue, the
pulse at various points in the body, the complexion, gen-
eral behavior, and other signs like coughs or pains. From
this, the practitioner will be able to determine patterns of
symptoms which indicate which organs and areas are
imbalanced. Depending on the problem, the acupunctur-
ist will insert needles to manipulate chi on one or more
of the twelve organ meridians. On these twelve meridi-
ans, there are nearly 2,000 points that can be used in
acupuncture, with around 200 points being most fre-
quently used by traditional acupuncturists. During an in-
dividual treatment, one to 20 needles may be used, de-
pending on which meridian points are chosen.
Acupuncture needles are always sterilized and
acupuncture is a very safe procedure. The depth of inser-
tion of needles varies, depending on which chi channels
are being treated. Some points barely go beyond superfi-
cial layers of skin, while some acupuncture points re-
quire a depth of 1-3 in (2. 5-7. 5 cm) of needle. The nee-
dles generally do not cause pain. Patients sometimes re-
port pinching sensations and often pleasant sensations,
as the body experiences healing. Depending on the prob-
lem, the acupuncturist might spin or move the needles,
or even pass a slight electrical current through some of
them. Moxibustion may be sometimes used, in which an
herbal mixture (moxa or mugwort) is either burned like
incense on the acupuncture point or on the end of the
needle, which is believed to stimulate chi in a particular
way. Also, acupuncturists sometimes use cupping, dur-
ing which small suction cups are placed on meridian
points to stimulate them.
How long the needles are inserted also varies. Some
patients only require a quick in and out insertion to clear
problems and provide tonification (strengthening of
health), while some other conditions might require nee-
dles inserted up to an hour or more. The average visit to
an acupuncturist takes about 30 minutes. The number of
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
visits to the acupuncturist varies as well, with some con-
ditions improved in one or two sessions and others re-
quiring a series of six or more visits over the course of
weeks or months.
Costs for acupuncture can vary, depending on
whether the practitioner is an MD. Initial visits with non-
MD acupuncturists can run from $50-$100, with follow-
up visits usually costing less. Insurance reimbursement
also varies widely, depending on the company and state.
Regulations have been changing often. Some states au-
thorize Medicaid to cover acupuncture for certain condi-
tions, and some states have mandated that general cover-
age pay for acupuncture. Consumers should be aware of
the provisions for acupuncture in their individual policies.
Precautions
Acupuncture is generally a very safe procedure. If a
patient is in doubt about a medical condition, more than
one physician should be consulted. Also, a patient should
always feel comfortable and confident that their
acupuncturist is knowledgable and properly trained.
Research & general acceptance
Mainstream medicine has been slow to accept
acupuncture; although more MDs are using the technique,
the American Medical Association does not recognize it as
a specialty. The reason for this is that the mechanism of
acupuncture is difficult to scientifically understand or
measure, such as the invisible energy of chi in the body.
Western medicine, admitting that acupuncture works in
many cases, has theorized that the energy meridians are
actually part of the nervous system and that acupuncture
relieves pain by releasing endorphins, or natural pain
killers, into the bloodstream. Despite the ambiguity in the
biochemistry involved, acupuncture continues to show ef-
fectiveness in clinical tests, from reducing pain to alleviat-
ing the symptoms of chronic illnesses, and research in
acupuncture is currently growing. The Office of Alterna-
tive Medicine of the National Institute of Health is cur-
rently funding research in the use of acupuncture for treat-
ing depression and attention-deficit disorder.
Training & certification
Medical acupuncture has evolved in America which
uses traditional methods mainly as surgical techniques
and pain management, and not as part of Chinese medi-
cine overall. Medical acupuncture is performed by an
MD or an osteopathic physician (DO). Currently 23
states allow only this type of acupuncture. Practitioners
get their training as part of conventional medical school
programs. As any MD can legally perform acupuncture,
19
Acupuncture
Ademetionine
KEY TERMS
Acupressure — Form of massage using acupunc-
ture points.
Auricular acupuncture — Acupuncture using only
points found on the ears.
Chi — Basic life energy.
Meridian — Channel through which chi travels in
the body.
Moxibustion — Acupuncture technique which
burns the herb moxa or mugwort.
Tonification — Acupuncture technique for
strengthening the body.
Yin/Yang — Universal characteristics used to de-
scribe aspects of the natural world.
The American Academy of Medical Acupuncture
(AAMA) was chartered in 1987 to support the education
and correct practice of physician-trained acupuncturists.
Its members must be either MDs or DOs who have com-
pleted proper study of acupuncture techniques. Address:
5820 Wilshire Blvd., Suite 500, Los Angeles, CA 90036,
(323) 937-5514, http://medicalcupuntcture.org
For traditional acupuncturists. The National Com-
mission for Certification of Acupuncturists (NCCA) con-
ducts certification exams, promotes national standards,
and registers members. Most states that license acupunc-
turists use the NCCA standards as certification. Address:
11 Canal Center Plaza, Ste. 300, Alexandra, VA 22314,
(703) 548-9004, http://www.nccaim.org.
The American Association of Acupuncture and Ori-
ental Medicine (AAAOM) is the largest organization for
practitioners, with more than 1,600 members. Address:
1925 W. County Rd B2, Roseville, MN 55113, (651) 631-
0204, http://www.aaaom.org.
Resources
BOOKS
Fleischman, Dr. Gary F. Acupuncture: Everything You Ever
Wanted To Know. New York: Barrytown, 1998.
Kakptchuk, Ted. The Web That Has No Weaver: Understanding
Chinese Medicine. New York: Congdon and Weed, 1983.
Requena, Yves, MD. Terrains and Pathology in Acupuncture.
Massachusetts: Paradigm, 1986.
PERIODICALS
American Journal of Acupuncture. 1840 41st Ave., Suite 102,
P.O. Box 610, Capitola, CA 95010.
Assefi, Nassim. “Acupuncture for Fibromyalgia.” Alternative
Medicine Alert. (February 2002): 13.
20
Savage, Lorraine. “Grant to Study Acupuncture”s Effective-
ness on Patients Suffering from Substance Abuse.”
Healthcare Review. (March 19, 2002): 16.
OTHER
American Association of Oriental Medicine, http://www.aaom.
org / (December 28, 2000).
North American Society of Acupuncture and Alternative Medi-
cine. http://www.nasa-altmed.com/ (December 28, 2000).
Douglas Dupler
Teresa G. Odle
Acute homeopathic remedies see
Homeopathy, acute prescribing
ADD see Attention-deficit hyperactivity
disorder
Addiction see Alcoholism; Substance abuse
and dependence
Ademetionine
Description
Ademetionine, also known as SAMe, is a specific
form of the amino acid methionine known as S-adeno-
syl-methionine. The body manufactures it, and it is found
in most tissues of the body. Ademetionine is essential for
the formation of glutathione, a water-soluble peptide that
helps the body fight free radicals. SAMe also helps the
liver to process fats (protecting against a fatty liver) and is
believed to play a role in protecting the body from heart
disease. SAMe is a methyl donor, which means that it
provides other molecules with methyl groups that are
critical to their metabolism. In general, ademetionine
raises the level of functioning of other amino acids in the
body. Severe deficiencies of SAMe can cause problems
with other important body functions, such as secretion of
important hormones like melatonin, which plays a key
role in regulating sleep and circadian rhythms.
General use
The synthetic formula of ademetionine has been
hailed as an anti-aging formula because it is such a power-
ful antioxidant. Antioxidants are substances that counter-
act the damaging effects of free radicals in human tissue.
Ademetionine has been widely popularized recently, but it
is not a recent discovery. In fact it was discovered in Italy
in 1952, and has been widely researched over the past few
decades. In the 1970s, Italian researchers investigating its
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
properties as a treatment for schizophrenia discovered
that it also had definite antidepressant properties. Ademe-
tionine became a useful treatment only during the 1990s,
however, when scientists found a way to stabilize it for re-
search purposes. After that technological development,
ademetionine could be sold as a medical supplement.
Ademetionine has been used successfully to treat de-
pression, arthritis, schizophrenia, liver disease, periph-
eral neuropathy, and other illnesses. Many people who
have these illnesses, particularly schizophrenia, peripher-
al neuropathy, and myelopathy, may have low blood lev-
els of folic acid, vitamin B 12 , and certain amino acids,
particularly SAMe and those with which it interacts.
Pain relief
The effectiveness of ademetionine has been studied
in clinical trials with human subjects. One six-week study
compared SAMe to transcutaneous electrical nerve stim-
ulation (TENS), which is a popular form of pain relief in
Europe. SAMe proved to be a more effective treatment.
Liver function
SAMe has been found to restore normal liver func-
tion in patients suffering from a variety of liver disease,
both alcohol induced and other. It has also been found to
reverse liver damage resulting from the ingestion of vari-
ous drugs and chemical agents (paracetamol and others).
Depression
Several clinical trials found that ademetionine has a
rapid effect on depression. Within double blind trials,
ademetionine was found to have a markedly greater ef-
fect than placebos, with only mild side effects. Although
the substance seems to work surprisingly well on most
forms of depression, a study done at Northwick Park
Hospital in Harrow, England, suggests that it is more ef-
fective for endogenous depression (depression that does
not have an obvious external cause) than for neurotic de-
pression (depression that has an identifiable cause).
These findings may be related to the fact that pa-
tients suffering from endogenous forms of depression are
often found to have low levels of this amino acid. This is
a particularly exciting discovery, because endogenous
depression is the most difficult form to treat. Ademetion-
ine was found to be particularly helpful to post-
menopausal women suffering from depression. Some
practitioners are suggesting the use of ademetionine in
conjunction with other antidepressants to shorten the pe-
riod between the beginning of antidepressant treatment
and the patient’s sense of improvement. Since ademetio-
nine generally has fewer side effects than many antide-
pressants, it may be preferable to use it alone.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Peripheral neuropathy
Ademetionine has been used successfully to treat
cases of peripheral neuropathy that had not previously
responded to treatment with vitamin B 12 (cyanocobal-
amin). This is an important discovery, because peripheral
neuropathy is difficult to treat.
Migraine
Ademetionine has been found to be a useful
painkiller. Over the long term, it may work less rapidly
than some other analgesics, but it does not have the high
incidence of gastrointestinal disturbance that results
from taking ibuprofen, for example. Ademetionine may
be the answer for patients who also suffer from GI tract
diseases and cannot safely take other analgesics.
Fibromyalgia
Fibromyalgia is characterized by persistent muscle
pain and aching that has no apparent cause. One Scandi-
navian study noted that patients with fibromyalgia who
took SAMe showed some improvement.
Osteoarthritis
Studies have shown that osteoarthritis patients not
only experienced less pain while taking ademetionine,
but that the depression that often accompanies the dis-
ease was less evident. Ademetionine is also less toxic
than the allopathic drugs used to treat such diseases.
Alzheimer’s and Parkinson’s diseases
Ademetionine has been shown to treat nerve dam-
age and depression sometimes as effectively as standard
pharmaceutical drugs without serious side effects. Some
believe that SAMe may increase the effectiveness of lev-
odopa, which is the drug most often prescribed for
Parkinson’s disease.
Preparations
Ademetionine is available in preparations for oral,
intravenous, and intramuscular administration. Treat-
ment with ademetionine should always be monitored by
a qualified practitioner.
For liver function: 200 mg of ademetionine can be
taken twice daily, gradually raising the dosage to 400 mg
three times daily. Patients with peripheral neuropathy
have been given dosages as high as 1600 mg daily.
For depression the following program may be effec-
tive: 200 mg taken twice daily for the first two days. For the
third to the ninth day, dosage may be increased to 400 mg
twice daily, and for days ten to nineteen, 400 mg should be
21
Ademetionine
Adie's pupil
taken three times daily. After the twentieth day, the dosage
should be stabilized at 400 mg four times daily. Some prac-
titioners recommend doses as high as 1600 mg daily.
Migraine and fibromyalgia sufferers can take 200
mg of ademetionine twice daily, increasing to 600 mg
doses. Osteoarthritis patients may be advised to take as
much as 1200 mg daily for effective treatment.
Precautions
Patients with serious diseases such as those men-
tioned above should seek the help of a qualified practition-
er. It is significant, however, that no patient has ever
dropped out of studies related to ademetionine testing due
to side effects, even though it has been administered in
high doses and in all forms, i.e., orally, intravenously, and
intramuscularly. In addition, antidepressants, particularly
the tricyclics, may cause accidental or intentional overdos-
es. SAMe is also free of the hazard of potential addiction.
One possible drawback to ademetionine treatment is
its cost. A month’s supply may cost between $60 and
$100. This is about the same as the cost of many antide-
pressants, but ademetionine is less likely to be covered
by medical insurance.
Side effects
SAMe is not suitable for patients with bipolar disor-
der, as it may amplify the manic phase of the condition.
The only side effects observed with SAMe in clini-
cal trials were mild gastrointestinal distress.
In patients who are deficient in the B vitamins, no-
tably B 6 and B 12 , there is a danger that SAMe may break
down to form homocysteine, an amino acid that has been
linked to heart disease and stroke. If the patient’s levels
of B vitamins are maintained, however, the body will be
able to convert the homocysteine back into methionine
and glutathione, and the use of SAMe will not increase
the risk of heart disease.
Interactions
Ademetionine should not be used in conjunction
with prescription medications for depression, as it in-
creases their effects. It should also not be taken with
MAO inhibitors, as it may produce a toxic reaction. Last-
ly, it should not be given to pregnant or lactating women.
Resources
PERIODICALS
Fournier, Isabelle, et al. “Folate Deficiency Alters Melatonin
Secretion in Rats.’’ The Journal of Nutrition (September
2002): 2781.
22
KEY TERMS
Analgesic — Any remedy that relieves pain.
Fibromyalgia — Chronic muscular or nerve pain
that has no obvious cause.
Free radicals — Unstable molecules resulting from
oxidation that cause damage to human tissue, in-
cluding signs of aging.
Glutathione — A water-soluble peptide composed
of cysteine, glycine, and glutamic acid. It func-
tions as an antioxidant. The body uses ademetion-
ine to form glutathione.
Myelopathy — Any disease of the spinal cord or
bone marrow.
Peripheral neuropathy — Damage to the nerve
endings of the hands and feet, often as a result of
diabetes.
Transcutaneous electrical nerve stimulation
(TENS)— A treatment for chronic pain that in-
volves the use of a self-operated portable device.
The device sends electrical impulses through elec-
trodes placed over the painful area.
ORGANIZATIONS
American Holistic Medicine Association. http://www.holistic
medicine.org/index.html.
The Linus Pauling Institute, http://osu.orst.edu/dept/lpi/
resagenda/timeline.html.
Patricia Skinner
Teresa G. Odle
ADHD see Attention-deficit hyperactivity
disorder
Adie's pupil
Definition
Adie’s pupil is a neurological condition of unknown
origin with an unusual, asymmetric presentation known
as anisocoria, an inequality in the size of the pupils of
the eyes. It is believed to be a result of damage to the
nerve innervating a muscle of the eye known as the cil-
iary body. Alternately, the problem may be located at the
ciliary ganglion, a kind of nerve junction structure from
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
which the nerve to the ciliary body runs. Accommoda-
tion, or the adjustment of the eye for distance, is affect-
ed, as well as pupillary dilation and contraction, the abil-
ity of the eye’s iris to open or close in response to ambi-
ent light. Adie’s pupil primarily affects women from 20
to 40 years of age. It is considered to be a benign condi-
tion with no known cure. When Deep Tendon Reflexes
(DTRs) of the legs — knee and ankle jerks — are also af-
fected, accompanied by symptoms including localized,
discreet areas of the skin that do not sweat, postural hy-
potension (low blood pressure related to sudden standing
or rising), and unsteady heart rhythms, the condition is
referred to as Adie’s syndrome.
Description
The eyes are a complex anatomical and neurological
unit. The outer surface of each eye is protected by a
cornea — a normally clear cover that initiates the bending
of light rays into the eye. Beneath the cornea lies the col-
orful iris, a membrane containing two muscles capable of
contracting and dilating like the diaphragm of a camera
as it floats in the “aqueous humor.” Beneath the iris, the
lens, under the influence of the ciliary body, further bends
and directs the incoming light back to the retina, where it
is received and transferred through the optic nerve at the
back of the eye to the visual center of the brain (the visual
cortex) at the back of the head. From the visual cortex, in-
struction based on whether the object of vision is near or
far, and whether the surrounding light is bright or dim,
goes back to the muscles of the eye — the ciliary body —
through the ciliary ganglion, and results in a re-shaping
of the lens (accommodation) and an opening or closing of
the pupil (pupillary reaction), as needed, in order to focus
more sharply. Under normal circumstances, brightness
and accommodation for near vision will result in contrac-
ture of the ciliary body and the pupil, whereas darkness
and accommodation for distance normally results in a re-
laxation of the ciliary body and dilation of the pupil. For
a person with Adie’s pupil, however, nerve signals arriv-
ing at the ciliary body of one eye are weaker than to the
other eye, believed to be a result of damage to or degener-
ation of the ciliary ganglion or the ciliary body. The af-
fected eye muscle is unable to contract, dilate, or focus
with the same strength and speed as the unaffected eye.
Relative to the opposite, unaffected eye, in normal day-
light the pupil of the affected eye will be larger whereas,
in a quickly darkened room, the affected eye will be
smaller. Furthermore, the nerve from the ciliary ganglion
to the ciliary body has 30 fibers dedicated to changing the
shape of the lens and only one fiber dedicated to dilating
the iris. As a result, a person with Adie’s pupil is even less
able to dilate their pupil than to focus. Some research
suggests that as the person ages, the ability to dilate grad-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
ually lessens to the point that the eye may have a smaller
(constricted) pupil almost all the time.
The list of other names by which Adie’s Pupil is
known includes: Adie’s Tonic Pupil; Tonic Pupil Syn-
drome; Holmes-Adie Syndrome and Adie-FIolmes Syn-
drome; Psuedotabes, Papillotonic Psuedotabes, and
Psuedotabes pupillotonica; Kehrer-Adie Syndrome;
Markus’ Syndrome; Weill’s Syndrome, Weill-Reys Syn-
drome, and Weill-Reys-Adie Syndrome; Psuedo- Argyll
Robertson Pupil, Psuedo-Argyll Robertson Syndrome,
and Nonluetic Argyll-Robertson Pupil; Myotonic Pupil
and Myotonic Pupillary Reaction; Saenger’s Syndrome;
and. Constitutional areflexy-tridoplegia interna. These
many names derive from the lengthy history of study of
this condition, beginning in 1813, when James Ware, a
London ophthalmologist, or medical doctor specializing
in the eyes, described some of these symptoms. Dr. Adie
added to an already long list of doctors who had studied
it, when in 1931 he described the condition as self-gen-
erating. It was first referred to as Adie’s syndrome in
1934 by the French neurologist, Jean-Alexandre Barre.
Causes & symptoms
Some external causes such as trauma or surgery to the
eye, and some internal causes such as an unknown virus,
an inflammatory condition, or a familial tendency have
been suggested. In the case of trauma or surgery, it is be-
lieved that the damaged or cut nerve fails to regrow with all
fibers running in the same direction for proper reattach-
ment to the ciliary body. The propensity to affect women
between 20 and 40 years of age more than men of all ages
promoted one doctor to speculate that it may be, or related
to, an autoimmune disorder, especially when the individual
lives a stressful lifestyle and other related family members
have suffered neurological diseases or disorders. Caffeine,
a high sugar diet, or an imbalance in essential fatty acids
that are important in maintaining nerve health may also be
factors, but no studies have been identified supporting this
hypothesis. Occasionally similar symptoms are seen in
syphilitic persons; however, one source notes that as early
as 1914, syphilis was ruled out as the cause of this condi-
tion. This unusual pupillary reflex, also known as “tonic
pupil,” because it is slow to change, may also be associated
with diabetes, alcoholism, a herpes viral infection, or a
cranial arterial condition known as giant cell arteritis.
Symptoms, in addition to the slow-to-respond, differently
sized pupil of the affected eye, may include headache, as a
result of the strain on the vision, a sensitivity to bright
lights, and loss of some reflexes, especially the knee-jerk.
Diagnosis
Diagnosis is made on the basis of a thorough history
and physical examination, followed by tests to rule out
23
Adie's pupil
Adie's pupil
other suspected causes according to the persons history.
An examination of the eye using a “slit lamp” — an in-
tensely bright lamp shielded by a shade with a slit it it —
reveals undulating, irregular, worm-like movements with
a segmented or ratcheted appearance in the iris of the af-
fected eye, uncoupled to movements in the iris of the un-
affected eye. A positive (hypersensitive) reaction to pilo-
carpine drops, an alkaloid substance from the jaborandi
tree that causes the otherwise slow-to-constrict pupil to
constrict intensely, is considered diagnostically additive.
Treatment
No specific treatments were noted; however, treat-
ments that strengthen or protect the nervous system
might be helpful, treatments such as the B complex of
vitamins, antioxidants including Vitamins C and E,
alpha lipoic acid, and Superoxidedismutase (S.O.D.),
and dietary modifications of fat that have been found
helpful in multiple sclerosis, another condition due to
damage to nerve pathways affecting nerve transmission,
including intake of essential fatty acids and reduced in-
take of trans-fatty acids and hydrogenated fats. Dietary
reductions in caffeine and sugar, including sugar substi-
tutes like aspartame, may be helpful. Lifestyle practices
that reduce stress and tone the parasympathetic nervous
system, such as yoga or massage, may be helpful.
Allopathic treatment
No specific treatments were noted, however cosmet-
ic use of dilute pilocarpine drops to constrict the tonic
pupil was suggested.
Prognosis
Partial recovery of function is more likely if the initi-
ating damage was to the ciliary body rather than to the
ciliary ganglion. As a result of the number of fibers dedi-
cated to each from the ciliary ganglion, recovery of inner-
vation to the lens controlling function is more likely than
recovery of the pupillary reactive function. One source
noted also that reinnervation may be slow, segmental and
irregular, similar to the ocular symptoms themselves.
Prevention
No preventative measures were noted.
Resources
BOOKS
Bates, Barbara. A Pocket Guide to Physical Examination and
History Taking. Philadelphia: Lippincott, 1991.
Mareib, Elaine N. Essentials of Human Anatomy and Physiolo-
gy. 3rd ed. Benjamin/Cummings, 1991. pp. 219
24
KEY TERMS
Accommodation — The adjustment made through
a change in shape of the lens allowing for vision
of objects near and far.
Aqueous humor — A clear fluid in the posterior
and anterior chambers of the eye that moves from
back to front and exits the eye through a small
canal into the venous system.
Knee and ankle jerk reflexes — Normal reflexes
elicited usually by testing with a reflex hammer
and demonstrating, by being present, a healthy
and intact nervous system.
Pupillary reaction — The normal change in the size
of the pupil due to the amount of ambient light.
Under normal circumstances, both pupils respond
simultaneously and equally.
Tonic pupil — A pupil that is slow to change.
Pavan-Langston, Deborah. Manual of Ocular Diagnosis &
Therapy, 4th ed. Little, Brown & Co., 1995, pp. 336.
Simon, Roger P., Michael J. Arnihoff, and David A. Greenberg.
Clinical Neurology, 4th ed. Stamford: Appleton & Lange,
1999, pp. 145.
Tasman, M.D., William. Duane’ s Clinical Ophthalmology.
2.15. Philadelphia: Lippincott, 1992. pp. 12.
Vander, M.D., Arthur J., James H. Sherman, Ph.D., and
Dorothy S. Luciano, Ph.D. Human Physiology, Mechanics
of Body Function, 5th ed. McGraw Hill, 1990, pp. 310.
Vaughn, Daniel, Taylor Asbury, and Paul Riordan-Eva. General
Ophthalmology, 15th ed. Stamford: Appleton & Lange,
1999, pp. 267.
OTHER
Enersen, Ole Daniel. Adie’s syndrome. 1994-2001. [cited May
12, 2004], <http://www.whonamedit.com/synd.cfm/1837.
html>.
Genetic Information and Patient Services, Inc. (GAPS) “The
Gaps Index.” Adie Syndrome, [cited May 12, 2004].
<http://www.icomm.ca/geneinfo/adie.htm>.
World & Medicine — Ophthalmology. Encyclopaedia of Oph-
thalmology — Greatest Links’ Collection. “Adie's syn-
drome." In Principles of Neurology, 6th ed., p.279. [cited
May 12, 2004]. <http://wmed.narod.ru/w_ophth/diseases/
o_mot il/om_06 ,htm> .
Katherine E. Nelson, N.D.
African medicine see Traditional African
medicine
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
African pygeum
Description
African pygeum (Primus africana), also known as
pygeum africanum, pygeum, and African plum tree, is an
evergreen tree native to higher elevations of southern
Africa. A 150 ft (46 m) tall member of the Rose family
(Rosacea), pygeum has been found to be useful in treat-
ing prostate problems, particularly benign prostatic hy-
pertrophy (BPH), a condition affecting many men.
The tree’s bark contains an oil with many active in-
gredients; waxes, fatty acids, and other less familiar
compounds. Pygeum’s principal biological activity is
traced to a “phytosterol” compound known as beta-sitos-
terol. Phyto (plant) sterols are structurally similar to, but
much less efficiently absorbed from the diet than, cho-
lesterol. The biological strength of phytosterols, howev-
er, is similar to that of hormones; therefore, a very small
amount seems sufficient to initiate a response. Pygeum’s
phytosterols are anti-inflammatory. Pygeum also reduces
edema (the swelling caused by an excess of fluids), re-
duces levels of the hormone prolactin, lowers and in-
hibits cholesterol activity within the prostate. Prolactin,
whose levels are increased by drinking beer, stimulates
testosterone uptake by the prostate, reportedly increasing
levels of a metabolite responsible for prostatic cell in-
creases, dihydrotestosterone (di-hydro-testosterone),
(DHT). Cholesterol is reported to increase the influence
of DHT. BPH imlies two prostate changes: increased
size and increase tissue density. These changes cause
symptoms of frequent urge to urinate small volumes, re-
duced prostatic secretions, reduced bladder emptying.
Incomplete bladder emptying increases risk of bladder
infections, edema and inflammation, and possibly, pro-
static cancer. Blood sugar levels and immune function
have also been found to improve.
In summary, african pygeum’s medicinal actions in-
clude:
• anti-inflamation
• reducing edema of the prostate
• inhibit cellular increase
• improving the natural flow of prostatic secretions
• lowering cholesterol
• regulating insulin activity, thereby affecting blood
sugar levels
• regulating the immune system
Although pygeum’s use is relatively new to the
United States, it has been imported from Africa to Eu-
rope since the 1700s, and is still used today as a major
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
treatment for BPH. Europeans learned of this plant’s
usefulness in treating what was then known as “old
man’s disease”. It continues to be a widely popular in
Europe as a remedy for BPH, especially in France where
the use of African pygeum for BPH is reported to be 'ns
about 80%. |
General use
Pygeum is Primarily used to treat benign prostatic
hypertrophy or BPH, a condition which affects men as
early as their 40s, but increasingly with age: 30% of fifty
year olds; 50% of sixty year olds; and nearly 80% of
men 70 and older. It has been found to be of use in the
related condition of chronic prostatitis, with and without
prostate related sexual dysfunction, and infertility due
to reduced prostatic secretions. Due to actions as an im-
mune system “up regulator” and anti-inflammatory,
pygeum is also being studied for use with other treat-
ments for hepatitis C and HIV.
According to one source, in a double blind placebo
controlled study involving 263 men on a dose of 1 00 mg
per day of African pygeum extract for 60 days, the fol-
lowing improvements versus controls were observed:
•31% decrease in “nocturia,” or night-time frequency
• 24.5% decrease in “residual urine,” the amount of urine
left in the bladder after urination
• 50% increase in overall relief and feeling of wellbeing.
Two-thirds of the group using Pygeum reported
feeling satisfaction. This was twice the improvement re-
ported by the control group on placebo.
In a study on chronic prostatitis, 60% of men with
urinary tract infections and nearly 80% of men without
infections reported improvements using 100 mg of
Pygeum extract for five to seven weeks. In the treatment
of sexual dysfunction due to chronic prostatitis, a dose of
200 mg for 60 days, with or without an antibiotic, pro-
duced improvements in urination and sexual function.
The few small and relatively short clinical trials of
pygeum in the treatment of Hepatitis C and HIV+ infec-
tions have been statistically significant; further trials are
under way in South Africa.
Preparations
Since the 1960s, in Europe, the most commonly used
form is the standardized herbal extract. The process is
highly technical and, for Pygeum, is designed to target
extraction of the active oils using a sequence of laborato-
ry extraction procedures. Standardization is the process
whereby the targeted active ingredients are quantified and
25
• 17.2% increase in urine flow
African
African pygeum
concentrated to a consistent therapeutic dose. The widely
modern use of the extract form of African pygeum in-
stead of the whole plant may derive from the discovery
that the plant’s activity is primarily due to its alcohol sol-
uble phytosterols. A month’s supply in capsules at a daily
dosage of 100 mg, standardized to contain approximately
14% of the active beta-sitosterol ingredient, costs be-
tween $40 and $50. In some preparations, synergistic in-
gredients such as amino acids, other herbs, and vitamins
or minerals, may be included. Studies cited used dosages
of 100 mg daily; however, one study compared and found
two dosages of 50 mg versus one dose of 100 mg per day
had the same therapeutic effect.
Precautions
Precautions noted include recommendations to seek
the guidance of a healthcare professional, and not to self
treat. Pygeum may cause a hormonal shift, and is not rec-
ommended for children. Also noted: pygeum may require
several weeks to months to make a noticeable difference;
studies noted reported benefits at ranges of five to eight
weeks. One source reported pygeum relieves symptoms
but does not reduce prostatic size. Another study specifi-
cally stated that the active components of pygeum have
symptom reversal and prevention characteristics.
Side effects
Pygeum appears to be relatively safe and non-toxic.
One report noted rare occurrences of diarrhea, dizziness,
disturbed vision, gastric pain and constipation. One
study reported satisfactory safety profiles after 12 months
of using 100 mg daily in 174 subjects. In animal studies it
was reported that dogs and rats given amounts equivalent
to more than 500 times the therapeutic dose showed no
adverse effects, and amounts equivalent to 50 times the
therapeutic dose had no effect on fertility. In vivo and in
vitro studies showed no carcinogenic effects. In fact,
pygeum ’s constituents have been found to be anti-carcino-
genic. The National Institute of Health (NIH), in 2002, es-
tablished a grant for a randomized controlled clinical
study involving 3,100 men, in order to learn more about
the medical potential of this alternative therapy, due to in-
creased BPH diagnoses as the population ages.
Interactions
Synergistic supplements may facilitate benefits. One
report advised dietary adjustments to enhance beneficial
result. Dietary recommendations to improve prostatic
health included avoiding the irritants of coffee and to-
bacco; eating pumpkin seeds for their zinc and Omega 3
anti-inflammatory content; increasing other dietary
26
KEY TERMS
Benign prostatic hypertrophy (BPH) — A condition
in many men affecting the prostate, wherein in-
creased number and size of cells produces many
urinary related symptoms.
Beta-sitosterol — A plant lipid with considerable
biological activity; even in very amounts it is
found to be anti-inflammatory and to have posi-
tive effects in treating BPH.
Dihydrotestosterone (DHT) — A testosterone
metabolite implicated in the increase in size and
number of prostatic cells.
Double blind placebo controlled study — A study
in which neither the patient nor the drug adminis-
trator knows who is receiving the trial drug and
who the placebo.
Metabolite — A by product of the physical and
chemical change process known as metabolism.
Prolactin — A hormone found in lactating women,
and in men. Levels are increased by drinking beer.
Prostatic secretions — Normal secretions of the
prostate gland intended to nourish and protect
sperm, improving fertility.
Standardized herbal extract — An herbal product
created by using water or alcohol to dissolve and
concentrate the active ingredients, which are then
quantified for medicinal pharmacological effect.
Synergistic — Describes an association which im-
proves the effectiveness of members of the associ-
ation.
Testosterone — The primary male reproductive
hormone. Uptake into prostatic tissues is stimulat-
ed by prolactin; its DHT metabolite stimulates
prostatic cell increases.
sources of Omega 3s, including the cold water fishes
salmon, sardines, and mackerel; taking antioxidants and
a good multiple vitamin; and the synergistic herb saw
palmetto ( Serenoa repens ), said to be more effective
than the pharmaceutical for BPH, Proscar, at inhibiting
the conversion of testosterone to its metabolite DHT, im-
plicated in prostatic cell increases. Vitamins E (400 IU)
and B 6 (50-100mg) were suggested to synergistically re-
duce prolactin levels. It was also noted that 200 meg of
selenium daily reduce the risk of prostate cancer.
No unfavorable interactions were noted. Common
sense might suggest that any lifestyle habit that aggra-
vates prostate health, for example, a high cholesterol,
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
high fat, high red meat, low fiber diet, frequent and high
intake of beer, and lack of exercise may decrease the ef-
fectiveness of pygeum or other medications indicated for
prostate health. Because pygeum has been found to up-
regulate immunity, its use may be contra-indicated
where immune system upregulation is undesirable. No
unfavorable herb-drug interactions have been noted.
Resources
BOOKS
Chevallier, Andrew. The Encyclopedia of Medicinal Plants.
D.K. Publishing. 1996.
PERIODICALS
Miller, N.D., Alan L. “Benign Prostatic Hyperplasia, Nutrition-
al and Botanical Therapeutic Options." Alternative Medi-
cine Review 1.1. (2001).
Patrick, N.D., Lyn. “Hepatits C: Epidemiology and Review of
Complementary/ Alternative Medicine Treatments.” Alter-
native Medicine Review. (2001).
OTHER
Brown, Don. "The Male Dilemma: Relief For Prostate Prob-
lems.” Total Health 12 June 1990. [cited May 7, 2004].
<http://galenet.galegroup.com/servlet/HWRC> Record#
A8994271>.
Iyker, Robert. “Men’s Health: Straight Talk On Your Health
and Life.” Natural Health April 1999. <http://www.find
articles.com>.
"The National Institutes of Health is Proceeding on a Study to
Determine if the Dietary Supplement Ingredients. . .Saw
Palmetto and Pygeum.” Food Chemical News 43.52. Feb-
ruary 11, 2002. [cited May 7, 2004]. <http://galenet.
galegroup.com/servlet/HWRC>.
"Pygeum africanum ( Primus Africana) (African plum tree).” Al-
ternative Medicine Review 7.1. February 2002. [cited May
7, 2004], <http://galenet.galegroup.com/servlet/HWRC>.
Katy Nelson, N.D.
Agastache
Description
Agastache is a genus of plants found almost world-
wide. Different species are used in several native cul-
tures for healing. The best know of these is Agastache
rugosa, also called the giant hyssop, wrinkled giant hys-
sop, Korean mint, or in Chinese Huo xiang.
Agastache rugosa is a perennial or biennial plant that
grows to a height of 4 ft (1.2 m). It is native to China, but
has spread to Japan, Korea, Laos, and Russia. It grows
wild on sunny hillsides and along roads, but also can be
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
cultivated in backyard gardens. The highly aromatic
leaves and purple or red flowers are used for healing.
Several other species of agastache found in other
parts of the world are used in healing. These include A.
nepetoides (yellow giant hyssop ), A. foeniculum (anise
hyssop), and A. mexicana. Leaf and flower color vary
considerably among the different species. Many species
of agastache also are grown commercially in the United
States for landscaping. In southern China and Taiwan,
Pogostemon cahlin , a relative of Pogostemon patchouli ,
the Indian plant that produces patchouli oil, is used inter-
changeably with A. rugosa.
General use
A. rugosa is used extensively in Chinese herbalism.
It’s first recorded use dates from about 500 a.d. It is asso-
ciated with the lungs, spleen, and stomach and is classi-
fied as having a warm nature and an acrid and aromatic
taste. Traditionally, agastache has been associated the
treatment of several different sets of symptoms. It has
long been used to treat stomach flu, stomachache, nau-
sea, vomiting, diarrhea, abdominal bloating, and ab-
dominal pain. It is combined with Scutellaria (skullcap)
to treat morning sickness in pregnant women. It is also a
component of formulas that improve digestive balance by
aiding the absorption of nutrients and intestinal function.
In Chinese herbalism, A. rugosa is also used to treat
summer flu or summer colds with accompanying low
fever, feelings of fullness in the chest, and headache. It
is also used to treat dark urine and a feeling of heaviness
in the arms and legs. A lotion containing A. rugosa is ap-
plied externally to treat fungal infections.
Other cultures independently have discovered simi-
lar uses for other species of agastache. A. mexicana is
grown in Mexico and used to treat gastrointestinal up-
sets, nervous, and cardiovascular ailments. The leaves of
A. nepetoides are used by Native Americans to treat skin
rashes caused by poison ivy. A. foeniculum leaves have a
strong licorice taste (accounting for its English name,
anise hyssop). These leaves can be brewed in a tea to
treat coughs, fever, and colds.
Although rigorous scientific testing of the healing
claims made for agastache is scarce, one 1999 study
done at Seoul National University in Korea has shown
that in test tube experiments an extract of the root of A.
rugosa significantly inhibited the action of certain pro-
teins associated with the reproduction of the HIV virus.
Preparations
Agastache can be prepared alone as a tea, incorpo-
rated into a lotion, or prepared as a pill. The leaves are
27
Agastache
Aging
KEY TERMS
Biennial — Biennial plants take two years to com-
plete their life cycle and produce fruit and flowers
only in the second year.
Qi — Qi is the Chinese term for the vital life force
that permeates the body. According to traditional
Chinese medicine, qi collects in channels in the
body and can be moved and redirected through
treatments and therapies.
strongly aromatic, but lose this quality with prolonged
boiling (over 15 minutes). Therefore agastache is added
last in formulas that must be boiled.
The best know formulas using agastache are agas-
tache formula and Huo Xiang Zheng Qi Wan, or agas-
tache qi-correcting formula. Agastache formula is used
to harmonize the stomach. It is given as treatment for
gastrointestinal upsets with chills, fever, and diarrhea.
Huo Xiang Zheng Qi Wan regulates qi and treats
seasonal gastric disorders, especially those occurring
during hot, humid weather. This formula is commercial-
ly available in both tablet and liquid form. Other cultures
prepare agastache either as a tea to be drunk, or use the
leaves externally.
Precautions
Agastache has a long history of use with no substan-
tial reported problems.
Side effects
No side effects have been reported with the use of
agastache.
Interactions
Agastache is often used in conjunction with other
herbs with no reported interactions. Since agastache has
been used almost exclusively in Chinese medicine, there
are no studies of its interactions with Western pharma-
ceuticals.
Resources
BOOKS
Chevallier, Andrew. Encyclopedia of Medicinal Plants. Boston:
DK Publishers, 1996.
Molony, David. Complete Guide to Chinese Herbal Medicine.
New York: Berkeley Books, 1998.
28
Zhu, Chun-Han. Clinical Handbook of Chinese Prepared Med-
icines. Brookline, MA: Paradigm Publications, 1989.
ORGANIZATIONS
American Association of Oriental Medicine (AAOM). 433
Front Street, Catasauqua, PA 18032. (610) 266-2433
Tish Davidson
Aging
Definition
Starting at what is commonly called middle age, op-
erations of the human body become more vulnerable to
daily wear and tear. There is a general decline in physical,
and possibly mental, functioning. In the Western coun-
tries, the length of life often extends into the 70s. Howev-
er, the upward limit of the life span can be as high as 120
years. During the latter half of life, an individual is more
prone to problems with the various functions of the body,
and to a number of chronic or fatal diseases. The cardio-
vascular, digestive, excretory, nervous, reproductive, and
urinary systems are particularly affected. The most com-
mon diseases of aging include Alzheimer’s, arthritis, can-
cer, diabetes, depression, and heart disease.
Description
Human beings reach a peak of growth and develop-
ment during their mid 20s. Aging is the normal transition
time after that flurry of activity. Although there are quite
a few age-related changes that tax the body, disability is
not necessarily a part of aging. Health and lifestyle fac-
tors, together with the genetic makeup of the individual,
determine the response to these changes. Body functions
that are most often affected by age include:
• Hearing, which declines especially in relation to the
highest pitched tones.
• The proportion of fat to muscle, which may increase by
as much as 30%. Typically, the total padding of body
fat directly under the skin thins out and accumulates
around the stomach. The ability to excrete fats is im-
paired, and therefore the storage of fats increases, in-
cluding cholesterol and fat-soluble nutrients.
• The amount of water in the body, which decreases, re-
ducing the body’s ability to absorb water-soluble nutri-
ents. Also, there is less saliva and other lubricating fluids.
• Liver and kidney activities, which become less effi-
cient, thus affecting the elimination of wastes.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Average annual growth rate (in percent) of the elderly population: 1910-30 to 2030-50. (Graph by Dana Hansen.)
• The ease of digestion, which is decreased, resulting in a
reduction in stomach acid production.
• Muscle strength and coordination, which lessens, with
an accompanying loss of mobility, agility, and flexibility.
• Sexual hormones and sexual function, which both de-
cline.
• Sensations of taste and smell, which decrease.
• Cardiovascular and respiratory systems, with changes
leading to decreased oxygen and nutrients throughout
the body.
• Nervous system, which experiences changes that result
in less efficient nerve impulse transmission, reflexes that
are not as sharp, and diminished memory and learning.
• Bone strength and density, which decrease.
• Hormone levels, which gradually decline. The thyroid
and sexual hormones are particularly affected.
• Visual abilities, which decline. Age-related changes
may lead to diseases such as macular degeneration.
• A compromised ability to produce vitamin D from
sunlight.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• Protein formation, which is reduced, leading to shrink-
age in muscle mass and decreased bone formation, pos-
sibly contributing to osteoporosis.
Causes & symptoms
There are several theories on why the aging body
loses functioning. It may be that several factors work to-
gether or that one particular factor is the culprit in a
given individual. These theories include:
• Programmed senescence, or aging clock, theory. The
aging of the cells for each individual is programmed
into the genes, and there is a preset number of possible
rejuvenations in the life of a given cell. When cells die
at a rate faster than they are replaced, organs do not
function properly, and they become unable to maintain
the functions necessary for life.
• Genetic theory. Human cells maintain their own seed of
destruction at the chromosome level.
• Connective tissue, or cross-linking theory. Changes in
the makeup of the connective tissue alter the stability of
body structures, causing a loss of elasticity and func-
tioning, and leading to symptoms of aging.
29
Aging
Aging
• Free -radical theory. The most commonly held theory of
aging, is based on the fact that ongoing chemical reac-
tions of the cells produce free radicals. In the presence
of oxygen, these free radicals cause the cells of the
body to break down. As time goes on, more cells die or
lose the ability to function, and the body ceases to
function as a whole.
• Immunological theory. There are changes in the im-
mune system as it begins to wear out, and the body is
more prone to infections and tissue damage, which
may ultimately cause death. Also, as the system breaks
down, the body is more apt to have autoimmune reac-
tions, in which the body’s own cells are mistaken for
foreign material and are destroyed or damaged by the
immune system.
Diagnosis
Many problems can arise due to age-related changes
in the body. Although there is no individual test to mea-
sure these changes, a thorough physical exam and a
basic blood screening and blood chemistry panel can
point to areas in need of further attention. When older
people become ill, the first signs of disease are often
nonspecific. Further exams should be conducted if any
of the following occur:
• diminished, or lack of, desire for food
• increased confusion
• failure to thrive
• urinary incontinence
• dizziness
• weight loss
• falling
Treatment
Nutritional supplements
Consumption of a high-quality multivitamin is rec-
ommended. Common nutritional deficiencies connected
with aging include B vitamins, vitamin A and vitamin
C, folic acid, calcium, magnesium, zinc, iron, chromi-
um, and trace minerals. Since stomach acids may be de-
creased, powdered multivitamin formula in gelatin cap-
sules are suggested, as this form is the easiest to digest.
Such formulas may also contain enzymes for further
help with digestion.
Antioxidants can help neutralize damage caused by
free radical actions, which are thought to contribute to
problems of aging. They are also helpful in preventing
and treating cancer, and in treating cataracts and glau-
coma. Supplements that serve as antioxidants include:
30
•Vitamin E, 400-1,000 IUs daily. Protects cell mem-
branes against damage. It shows promise in preventing
heart disease, and Alzheimer’s and Parkinson’s diseases.
• Selenium, 50 mg taken twice daily. Research suggests
that selenium may play a role in reducing cancer risk.
• Beta-carotene, 25,000-40,000 IUs daily. May help in
treating cancer, colds and flu, arthritis, and immune
support.
• Vitamin C, 1,000-2,000 mg per day. It may cause diar-
rhea in large doses. The dosage should be decreased if
this occurs.
Other supplements that are helpful in treating age-
related problems include:
• B l2 /B-complex vitamins. Studies show that B 12 may
help reduce mental symptoms, such as confusion,
memory loss, and depression.
• Coenzyme Q 10 may be helpful in treating heart disease.
Up to 75% of cardiac patients have been found to lack
this heart enzyme.
Hormones
The following hormone supplements may be taken
to prevent or treat various age-related problems. Howev-
er, caution should be taken before beginning treatment,
and the patient should consult his or her health care pro-
fessional prior to hormone use.
DHEA improves brain functioning and serves as a
building block for many other important hormones. It
may be helpful in restoring hormone levels that have de-
clined, building muscle mass, strengthening bones, and
maintaining a healthy heart.
Melatonin may be helpful for insomnia. It has also
been used to help fight viruses and bacterial infections,
reduce the risk of heart disease, improve sexual function,
and to protect against cancer.
Human growth hormone (hGH) has been shown to
regulate blood sugar levels and to stimulate bone, carti-
lage, and muscle growth while reducing fat.
Herbs
Garlic ( Allium sativa ) is helpful in preventing heart
disease, and improving the tone and texture of skin. Gar-
lic stimulates liver and digestive system functions, and
also helps manage heart disease and high blood pressure.
Siberian ginseng ( Eleutherococcus senticosus) sup-
ports the adrenal glands and immune functions. It is be-
lieved to be helpful in treating problems related to stress.
Siberian ginseng also increases mental and physical per-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
formance, and may be useful in treating memory loss,
chronic fatigue, and immune dysfunction.
Ginkgo biloba works particularly well on the brain
and nervous system, it is effective in reducing the symp-
toms of such conditions as Alzheimer’s disease, depres-
sion, visual disorders, and problems of blood circulation.
It may also help treat heart disease, strokes, dementia,
Raynaud’s disease, head injuries, leg cramps, macular
degeneration, tinnitus, impotence due to poor blood
flow, and diabetes-related nerve damage.
Proanthocyanidins, or PCO, (brand name Pycnogenol),
are derived from grape seeds and skin, as well as pine tree
bark. They may help prevent cancer and poor vision.
Green tea has powerful antioxidant qualities, and
has been used for centuries as a natural medicine in
China, Japan, and other Asian cultures. In alternative
medicine, it aids in treating cancer, rheumatoid arthri-
tis, high cholesterol, heart disease, infection, and im-
paired immune function. Several scientific studies have
shown that antioxidant benefits are obtained by drinking
two cups of green tea each day.
In Ayurvedic medicine, aging is described as a
process of increased vata, in which there is a tendency to
become thinner, drier, more nervous, more restless, and
more fearful, while experiencing declines in both sleep
and appetite. Bananas, almonds, avocados, and coconuts
are some of the foods used in correcting such conditions.
One of the main herbs used to treat these problems is
gotu kola ( Centella asiatica). It is taken to revitalize the
nervous system and brain cells, and to fortify the im-
mune system. Gotu kola is also used to treat memory
loss, anxiety, and insomnia.
In Chinese medicine, most symptoms of aging are
regarded as signs of a yin deficiency. Moistening foods
are recommended, and include barley soup, tofu, mung
beans, wheat germ, spirulina, potatoes, black sesame
seeds, walnuts, and flax seeds. Jing tonics may also be
used. These include deer antler, dodder seeds, processed
rehmannia, longevity soup, mussels, and chicken.
Allopathic treatment
For the most part, doctors prescribe medications to
control the symptoms and diseases of aging. In the Unit-
ed States, about two-thirds of people age 65 and over
take medications for various conditions. More women
than men use these medications. The most common
drugs used by the elderly are painkillers, diuretics or
water pills, sedatives, cardiac medications, antibiotics,
and mental health remedies.
Estrogen replacement therapy (ERT) is commonly
prescribed to alleviate the symptoms of aging in post-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
menopausal women. It is often used in conjunction with
progesterone. These drugs help keep bones strong, re-
duce the risk of heart disease, restore vaginal lubrication,
and improve skin elasticity. Evidence suggests that they
may also help maintain mental functions.
Expected results
Aging is unavoidable, but major physical impair-
ment is not. People can lead healthy, disability-free lives
throughout their later years. A well-established support
system of family, friends, and health care providers,
along with a focus on good nutrition and lifestyle
habits, and effective stress management, can prevent dis-
ease and lessen the impact of chronic conditions.
Prevention
Preventive health practices such as healthy diet,
daily exercise, stress management, and control of
lifestyle habits, such as smoking and drinking, can
lengthen the life span and improve the quality of life as
people age. Exercise can improve appetite, bone
health, emotional and mental outlook, digestion, and
circulation.
Drinking plenty of fluids aids in maintaining healthy
skin, good digestion, and proper elimination of wastes.
Up to eight glasses of water should be consumed daily,
along with plenty of herbal teas, diluted fruit and veg-
etable juices, and fresh fruits and vegetables that have a
high water content.
Because of a decrease in the sense of taste, older
people often increase their salt intake, which can con-
tribute to high blood pressure and nutrient loss. Use of
sugar is also increased. Seaweeds and small amounts of
honey can be used as replacements.
Alcohol, nicotine, and caffeine all have potential
damaging effects, and consumption should be limited or
completely eliminated.
A diet high in fiber and low in fat is recommended.
Processed foods should be replaced by such complex
carbohydrates as whole grains. If chewing becomes a
problem, there should be an increased intake of protein
drinks, freshly juiced fruits and vegetables, and
creamed cereals.
Resources
BOOKS
Cox, Harold. Aging. New York, NY: McGraw Hill College Di-
vision, 2004.
Giampapa, Vincent, et al. The Anti-Aging Solution: 5 Simple
Steps to Looking and Feeling Young. Hoboken, NJ: John
Wiley & Sons, 2004.
31
Aging
AIDS
KEY TERMS
Antioxidants — Substances that counteract the
damaging effects of oxidation in the body's tis-
sues.
Alzheimer's disease — A condition causing a de-
cline in brain function that interferes with the abil-
ity to reason and to perform daily activities.
Senescence — Aging.
Vata — One of the three main constitutional types
found under Ayurvedic principles. Keeping one's
particular constitution in balance is considered
important in maintaining health.
Panno, Joseph. Aging: Theories and Potential Therapies New
York, NY: Facts on File. Inc., 2004.
Landis, Robyn, with Karta Purkh Singh Khalsa. Herbal De-
fense: Positioning Yourself to Triumph Over Illness and
Aging New York, NY: Warner Books, 1997.
Weil, Andrew M.D. Healthy Aging New York, NY: Knopf,
2004.
PERIODICALS
“Chemopreventive Effects of Green Tea Said to Delay Aging of
Skin.” Cancer Weekly (April 13, 2004): 10.
“Discovery Claims to Link DNA Test to Reversing Signs of
Aging.” Drug Week (February 27, 2004): 122.
“Fitness Can Improve Thinking Among Aging.” Obesity, Fit-
ness & Wellness Week (March 13, 2004): 16.
“Hormonal Activity Plays Role in Body Composition Changes
with Aging.” Obesity, Fitness & Wellness Week (March 20,
2004): 3.
Lofshult, Diane. “Aging Trends for 2004.” IDEA Health & Fit-
ness Source (March 2004): 14.
“Research Reports on Key Antioxidant to Slow Aging.” Drug
Week (April 2, 2004): 194.
ORGANIZATIONS
The Anti- Aging Institute. 843 William Hilton Parkway. Hilton
Head, SC 29928. (912) 238-3383. <http://www.anti-aging.
org>.
The Rosenthal Center for Complementary and Alternative
Medicine Research in Aging and Women's Health. Co-
lumbia University, College of Physicians and Surgeons,
630 W. 168th St., New York, NY 10032. <http://www.
rosenthal.hs.columbia.edu>.
OTHER
National Institute on Aging Senior Health Web site. <http://
www.nihseniorhealth.gov>.
Patience Paradox
Ken Wells
32
AIDS
Definition
Acquired immune deficiency syndrome (AIDS) is
an infectious disease caused by the human immunodefi-
ciency virus (HIV). It was first recognized in the United
States in 1981. AIDS is the advanced form of infection
with the HIV virus, which may not cause disease for a
long period after the initial exposure (latency). Infection
with HIV weakens the immune system which makes in-
fected people susceptible to infection and cancer.
Description
AIDS is considered one of the most devastating pub-
lic health problems in recent history. In 1996, the Centers
for Disease Control and Prevention (CDC) estimated that
one million persons in the United States were HlV-posi-
tive, and 223,000 are living with AIDS. Of these patients,
44% were gay or bisexual men, 26% are heterosexual in-
travenous drug users, and 18% were women. In addition,
approximately 1 ,000-2,000 children are born each year
with HIV infection. In 2002, the CDC reported 42,136
new AIDS diagnoses in the United States, a 2.2% increase
from the previous year. AIDS cases rose among gay and
bisexual men (7.1% in 25 states that report regularly). The
disease also seems to be rising among older Americans.
From 1990 to 2001, the number of cases in Americans age
50 years or older rose from 16,288 to 90,153.
The World Health Organization (WHO) estimates
that 40 million people worldwide were infected with
AIDS/HIV as of 2001. Most of these cases are in the de-
veloping countries of Asia and Africa. In 2003, WHO
cautioned that if treatment were not delivered soon to
nearly 6 million people with AIDS in developing coun-
tries, there could be 45 million cases by 2010.
Risk factors
AIDS can be transmitted in several ways. The risk
factors for HIV transmission vary according to category:
• Sexual contact. Persons at greatest risk are those who
do not practice safe sex, are not monogamous, partici-
pate in anal intercourse, and have sex with a partner
with symptoms of advanced HIV infection and/or
other sexually transmitted diseases (STDs). In the
United States and Europe, most cases of sexually
transmitted HIV infection have resulted from homo-
sexual contact, whereas in Africa, the disease is
spread primarily through sexual intercourse among
heterosexuals.
• Transmission in pregnancy. High-risk mothers include
women married to bisexual men or men who have an ab-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Because the immune system cells are destroyed by the AIDS virus, many different types of infections and cancers can de-
velop, taking advantage of a person’s weakened immune system. (Illustration by Electronic Illustrators Group. The Gale Group.)
normal blood condition called hemophilia and require
blood transfusions, intravenous drug users, and women
living in neighborhoods with a high rate of HIV infection
among heterosexuals. The chances of transmitting the dis-
ease to the child are higher in women in advanced stages
of the disease. Breast feeding increases the risk of trans-
mission by 10-20% and is not recommended. The use of
zidovudine (AZT) during pregnancy and delivery, howev-
er, can decrease the risk of transmission to the baby.
• Exposure to contaminated blood or blood products.
With the introduction of blood product screening in the
mid-1980s, the incidence of HIV transmission in blood
transfusions has dropped to 1 in 100,000.
• Needle sticks among health care professionals. Present
studies indicate that the risk of HIV transmission by a
needle stick is about 1 in 250. This rate can be de-
creased if the injured worker is given AZT or triple
therapy (HAART), the current standard.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
HIV is not transmitted by handshakes or other casu-
al non-sexual contact, coughing or sneezing, or by
bloodsucking insects such as mosquitoes.
AIDS in women
AIDS in women is a serious public health concern.
Women exposed to HIV infection through heterosexual
contact are the most rapidly growing risk group in the
United States. The percentage of AIDS cases diagnosed
in women has risen from 7% in 1985 to 18% in 1996.
For unknown reasons, women with AIDS do not live as
long as men with AIDS.
AIDS in children
Because AIDS can be transmitted from an infected
mother to her child during pregnancy, during the birth
process, or through breast milk, all infants born to HIV-
33
AIDS
AIDS
Kaposi’s sarcoma an AIDS-related cancer, usually appears
on the lower extremities, as evidenced on this patient’s hip.
(Custom Medical Stock Photo. Reproduced by permission.)
positive mothers are at risk. As of 1997, it was estimated
that 84% of HIV-positive women are of childbearing
age; 41% of them are drug abusers. Between 15-30% of
children born to HIV-positive women will be infected
with the virus.
AIDS is one of the 10 leading causes of death in
children between one and four years of age worldwide.
The interval between exposure to HIV and the develop-
ment of AIDS is shorter in children than in adults. In-
fants infected with HIV have a 20-30% chance of devel-
oping AIDS within a year and dying before age three. In
the remainder, AIDS progresses more slowly; the aver-
age child patient survives to seven years of age. Some
survive into early adolescence.
Causes & symptoms
Because HIV destroys immune system cells, AIDS
is a disease that can affect any of the body’s major organ
systems. HIV attacks the body through three disease
processes: immunodeficiency, autoimmunity, and ner-
vous system dysfunction.
Immunodeficiency describes the condition in which
the body’s immune response is damaged, weakened, or
is not functioning properly. In AIDS, immunodeficiency
results from the way that the virus binds to a protein
called CD4, which is found on certain white blood cells,
including helper T cells, macrophages, and monocytes.
Once HIV attaches to an immune system cell, it can
replicate within the cell and kill the cell. In addition to
killing some lymphocytes directly, the AIDS virus dis-
rupts the functioning of other CD4 cells. Because the im-
mune system cells are destroyed, infections and cancers
that take advantage of a person’s weakened immune sys-
tem (opportunistic) can develop.
34
Autoimmunity is a condition in which the body’s
immune system produces antibodies that work against its
own cells. Antibodies are specific proteins produced in
response to exposure to a specific, usually foreign, pro-
tein or particle called an antigen. In this case, the body
produces antibodies that bind to blood platelets that are
necessary for proper blood clotting and tissue repair.
Once bound, the antibodies mark the platelets for re-
moval from the body, and they are filtered out by the
spleen. Some AIDS patients develop a disorder, called
immune-related thrombocytopenia purpura (ITP), in
which the number of blood platelets drops to abnormally
low levels.
The course of AIDS generally progresses through
three stages, although not all patients will follow this
progression precisely:
Acute retroviral syndrome
Acute retroviral syndrome is a term used to describe
a group of symptoms that can resemble mononucleosis
and that may be the first sign of HIV infection in 50-
70% of all patients and 45-90% of women. The symp-
toms may include fever, fatigue, muscle aches, loss of
appetite, digestive disturbances, weight loss, skin
rashes, headache, and chronically swollen lymph nodes
(lymphadenopathy). Approximately 25-33% of patients
will experience a form of meningitis during this phase,
in which the membranes that cover the brain and spinal
cord become inflamed. Acute retroviral syndrome devel-
ops between one and six weeks after infection and lasts
two to four weeks, sometimes up to six weeks. Blood
tests during this period will indicate the presence of virus
(viremia) and the appearance of the viral p24 antigen in
the blood.
Latency period
After the HIV virus enters a patient’s lymph nodes
during the acute retroviral syndrome stage, the disease
becomes latent for as many as 10 years or more before
symptoms of advanced disease develop. During latency,
the virus continues to replicate in the lymph nodes, where
it may cause one or more of the following conditions.
PERSISTENT GENERALIZED LYMPHADENOPATHY
(PGL). Persistent generalized lymphadenopathy, or PGL,
is a condition in which HIV continues to produce chronic
painless swellings in the lymph nodes during the latency
period. The lymph nodes most frequently affected by PGL
are those in the areas of the neck, jaw, groin, and armpits.
PGL affects between 50-70% of patients during latency.
CONSTITUTIONAL SYMPTOMS. Many patients will
develop low-grade fevers, chronic fatigue, and general
weakness. HIV also may cause a combination of food
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
malabsorption, loss of appetite, and increased metabo-
lism that contribute to the so-called AIDS wasting or
wasting syndrome.
OTHER ORGAN SYSTEMS. At any time during the
course of HIV infection, patients may suffer from a
yeast infection in the mouth called thrush, open sores or
ulcers, or other infections of the mouth; diarrhea and
other gastrointestinal symptoms that cause malnutrition
and weight loss; diseases of the lungs and kidneys; and
degeneration of the nerve fibers in the arms and legs.
HIV infection of the nervous system leads to general loss
of strength, loss of reflexes, and feelings of numbness or
burning sensations in the feet or lower legs.
La t e-stage AIDS
Late-stage AIDS usually is marked by a sharp de-
cline in the number of CD4+ lymphocytes (a type of
white blood cell), followed by a rise in the frequency of
opportunistic infections and cancers. Doctors monitor
the number and proportion of CD4+ lymphocytes in the
patient’s blood in order to assess the progression of the
disease and the effectiveness of different medications.
About 10% of infected individuals never progress to this
overt stage of the disease.
OPPORTUNISTIC INFECTIONS. Once the patient’s
CD4+ lymphocyte count falls below 200 cells/mm 3 , he
or she is at risk for opportunistic infections. The infec-
tious organisms may include:
• Fungi. Fungal infections include a yeast infection of
the mouth (candidiasis or thrush) and cryptococcal
meningitis.
• Protozoa. The most common parasitic disease associat-
ed with AIDS is Pneumocystis carinii pneumonia
(PCP). About 70-80% of AIDS patients will have at
least one episode of PCP prior to death. PCP is the im-
mediate cause of death in 15-20% of AIDS patients. It
is an important measure of a patient’s prognosis. Toxo-
plasmosis is another common infection in AIDS pa-
tients that is caused by a protozoan. Other diseases in
this category include amebiasis and cryptosporidiosis.
• Mycobacteria. AIDS patients may develop tuberculo-
sis or MAC infections. MAC infections are caused by
Mycobacterium avium-intracellulare, and occur in
about 40% of AIDS patients.
• Bacteria. AIDS patients are likely to develop bacterial
infections of the skin and digestive tract.
• Viruses. AIDS patients are highly vulnerable to cy-
tomegalovirus (CMV), herpes simplex virus (HSV),
varicella zoster virus (VZV), and Epstein-Barr virus
(EBV) infections. Another virus, JC virus, causes pro-
gressive destruction of brain tissue in the brain stem,
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
ESTIMATED NUMBER OF ADULTS AND
CHILDREN LIVING WITH AIDS/HIV
WORLDWIDE AS OF 2001
Regions
Estimate
Australia & New Zealand
15,000
Caribbean
420,000
East Asia & Pacific
1,000,000
Eastern Europe & Central Asia
1,000,000
Latin America
1,500,000
North Africa & Middle East
500,000
North America
950,000
South & Southeast Asia
5,600,000
Sub-Saharan African
28,500,000
Western Europe
550,000
Global total
40,000,000+
cerebrum, and cerebellum (multifocal leukoen-
cephalopathy or PML), which is regarded as an AIDS-
defining illness by the Centers for Disease Control and
Prevention.
AIDS DEMENTIA COMPLEX AND NEUROLOGIC COM-
PLICATIONS. AIDS dementia complex is a late complica-
tion of the disease. It is unclear whether it is caused by the
direct effects of the virus on the brain or by intermediate
causes. AIDS dementia complex is marked by loss of rea-
soning ability, loss of memory, inability to concentrate,
apathy and loss of initiative, and unsteadiness or weakness
in walking. Some patients also develop seizures.
MUSCULOSKELETAL COMPLICATIONS. Patients in
late-stage AIDS may develop inflammations of the mus-
cles, particularly in the hip area, and may have arthritis-
like pains in the joints.
ORAL SYMPTOMS. Patients may develop a condition
called hairy leukoplakia of the tongue. This condition
also is regarded by the CDC as an indicator of AIDS.
Hairy leukoplakia is a white area of diseased tissue on
the tongue that may be flat or slightly raised. It is caused
by the Epstein-Barr virus.
AIDS-RELATED CANCERS. Patients with late-stage
AIDS may develop Kaposi’s sarcoma (KS), a skin tumor
that primarily affects homosexual men. KS is the most
common AIDS -related malignancy. It is characterized by
reddish-purple blotches or patches (brownish in African-
Americans) on the skin or in the mouth. About 40% of
35
AIDS
AIDS
patients with KS develop symptoms in the digestive tract
or lungs. KS appears to be caused by a herpes virus.
The second most common form of cancer in AIDS
patients is a tumor of the lymphatic system (lymphoma).
AIDS -related lymphomas often affect the central ner-
vous system and develop very aggressively.
Invasive cancer of the cervix is an important diag-
nostic marker of AIDS in women.
Diagnosis
Because HIV infection produces such a wide range
of symptoms, the CDC has drawn up a list of 34 condi-
tions regarded as defining AIDS. The physician will use
the CDC list to decide whether the patient falls into one
of these three groups:
• definitive diagnoses with or without laboratory evi-
dence of HIV infection
• definitive diagnoses with laboratory evidence of HIV
infection
• presumptive diagnoses with laboratory evidence of
HIV infection
Physical findings
Almost all symptoms of AIDS can occur with other
diseases. The general physical examination may range
from normal findings to symptoms that are closely asso-
ciated with AIDS. These symptoms are hairy leukoplakia
of the tongue and Kaposi’s sarcoma. When the doctor
examines the patient, he or she will look for the overall
pattern of symptoms rather than any one finding.
Laboratory tests for HIV infection
BLOOD TESTS (SEROLOGY). The first blood test for
AIDS was developed in 1985. At present, patients who
are being tested for HIV infection usually are given an
enzyme-linked immunosorbent assay (ELISA) test for
the presence of HIV antibody in their blood. Positive
ELISA results then are tested with a Western blot or im-
munofluorescence (1FA) assay for confirmation. The
combination of the ELISA and Western blot tests is more
than 99.9% accurate in detecting HIV infection within
four to eight weeks following exposure. The polymerase
chain reaction (PCR) test can be used to detect the pres-
ence of viral nucleic acids in the very small number of
HIV patients who have false-negative results on the
ELISA and Western blot tests. In 2003, a one-step test
that was quicker and cheaper was shown effective for de-
tecting HIV in the physician office setting. However, fur-
ther research was ongoing as to its effectiveness in re-
placing current tests as a first check for HIV.
36
OTHER LABORATORY TESTS. In addition to diagnos-
tic blood tests, there are other blood tests that are used to
track the course of AIDS. These include blood counts,
viral load tests, p24 antigen assays, and measurements of
(3 2 -microglobulin ((3 2 M).
Doctors will use a wide variety of tests to diagnose
the presence of opportunistic infections, cancers, or
other disease conditions in AIDS patients. Tissue biop-
sies, samples of cerebrospinal fluid, and sophisticated
imaging techniques, such as magnetic resonance imag-
ing (MRI) and computed tomography scans (CT) are
used to diagnose AIDS-related cancers, some oppor-
tunistic infections, damage to the central nervous sys-
tem, and wasting of the muscles. Urine and stool sam-
ples are used to diagnose infections caused by parasites.
AIDS patients also are given blood tests for syphilis and
other sexually transmitted diseases.
Diagnosis in children
Diagnostic blood testing in children older than 18
months is similar to adult testing, with ELISA screening
confirmed by Western blot. Younger infants can be diag-
nosed by direct culture of the HIV virus, PCR testing,
and p24 antigen testing.
In terms of symptoms, children are less likely than
adults to have an early acute syndrome. They are, how-
ever, likely to have delayed growth, a history of frequent
illness, recurrent ear infections, a low blood cell count,
failure to gain weight, and unexplained fevers. Children
with AIDS are more likely to develop bacterial infec-
tions, inflammation of the lungs, and AIDS-related brain
disorders than are HIV-positive adults.
Treatment
AIDS patients turn to alternative medicine when
conventional treatments are ineffective, and to supple-
ment conventional treatment, reduce disease symptoms,
counteract drug effects, and improve quality of life. Be-
cause alternative medicines may interact with conven-
tional medicines, it is important for the patient to inform
his or her doctor of all treatments being used.
A report released in 2003 showed trends in in-
creased use of alternative medicine among HIV-positive
individuals. Based on 1997 figures, the study reported
that 79% of those seeking alternative therapy to help
with AIDS treatment or symptom relief were men and
63% were women. The types of therapies they used most
were relaxation techniques, massage, chiropractic care,
self-help groups, commercial diets, and acupuncture.
Supplements
• Laurie oils (coconut oil) are used by the body to make
monolaurin, which inactivates HIV.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• Selenium deficiency increases the risk of death due to
AIDS-related illness. One study found that 250 micro-
grams of selenomethionin daily for one year showed no
improvement in CD4 cell counts or disease symptoms.
Greater than 1,000 micrograms daily is toxic.
• Vitamin C has antioxidant and antiretroviral activities.
One study found that treatment caused a trend to de-
crease viral load.
• DHEA (dehydroepiandrosterone) is commonly used by
AIDS patients to counteract wasting. One study found
that DHEA had no effect on lymphocytes or p24 anti-
gen levels. However, a 2002 study found that it was as-
sociated with a significant increase in measures that in-
dicate mental health improvement.
• Vitamin A deficiency is associated with increased mor-
tality. One study of pregnant women with AIDS found
that 5000 IU of vitamin A daily led to stabilized viral
load as compared to a placebo group. Another study
found that 60 mg of vitamin A had no effect on CD4
cells or viral load. Vitamin A has been associated with
faster disease progression. Excessive vitamin A during
pregnancy can cause birth defects.
• Beta-carotene supplementation for AIDS is controver-
sial as studies have shown both beneficial and detri-
mental effects. Beta-carotene supplementation has led
to elevation in white blood cell counts and changes in
the CD4 cell count. Some studies have found that beta-
carotene supplementation led to an increase in deaths
due to cancer and heart disease.
Naturopathic doctors often recommend the follow-
ing supplements for AIDS:
• beta-carotene, 150,000 IU daily
• vitamin C, 2,000 mg thrice daily
• vitamin E, 400 IU twice daily
• cod liver oil, 1 tablespoon daily
• multivitamin, as directed
• coenzyme Q 10 , 50-60 mg twice daily
Herbals and Chinese medicine
One small study of the effectiveness of Chinese
herbal treatment in AIDS showed promise. AIDS pa-
tients took a tablet that contained 31 herbs that was
based on the formulas Enhance and Clear Heat. Disease
symptoms were reduced in the herbal treatment group as
compared to the placebo group.
Herbals used in treating AIDS include:
• Maitake mushroom extract. Recommended dose is 10
drops twice daily
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• Licorice ( Glycyrrhiza glabra ) solid extract. Recom-
mended dose is one quarter to one half teaspoon twice
daily
• Boxwood extract (SPV-30) has antiviral activity. Rec-
ommended dose is one capsule thrice daily.
• Garlic concentrate (Allicin) helped reduce bowel
movements, stabilized or increased body weight, or
cured Cryptosporidium parvum infection in affected
AIDS patients. However, a 2002 National Institutes of
Health study cautioned that garlic supplements could
reduce levels of a protease inhibitor that is used to treat
AIDS patients, so patients should discuss using garlic
supplements with their physicians.
• Tea tree oil ( Malaleuca ) improves or cures infection of
the mouth by the yeast Candida. Tea tree oil is avail-
able as soap, dental floss, toothpick, and mouthwash.
• Marijuana is used to treat wasting. Studies have found
that patients who use marijuana had increased food in-
take and weight gain. The active ingredient delta-9-
tetrahydrocannabinol is licensed for treating AIDS
wasting.
Psychotherapy and stress reduction
Many therapies that are directed at improving men-
tal state can have a direct impact on disease severity and
quality of life. The effectiveness of many have been
proven in clinical studies. These include:
• massage
• laughter/humor
• stress management training
• visualization
• cognitive therapy
• aerobic exercise
• prayer
Other treatments for AIDS include homeopathy,
naturopathy, acupuncture, and chiropractic.
Allopathic treatment
Treatment for AIDS covers four categories:
Antiretroviral treatment
In recent years researchers have developed drugs
that suppress HIV replication. The drugs are used in
combination with one another and fall into four classes:
• Nucleoside reverse transcriptase inhibitors. These drugs
work by interfering with the action of HIV reverse tran-
scriptase, thus ending the virus replication process.
These drugs include zidovudine (sometimes called Zi-
37
AIDS
AIDS
dovudine or AZT, trade name Retrovir), didanosine
(ddi, Videx), emtricitabine (FTC, Emtriva), zalcitabine
(ddC, Hivid), stavudine (d4T, Zerit), abacavir (Ziagen),
tenofovir (df, Viread), and lamivudine (3TC, Epivir).
• Protease inhibitors. Protease inhibitors are effective
against HIV strains that have developed resistance to
nucleoside analogues, and often are used in combina-
tion with them. These compounds include saquinavir
(Fortovase), ritonavir (Norvir), indinavir (Crixivan),
amprenavir (Agenerase), lopinavir plus ritonavir (Rey-
ataz), and nelfinavir (Viracept).
• Non-nucleoside reverse transcriptase inhibitors. This is
a newer class of antiretroviral agents. Three are avail-
able, nevirapine (Viramune), efavirenz (Sustiva), and
delavirdine (Rescript or).
• Fusion inhibitors. These drugs are less common, ex-
pensive and difficult to use. They block infection early
by preventing HIV from fusing with and entering a
human cell. This class includes only one compound:
Enfuvirtide (Fuzeon).
Treatment guidelines for these agents are in constant
change as new medications are developed and intro-
duced. In mid-2003, the U.S. Department of Health and
Human Services revised its guidelines for the use of
these agents to help clinicians better choose the best
combinations. The new guidelines offer a list of suggest-
ed combination regimens classified as either “preferred”
or “alternative”.
Treatment of opportunistic infections
and malignancies
Most AIDS patients require complex long-term
treatment with medications for infectious diseases. This
treatment often is complicated by the development of re-
sistance in the disease organisms. AIDS-related malig-
nancies in the central nervous system usually are treated
with radiation therapy. Cancers elsewhere in the body
are treated with chemotherapy.
Prophylactic treatment for opportunistic infections
Prophylactic treatment is treatment that is given to
prevent disease. AIDS patients with a history of Pneu-
mocystis pneumonia; with CD4+ counts below 200
cells/mm 3 or 14% of lymphocytes; weight loss; or thrush
should be given prophylactic medications. The three
drugs given are trimethoprim-sulfamethoxazole, dap-
sone, or pentamidine in aerosol form.
STIMULATION OF BLOOD CELL PRODUCTION. Be-
cause many patients with AIDS suffer from abnormally
low levels of both red and white blood cells, they may be
given medications to stimulate blood cell production.
38
Epoetin alfa (erythropoietin) may be given to anemic pa-
tients. Patients with low white blood cell counts may be
given filgrastim or sargramostim.
Treatment in women
Treatment of pregnant women with HIV is particu-
larly important because antiretroviral therapy has been
shown to reduce transmission to the infant by 65%.
Expected results
At the present time, there is no cure for AIDS. Treat-
ment stresses aggressive combination drug therapy when
possible. The use of multi-drug therapies has significant-
ly reduced the number of U.S. deaths resulting from
AIDS. The potential exists to possibly prolong life indef-
initely using these and other drug therapies to boost the
immune system, keep the virus from replicating, and
ward off opportunistic infections and malignancies.
Prognosis after the latency period depends on the
patient’s specific symptoms and the organ systems af-
fected by the disease. Patients with AIDS-related lym-
phomas of the central nervous system die within two to
three months of diagnosis; those with systemic lym-
phomas may survive for eight to ten months. In America,
the successful treatment of AIDS patients with HAART
has actually led to a growing number of people living
with HIV. About 25,000 infected people per year are
added to the list of HIV-infected Americans.
However, not only does HAART and other treat-
ment prolong AIDS patients’ lives, it has led to some im-
provement in quality of life too. A recent study shows
that HAART therapy substantially reduces risk of AIDS-
related pneumonia (PCP), although PCP still remains the
most common AIDS-defining illness among opportunis-
tic infections. Other recent studies show that these pro-
tease inhibitors may result in high cholesterol and put
AIDS patients at eventual risk for heart disease. Further
research must be done, since long-term effects of
HAART treatment are just now being studied. Most clin-
icians would say the benefits outweigh the risks anyway.
Prevention
As of 2000, there is no vaccine effective against
AIDS. Several vaccines to prevent initial HIV infection
and disease progression are being tested. In 2002, reports
showed a new “library” vaccine showed potential. The
vaccine is composed of up to 32 HIV gene fragments
that can induce a number of immune responses. In the
same year, the British government worked with five
African countries in a trial to find an effective gel that
would protect women against HIV during sex. The study
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
leaders believed if they could find a lotion that could be
applied before intercourse that would help prevent HIV
transmission, they would give women the ability to bet-
ter protect themselves from HIV. In 2003, the first
human test of a vaccine against the most common sub-
type of HIV was underway.
Precautions to take to prevent the spread of AIDS
include:
• Monogamy and practicing safe sex. Besides avoiding
the risk of HIV infection, condoms are successful in
preventing other sexually transmitted diseases and un-
wanted pregnancies.
• Avoiding needle sharing among intravenous drug users.
• Although blood and blood products are carefully moni-
tored, those individuals who are planning to undergo
major surgery may wish to donate blood ahead of time
to prevent a risk of infection from a blood transfusion.
• Healthcare professionals should wear gloves and masks
when handling body fluids and avoid needle-stick in-
juries.
• A person who suspects that he or she may have become
infected should get tested. If treated aggressively and
early, the development of AIDS can sometimes be post-
poned indefinitely. If HIV infection is confirmed, it
also is vital to inform sexual partners.
Resources
BOOKS
Abrams, Donald I. "Alternative Therapies.” AIDS Therapy.
edited by Raphael Dolin et al. Philadelphia: Churchill
Livingstone, 1999.
Early HIV Infection Guideline Panel. Evaluation and Manage-
ment of Early HIV Infection. Rockville, MD: U.S. Depart-
ment of Health and Human Services, Agency for Health
Care Policy and Research, 1994.
The Global AIDS Policy Coalition. AIDS in the World. Cam-
bridge, MA: Harvard University Press, 1992.
Huber, Jeffrey T. Dictionary of AIDS-Related Terminology.
New York and London: Neal-Schuman Publishers, Inc.,
1993.
"Infectious Diseases: Human Immunodeficiency Virus (HIV).”
In Neonatology: Management, Procedures, On-Call Prob-
lems, Diseases and Drugs, edited by Tricia Lacy Gomella,
et al. Norwalk, CT: Appleton & Lange, 1994.
Katz, Mitchell H. and Harry Hollander. "HIV Infection.” In
Current Medical Diagnosis & Treatment 1998. edited by
Lawrence M. Tierney Jr., et al. Stamford, CT: Appleton &
Lange, 1998.
McCutchan, J. Allen. "Alternative, Unconventional, and Un-
proven Therapies.” Textbook of AIDS Medicine, 2nd edi-
tion. edited by Thomas C. Merigan, et al. Baltimore:
Williams & Wilkins, 1999.
McFarland, Elizabeth J. “Human Immunodeficiency Virus
(HIV) Infections: Acquired Immunodeficiency Syndrome
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
(AIDS).” In Current Pediatric Diagnosis & Treatment.
edited by William W. Hay Jr., et al. Stamford, CT: Apple-
ton & Lange, 1997.
So, Peter and Livette Johnson. "Acquired Immune Deficiency
Syndrome (AIDS).” In Conn's Current Therapy, edited by
Robert E. Rakel. Philadelphia: W. B. Saunders Company,
1997.
Standish, Leanna J., Roberta C.M. Wines, and Cherie Reeves.
“Complementary/Alternative Therapies in Select Popula-
tions: Women with HIV and AIDS.” In Complementary /
Alternative Medicine: An Evidence Based Approach, edit-
ed by John W. Spencer and Joseph J. Jacobs. St. Louis:
Mosby, 1999.
PERIODICALS
“DHEA in HIV Infection.” Infectious Disease Alert. (March 1 .
2002) : S7.
Ernst, Jerome. “Alternative Treatment Modalities in Human
Immunodeficiency Virus/Acquired Immune Deficiency
Syndrome.” Clinical Infectious Diseases (September 1,
2003) : 150-154.
"First Human Tests Under Way of HIV Vaccine Pioneered at
UNC.” AIDS Vaccine Week (August 25, 2003): 2.
Fleck, Fiona. "British Medical Journal.” British Medical Jour-
nal (September 27, 2003): 698.
Gangel, Elaine K. "Garlic Supplements and HIV Medication.”
American Family Physician (March 15, 2002): 1225.
“Government Lauches Trial of Gel to Protect Women Against
HIV.” AIDS Weekly (March 25, 2002): 11.
"HIV Drugs Approved as of August 2003.” AIDS Treatment
News (July 25, 2003): 4.
"HIV Rising Among Gay, Bisexual Men.” Medical Letter on
the CDC & FDA (August 24, 2003): 9.
"Is HAART Hard on the Heart” Science News (March 9, 2002):
158.
"Library Vaccine Shows Promise.” Vaccine Weekly. (February
13, 2002): 2.
"One-step HIV Test May Be Cheaper. Faster, Less Wasteful.”
AIDS Weekly (September 29, 2003): 13.
Ozsoy, Metin and Edzard Ernst. "How Effective are Comple-
mentary Therapies for HIV and AIDS? — a Systematic Re-
view.” International Journal of STD & AIDS 10 (1999):
629- 635.
"Prevalence of HIV Infection Increasing in Older Americans.”
AIDS Weekly (September 1, 2003): 16.
"Revised Guidelines Will Ease Selection of HIV/AIDS Treat-
ments.” Drug Week (August 8, 2003): 10.
“Successful HAART Reduces Risk of Pneumonia.” AIDS
Weekly (January 14, 2002): 24.
“Success of Treatment Swells Ranks of HIV Infected.” AIDS
Weekly (March 25, 2002): 13.
Wootton, Jacqueline C. “Web Watch: Alternative and Comple-
mentary Therapies.” AIDS Patient Care and STDs 12
(1998): 811-813.
ORGANIZATIONS
American Foundation for AIDS Research, 733 Third Avenue,
12th floor, 1515 Broadway, Suite 3601, New York, NY
10017. (212) 682- 7440.
39
AIDS
AIDS
KEY TERMS
Acute retroviral syndrome — A group of symptoms
resembling mononucleosis that often are the first
sign of HIV infection.
AIDS dementia complex — A type of brain dysfunction
caused by HIV infection that causes difficulty thinking,
confusion, and loss of muscular coordination.
Antibody — A specific protein produced by the im-
mune system in response to a specific foreign pro-
tein or particle called an antigen.
Antigen — Any substance that stimulates the body
to produce antibody.
Autoimmunity — A condition in which the body's
immune system produces antibodies in response to
its own tissues or blood components instead of to
foreign particles or microorganisms.
CD4 — A type of protein molecule in human blood.
The HIV virus infects cells with CD4 surface pro-
teins, and as a result, depletes the number of T
cells, B cells, natural killer cells, and monocytes in
the patient's blood.
Hairy leukoplakia of the tongue — A white area of
diseased tissue on the tongue that may be flat or
slightly raised. It is caused by the Epstein-Barr virus
and is an important diagnostic sign of AIDS.
Hemophilia — Hereditary blood clotting disorders
occurring almost exclusively in males.
Human immunodeficiency virus (HIV) — A trans-
missible retrovirus that causes AIDS in humans. Two
forms of HIV are now recognized: HIV-1, which
causes most cases of AIDS in Europe, North and
South America, and most parts of Africa; and HIV-2,
which is chiefly found in West African patients.
Immunodeficient — A condition in which the
body's immune response is damaged, weakened,
or is not functioning properly.
Kaposi's sarcoma — A cancer of the connective tis-
sue that produces painless purplish red (in people
with light skin) or brown (in people with dark skin)
blotches on the skin. It is a major diagnostic mark-
er of AIDS.
Latent period — Also called incubation period, the
time between infection with a disease-causing
agent and the development of disease.
Lymphocyte — A type of white blood cell that is im-
portant in the formation of antibodies and that can
be used to monitor the health of AIDS patients.
Lymphoma — A cancerous tumor in the lymphatic
system that is associated with a poor prognosis in
AIDS patients.
Macrophage — A large white blood cell, found pri-
marily in the bloodstream and connective tissue,
that helps the body fight off infections by ingesting
the disease-causing organism.
Monocyte — A large white blood cell that is formed
in the bone marrow and spleen.
Mycobacterium avium (MAC) infection — A type
of opportunistic infection that occurs in about 40%
of AIDS patients and is regarded as an AIDS-defin-
ing disease.
Opportunistic infection — An infection by organ-
isms that usually don't cause infection in people
whose immune systems are working normally.
Persistent generalized lymphadenopathy (PGL) —
A condition in which HIV continues to produce
chronic painless swellings in the lymph nodes dur-
ing the latency period.
Pneumocystis carinii pneumonia (PCP) — An op-
portunistic infection caused by a fungus that is a
major cause of death in patients with late-stage
AIDS.
Progressive multifocal leukoencephalopathy
(PML) — A d isease caused by a virus that destroys
white matter in localized areas of the brain. It is re-
garded as an AIDS-defining illness.
Protozoan — A single-celled, usually microscopic
organism that has a nucleus and is, therefore differ-
ent from bacteria.
Retrovirus — A virus that contains a unique enzyme
called reverse transcriptase that allows it to repli-
cate within new host cells.
T cells — Lymphocytes that originate in the thymus
gland. CD4 lymphocytes are a subset of T lympho-
cytes.
Thrush — A yeast infection of the mouth character-
ized by white patches on the inside of the mouth
and cheeks.
Viremia — The measurable presence of virus in the
bloodstream that is a characteristic of acute retro-
viral syndrome.
Wasting syndrome — A progressive loss of weight
and muscle tissue caused by the AIDS virus.
40
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Gay Men's Health Crisis, Inc., 129 West 20th Street, New
York, NY 10011-0022. (212) 807-6655.
National AIDS Hot Line. (800) 342-AIDS (English). (800) 344-
SIDA (Spanish). (800) AIDS-TTY (hearing-impaired).
Belinda Rowland
Teresa G. Odle
Alcoholism
Definition
Alcoholism is the layman’s term for alcohol depen-
dence and alcohol abuse. According to the Diagnostic and
Statistical Manual of Mental Disorders, published by the
American Psychiatric Association and commonly called the
DSM-IV, the essential feature of substance abuse (in this in-
stance, alcohol abuse) is maladaptive use of the substance
with recurrent and significant adverse consequences related
to its repeated use. Dependence is a physical addiction with
psychological, social and genetic components. Despite
damage to health, finances, reputations, and relationships,
the alcohol dependent person will continue to drink unless
an intervention occurs. Abuse, distinguished from depen-
dence by retaining some control over the use of alcohol,
nevertheless carries many of the same consequences over
time, and certainly increases risk of dependence.
Today, alcohol abuse and alcohol dependence are
often associated with abuse of, or dependence on, other
substances including nicotine, marijuana, cocaine,
heroin, amphetamines, sedatives, and anxiolytics (anti-
anxiety drugs). Alcoholism is more common in males
than in females, with an estimated male-to-female ratio
as high as five-to-one. A United States study conducted
between 1990 and 1991, using DSM standards, found
that 14% of the adult population (ages 15-54) had, at
some time, met the criteria for alcohol dependence; and
7% had been alcohol-dependent in the past year. An ear-
lier, similar study showed that about 5% of Americans
qualified for a diagnosis of alcohol abuse at some point
during their life. According to a 2002 report by the Na-
tional Council on Alcoholism and Drug Dependence, 14
million Americans abuse alcohol, and 100,000 die annu-
ally of alcohol related preventable causes. Though it is
difficult to develop accurate statistics worldwide, it is
known that the incidence of what we call alcoholism has
been steadily rising around the globe for several years.
Description
The effects of alcoholism are quite far-reaching. Al-
coholism affects every body system, causing a wide
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
range of drinking related health problems, including
lower testosterone, shrinking gonads, erectile dysfunc-
tion, interference with reproductive fertility, weak bones,
memory disorders, difficulty with balance and walking,
liver disease (including cirrhosis and hepatitis), high
blood pressure, weakness of muscles (including the
heart), disturbances of heart rhythm, anemia, clotting
disorders, weak immunity to infections, inflammation
and irritation of the entire gastrointestinal system, acute
and chronic problems with the pancreas, low blood
sugar, high blood fat content, and poor nutrition.
Its mental health implications include marital and
other relationship difficulties, depression, unemploy-
ment, poor performance at school or work, spouse and
child abuse, and general family dysfunction. Alcoholism
causes or contributes to a variety of severe social prob-
lems: homelessness, murder, suicide, injury, and violent
crime. Alcohol is a contributing factor in 50% of all
deaths from motor vehicle accidents. In fact, 50% of the
100,000 deaths that occur each year due to the effects of
alcohol are due to injuries of some sort. Alcohol costs
the United States over $150 billion yearly in lost produc-
tivity and alcohol related medical expense.
Causes & symptoms
A physical dependence on alcohol develops insidi-
ously, over time. The body is a magnificent adaptor;
therefore, with persistent use, many adaptations occur
physically and psychologically, resulting in both a higher
tolerance to and increased need for alcohol — craving it —
The physical adaptation to alcohol involves changing lev-
els and altered balances of neuro transmitters, chemicals
in the brain which not only affect physical abilities like
muscle coordination, but also mood. The abuse of alcohol
is associated with a desire to feel better and to avoid feel-
ing poorly. Initially a stimulant, it eventually acts as a
central nervous system (CNS) depressant and is used in a
majority of societies or cultures in the world as an accept-
ed part of dealing with life events, except where religious
opposition bans, discourages or prohibits its use, as in
most Muslim communities. It is included in celebrations
and, ironically, its use is perceived as an appropriate re-
sponse to sadness and loss, such as at wakes.
There is, at this point, no single known factor that
causes some people to be alcohol-dependent and others
not. Recent genetic studies have demonstrated that close
biological relatives of an alcoholic are four times more
likely to become alcoholics themselves. Furthermore,
this risk holds true even for children who were adopted
away from their biological families at birth and raised in
non-alcoholic homes, without knowledge of their biolog-
ical family’s difficulties with alcohol. Male gender,
41
Alcoholism
Alcoholism
BAC (%)
Effects
0.02-0.03
Mood elevation; slight muscle relaxation
0.05-0.06
Relaxation and warmth; increased reaction time; decreased fine muscle coordination
0.08-0.09
Impaired balance, speech, vision, hearing, and muscle coordination; euphoria
0.14-0.15
Gross impairment of physical and mental control
0.20-0.30
Severely intoxicated; very little control of mind or body
0.40-0.50
Unconscious; deep coma; death from respiratory depression
being the child of an alcoholic parent or parents, extend-
ed family history and being of Irish (Celtic), Scandina-
vian, German, Polish, Russian or Native American an-
cestry, beginning drinking as a teenager, and being de-
pressed or highly anxious all increase the risk of experi-
encing problems with alcohol. Further research may
determine if genetic factors are accountable, in part, for
differences in alcohol metabolism and increase the risk
of an individual becoming an alcoholic. Other cause re-
lated factors in alcoholism include high levels of stress
and turmoil or pain, having drinking friends, drinking
partners, and “enablers” — people who facilitate a
drinkers habits and denial mechanisms. Heavy advertis-
ing that makes drinking appear to be “sexy” or the basis
of a good time also contributes. Consider, for example,
the number of televised sporting events that are spon-
sored heavily by alcohol related enterprises.
One of the classic symptoms of alcoholism is denial
of a problem with alcohol. An addicted person, under the
influence of the addictive substance, is physically and
psychologically motivated to perpetuate the addiction.
Therefore, intervention often starts when loved ones,
recognizing the signs and symptoms, bring attention to
the problem and call for help. Occasionally, an interven-
tion requires a whole family unit and outside assistance.
Signs and symptoms of alcohol dependence and abuse
may include the following:
• not remembering conversations or commitments
• losing interest in activities that were once pleasurable
• ritualized drinking, before, with, and after dinner and
being upset if the pattern is interrupted
• becoming irritable as “happy hour” approaches, espe-
cially if alcohol is not available
• drinking alone or secretly
• hiding alcohol in unusual places
• ordering doubles, drinking quickly, and drinking to be-
come drunk, intentionally
42
• focusing attention on the source of one’s next drink
• unstable relationships, financial, legal, and employ-
ment difficulties
Physical symptoms of alcoholism can be broken
into two major categories: symptoms of acute alcohol
use and symptoms of long-term alcohol use.
Immediate (acute) effects of alcohol use
Though the initial reaction to alcohol may be stimu-
latory, ultimately alcohol exerts a depressive, uninhibit-
ing effect on the brain. The blood-brain barrier does not
prevent alcohol from entering the brain, so the brain al-
cohol level quickly becomes equivalent to the blood al-
cohol level. Alcohol’s depressive effects result in im-
paired thinking, feeling and judgment, short term memo-
ry loss, muscle weakness difficulty walking, poor bal-
ance, slurring of speech, and generally poor coordination
(accounting for the increased likelihood of injury and al-
cohol related injury statistics). At higher alcohol levels, a
person’s breathing and heart rate slows. Vomiting may
occur, with a high risk of vomitus “aspiration” (inhaling
vomit into the lungs), and may result in further compli-
cations includingpneumonia. Still higher alcohol levels
may result in coma and death.
Effects of long-term (chronic) alcoholism
Alcohol is considered a lethal poison, requiring con-
tinuous detoxification by the liver. As drinking contin-
ues and overwhelms the liver’s ability to detoxify, long
term consequences to health occur, affecting virtually
every organ system of the body.
NERVOUS SYSTEM. It is estimated that 30-40% of
all men in their teens and twenties have experienced al-
coholic blackout (loss of consciousness) as a result of
drinking a large quantity of alcohol. In an alcoholic
blackout, all memory of time and behavior surrounding
the episode of drinking is lost. Alcohol causes sleep dis-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
turbances, thus affecting overall sleep quality. Numbness
and tingling may occur in the arms and legs. Two condi-
tions that may occur either together or separately are
Wernicke’s and Korsakoff’s syndromes. Both are due to
the depleted thiamin levels found in alcoholics. Wer-
nicke’s syndrome results in disordered eye movements,
very poor balance, and difficulty walking, while Kor-
sakoff’s syndrome severely affects one’s memory, pre-
venting new learning from taking place.
GASTROINTESTINAL SYSTEM. Alcohol causes a loos-
ening of the muscular ring (the cardiac sphincter) that
prevents the stomach’s contents from reentering the
esophagus. As a result, acid from the stomach flows up-
ward into the esophagus, burning those tissues and caus-
ing pain and bleeding, or gastro-esophageal reflux dis-
ease (GERD). Inflammation of the stomach can also re-
sult in bleeding (ulcers) and pain as well as a decreased
desire to eat. A major cause of severe, uncontrollable
bleeding (hemorrhage) in an alcoholic is the develop-
ment in the esophagus of enlarged (dilated) blood ves-
sels, which are called esophageal varices (varicose veins
of the esophagus). These varices actually develop in re-
sponse to the toxic effect of alcohol on the liver, and are
extremely prone to bursting and hemorrhage.
A malnourished state arises from the loss of appetite
for food — due to caloric substitution of alcohol and its ef-
fects on blood sugar levels — and interference with the ab-
sorption of nutrients throughout the intestinal tract. Inflam-
mation of the pancreas (pancreatitis) is a serious and
painful problem in alcoholics that disrupts carbohydrate
and fat digestion, and increases the risk of insulin resis-
tance, weight gain, hyperlipidemia, diabetes, and pancreat-
ic cancer. Diarrhea is also a common symptom of chronic
alcohol use, due to alcohol’s effect on the pancreas.
LIVER. Because alcohol is broken down (metabo-
lized) within the liver, that organ is severely affected by
constant levels of alcohol. Alcohol interferes with the
large number of important chemical processes that occur
in the liver. As alcohol converts to blood sugar, which in
turn converts to blood fat, the liver begins to enlarge, fill-
ing with fat, a condition called fatty liver. Cirrhosis, a
potentially deadly complication, develops when fibrous
tissue, while trying to support the extra burden placed on
the liver by the accumulation of fat and liver cell weak-
ness, interferes with the liver’s normal structure and
function. The liver may also become inflamed, a condi-
tion called hepatitis, producing jaundice, fatigue, and
elevated liver enzymes indicative of liver cell death and
destruction. Because of the liver’s enormous role in di-
gestion, metabolism and immunity, damage to the liver
takes a serious toll throughout the body.
BLOOD. Alcohol can cause changes to any of the
types of blood cells. Red blood cells become abnormally
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
large. White blood cells (important for fighting infec-
tions) decrease in number, resulting in a weakened im-
mune system. This places alcoholics at increased risk for
infections and is thought to account in part for an alco-
holic’s increased risk of cancer (ten times greater than
normal). Platelets and blood clotting factors are affected,
causing an increased risk of bleeding and hemorrhage,
especially when coupled with vascular weaknesses,
varices, or aneurism.
HEART AND CIRCULATORY SYSTEM. Small amounts
of alcohol cause a drop in blood pressure, but increased
use begins to raise blood pressure dangerously. Increased
blood pressure negatively affects the kidneys. While
some studies demonstrate that one to two alcoholic
drinks per night improves heart disease risk values,
higher amounts and chronic intake produce high levels
of circulating fats, which increases the risk of heart dis-
ease. Heavy drinking results in an enlarged heart, coro-
nary arterial disease (CAD), peripheral vascular disease,
weakening of the heart muscle, abnormal heart rhythms,
a risk of blood clots forming within the chambers of the
heart, and a greatly increased risk of stroke. Strokes re-
sult when a blood clot from the heart enters the circula-
tory system, goes to the brain, and blocks a blood vessel.
Stroke may also result from a hemorrhage within the
brain, as weakened vessel walls give way and platelet de-
ficient blood pours through.
REPRODUCTIVE SYSTEM. Heavy drinking has a neg-
ative effect on fertility in both men and women, decreas-
ing testicular and ovarian size, interfering with sperm
and egg production and viability, disrupting menstrual
cycles, and reducing libido. When pregnancy is
achieved reduced quality of sperm and egg may signifi-
cantly and permanently affect the quality of life, pre-,
peri- and postnatally, of the child. A child born to an al-
cohol using woman has a great risk of being born with
fetal alcohol syndrome, which causes distinctive cranial
and facial defects, including a smaller head size, shorten-
ing of the eyelids, and a lowered IQ. Developmental dis-
abilities, heart defects, and behavioral problems are also
more likely.
Diagnosis
The DSM-IV breaks substance abuse into specific
criteria that can be of aid in diagnosing a substance
abuse problem. These criteria are paraphrased here to re-
late to alcoholism. At least one of the following must
have manifested itself within a 12-month period to quali-
fy for a diagnosis of alcohol abuse:
• Recurrent alcohol use that results in failure to fulfill
major role obligations at work, school, or home. Spe-
cific examples are repeated absences from work or
43
Alcoholism
Alcoholism
poor work performance related to alcohol use; alcohol-
related absences, suspensions, or expulsions from
school; and neglect of children or household.
• Recurrent alcohol use in situations in which it is physi-
cally hazardous. Specific examples are driving an auto-
mobile and operating a machine while impaired by al-
cohol use.
• Recurrent alcohol-related legal problems, such as ar-
rests for alcohol-related disorderly conduct.
• Continued alcohol use despite having persistent and re-
curring social or interpersonal problems caused or ex-
acerbated by the effects of the alcohol. Examples in-
clude arguments with a spouse about the consequences
of intoxication, and alcohol-related physical fights.
A diagnosis of alcohol dependence requires habitu-
al, long-term tolerance for and heavy consumption of al-
cohol as well as the development of symptoms of with-
drawal when the amount of alcohol in the system is sub-
stantially lowered or completely stopped. Once a pattern
of compulsive alcohol use has developed, alcohol-depen-
dent people may devote large portions of their time to
the procurement and drinking of alcohol.
A significant number of illnesses categorized in
DSM-IV as alcohol-induced disorders has come into
being as a result of alcohol abuse and dependence, illus-
trating the negative impacts of alcoholism on physical
and mental health. Among the psychiatric diagnoses that
are included in alcohol-induced disorders are:
• dementia
• amnestic disorder
• psychotic disorder
• mood disorder
• anxiety disorder
• sexual dysfunction
• sleep disorder
As previously mentioned, due to the strong element
of denial and a need, usually, for an intervention, diagno-
sis is often brought about because family members call
an alcoholic’s difficulties to the attention of a physician.
A physician may become suspicious when a patient suf-
fers repeated injuries or begins to experience medical
problems that are related to the use of alcohol. In fact,
some estimates suggest that about 20% of a physician’s
patients are alcoholics, a percentage which is higher than
the general population and lower than the increased risk
to health posed by alcoholism. In other words, alcohol
related illness may prompt an alcoholic to see medical
counsel, but their illness may not be recognized as alco-
hol related until the disease toll is quite advanced.
44
Questionnaires that try to determine what aspects of
a person’s life may be affected by use of alcohol can be
an effective diagnostic aid. Determining the exact quan-
tity of alcohol that a person drinks is much less impor-
tant than determining how his or her drinking affects
health, relationships, jobs, educational goals, and family
life. In fact, because the metabolism of alcohol (how the
body breaks down and processes alcohol) is so individ-
ual, the quantity of alcohol consumed is not part of the
criteria list for diagnosing either alcohol dependence or
alcohol abuse.
One very simple tool for beginning the diagnosis of
alcoholism is called the CAGE questionnaire. It consists
of four questions, with the first letter of each key word
spelling out the word CAGE:
• Have you ever tried to Cut down on your drinking?
• Have you ever been Annoyed by anyone’s comments
about your drinking?
• Have you ever felt Guilty about your drinking?
• Do you ever need an Eye-opener (a morning drink of
alcohol) to start the day?
Other, longer lists of questions may help determine
the severity and effects of a person’s alcohol use. A thor-
ough physical examination may reveal the physical signs
suggestive of alcoholism, such as an enlarged liver, a vis-
ible network of enlarged veins just under the skin around
the navel (called caput medusae) (or herniated umbili-
cus), fluid in the abdomen (ascites), yellowish tone to the
skin (jaundice), decreased testicular size or gynecomas-
tia (breast enlargement in men), osteoporosis, physical
deterioration, loss of teeth, evidence of old injuries, and
poor nutritional status. Diagnostic testing may include
cardiovascular, CNS, GI, general chemistry and liver
function tests (LFTs) and reveal poor stress test perfor-
mance, arterial disease, congestive heart failure, palsy,
loss of coordination, reflux disease or history of stomach
ulcer, irritable bowel syndrome, an increased red blood
cell size and anemia, abnormal white blood cells (cells
responsible for fighting infection) counts or characteris-
tics, abnormal platelets (particles responsible for clot-
ting), and increased liver enzymes. Given the genetic
risk factors for alcoholism, determinations of familiar al-
coholism related illness and death may be additive.
Treatment
Alternative treatments can be a helpful adjunct for
the alcoholic patient once the medical danger of with-
drawal has passed. Because many alcoholics have very
stressful lives (because of, or leading to, the alcoholism),
many of the treatments for alcoholism involve dealing
with and relieving stress. These include massage, medi-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
tation, and hypnotherapy. A list from the Mayo Clinic
also includes acupuncture (may reduce craving, anxi-
ety, depression, tremor, fatigue, and the symptoms of
withdrawal), biofeedback (monitoring of internal systems
for stress reduction), behavioral therapy motivational en-
hancement therapy (problem acknowledgment), and
aversion therapy (may involve simultaneous use of med-
ications the cause nausea or vomiting with relapse.)
Nutritionally oriented practitioners may be consult-
ed to address the malnutrition associated with long-term
alcohol use. Careful and remedial attention toward a
healthier diet and lifestyle, including use of nutritional
supplements, such as vitamins A, B complex, and C; cer-
tain fatty acids; amino acids; zinc; magnesium; and se-
lenium — supplements that support antioxidant, detoxify-
ing, restorative and corrective deficiencies — may further
enhance recovery and lessen the likelihood of relapse.
Herbal treatments include milk thistle ( Silybum
marianum ), which is thought to protect the liver against
damage. Other herbs are thought to be helpful for the pa-
tient suffering through withdrawal. Some of these in-
clude the antidepressive attributes of lavender ( Lavan-
dula officinalis), the calming and restorative nerve toni-
fying effects of skullcap ( Scutellaria lateriflora),
chamomile ( Matricaria recutita), and valerian ( Valeri-
ana officinalis), the stimulating and GI helpful effects of
peppermint ( Mentha piperita), and the bladder aid,
yarrow ( Achillea millefolium).
Allopathic treatment
Allopathic treatment of alcoholism has two parts.
The first phase is the treatment of acute effects of alco-
holism, called detoxification. The second phase involves
learning how to live with the disease of alcoholism.
Withdrawal
Detoxification, or withdrawal, involves helping the
person to rid his or her body of alcohol as well as the
harmful physical effects of the alcohol. Because the per-
son’s body has become accustomed to alcohol, he or she
needs care and monitoring during withdrawal. With-
drawal is an individual experience, depending on the
severity of the alcoholism as measured by the quantity of
alcohol ingested daily and the length of time the patient
has been drinking (the adaptation factor). Withdrawal
symptoms can range from mild to life threatening. Mild
withdrawal symptoms include nausea, ache, diarrhea,
difficulty sleeping, excessive sweating, anxiety, and
trembling. This phase may last from three to seven days.
More severe effects of withdrawal may include halluci-
nations (in which a patient sees, hears, or feels some-
thing that is not real), seizures, an unbearable craving for
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
more alcohol, confusion, fever, fast heart rate, high
blood pressure, and delirium (a fluctuating level of con-
sciousness). Patients at highest risk for the most severe
symptoms of withdrawal (referred to as delirium tremens
or DTs) are those with other medical problems, such as
malnutrition, liver disease, or Wernicke’s syndrome.
Delirium tremens usually begins about three to five days
after the patient’s last drink and may last a number of
days. Withdrawal usually progresses from the more mild
symptoms to the more severe ones.
Patients going through only mild withdrawal, moni-
tored carefully to make sure that more severe symptoms
do not develop, may not require medication, however,
fluids are encouraged to facilitate detoxifying the per-
son’s system. Patients suffering more severe effects of
withdrawal may need to be given sedative medications,
benzodiazepines like Valium or Librium, to relieve dis-
comfort and to avoid the potentially life threatening
complications of high blood pressure, fast heart rate, and
seizures. Because of the patient’s nausea, fluids may
need to be given intravenously (through a vein), along
with some necessary sugars and salts (electrolyte push-
es). It is crucial that thiamin be included in the fluids, be-
cause thiamin is usually quite low in alcoholic patients,
and deficiency of thiamin is responsible for the Wer-
nicke-Korsakoff syndrome. In-patient treatment is usual-
ly short-term (three to seven days), though longer reha-
bilitation programs lasting weeks or even months are
sometimes needed. Any treatment is usually followed by
longer-term outpatient treatment.
Recovery
After the physical problems associated with alcohol
withdrawal have been treated, the more difficult task be-
gins: helping the person to clearly recognize the nature
and severity of his or her illness. This is done on both an
in-patient and outpatient basis. Alcoholism is a disease
of denial; as members of Alcoholics Anonymous put it, it
is “the only disease that keeps telling you that you do not
have a disease.” Recall that often the alcoholic is made
aware of his or her condition through what is called an
intervention, a meeting with family and/or significant
people who describe for the alcoholic the symptoms of
alcoholism that they have witnessed and how these
symptoms have affected them. This is important because
alcoholics who are actively drinking are often not aware
of what they do, nor do they remember later what they
have done. (Interventions are sometimes done before the
problem becomes serious enough to require detoxifica-
tion from alcohol). Essential to recovery is the awareness
of powerlessness over the disease, acceptance of having
the disease, and abstinence from the substance that per-
petuates the disease.
45
Alcoholism
Alcoholism
There is no cure for alcoholism. Sessions led by
peers, such as Alcoholics Anonymous (AA) meetings,
are often part of in-patient hospital treatment. AA meet-
ings, where recovering alcoholics meet regularly and
provide support for each other’s recovery, are considered
among the best methods of preventing a return to drink-
ing (relapse). The AA program is a twelve-step program.
Its steps involve recognizing the destructive power that
alcohol has held over the alcoholic’s life, looking to a
Higher Power for help in overcoming the problem, re-
flecting on the ways in which the use of alcohol has hurt
others, and if possible, making amends to those people.
The final step involves carrying the message of hope and
recovery to other sick and suffering alcoholics. The
Serenity Prayer becomes an ally: “God grant me the
strength to accept the things I cannot change, the
courage to change the things I can change, and the wis-
dom to know the difference.”
The best programs incorporate the alcoholic’s fami-
ly or loved ones into the therapy, because loved ones
have undoubtedly been severely affected by the drinking.
Many therapists believe that families, in an effort to deal
with the alcoholic’s drinking problem, develop patterns
of behavior that unwittingly support or “enable” the pa-
tient’s drinking. This situation is referred to as co-depen-
dency. The twelve-step programs of A1 Anon and Adult
Children of Alcoholics are often very successful in help-
ing the families or loved ones of alcoholics.
There are also medications that may help an alco-
holic avoid returning to drinking. These have been used
with variable success. Disulfiram (Antabuse) is a drug
which, when mixed with alcohol, causes a very unpleas-
ant reaction that includes nausea and vomiting, diarrhea,
and trembling. Naltrexone (a drug that blocks a narcotic
high and may reduce the urge to drink) and acamprosate
seem to be helpful in limiting the effects of a relapse.
Naltrexone, found to produce liver damaging side ef-
fects, may be a difficultly exercised option. None of
these medications has been found to be helpful unless
the patient is also willing to work very hard to change
his or her behavior.
Expected results
As noted earlier, there is no cure for alcoholism. Re-
covery from alcoholism is a lifelong process. In fact,
people who have suffered from alcoholism are encour-
aged to refer to themselves ever after as a recovering al-
coholic, never a recovered alcoholic. Alcoholism can
only be arrested — by abstaining from the drug, alcohol.
The potential for relapse (returning to illness) is always
there, and it must be acknowledged and respected. Sta-
tistics suggest that among middle-class alcoholics in sta-
46
ble financial and family situations who have undergone
treatment, 60% or more can successfully stop drinking
for at least a year, and many for a lifetime.
Prevention
Prevention is primarily related to education and
early intervention. In a culture where alcohol is so in-
grained, education about the dangers of this drug is vital-
ly important, even as early as early childhood. Since al-
cohol is the easiest and cheapest drug to obtain and the
one most commonly used by teens, the first instance of
intoxication (drunkenness) with alcohol usually occurs
during the teenage years. It is particularly important that
teenagers who are at high risk for alcoholism be made
aware of this danger. Those at high risk include those
with a family history of alcoholism, an early or frequent
use of alcohol, a tendency to drink to drunkenness, alco-
hol use that interferes with schoolwork, a poor family
environment, or a history of domestic violence. Peers are
often the best people to provide this education, and
groups such as SADD (Students Against Drunk Driving,
a Marlborough, Massachusetts-based organization), ap-
pear very effective. Courts and schools sometimes pro-
vide education through local substance abuse programs,
as well. Setting a good example, developing and practic-
ing communication skills with your children, and frank
discussions about the consequences of drinking, are all
encouraged to prevent alcoholism related problems. De-
veloping alternative coping skills to life’s problems is
also essential, as is encouraging a more distant perspec-
tive on the pervasive advertising that deceptively pro-
motes alcohol’s health reducing glamour.
Resources
BOOKS
American Psychiatric Association. Diagnostic and Statistical
Manual of Mental Disorders. 4th ed. Washington, DC:
American Psychiatric Association, 1994.
Diamond, Ivan. “Alcoholism and Alcohol Abuse.” Cecil Text-
book of Medicine, edited by J. Claude Bennett and Fred
Plum. Philadelphia: W.B. Saunders, 1996.
Schuckit, Marc A. "Alcohol and Alcoholism.” In Harrison's
Principles of Internal Medicine, edited by Anthony S.
Fauci, et al. New York: McGraw-Hill, 1998.
PERIODICALS
Aesoph. Lauri M. “Kick the Habit — Naturally: Quit Drinking
or Smoking With Herbs, Acupuncture, and the Right
Diet.” Vegetarian Times (March 1996): 100+.
Bullock, M. L., P. D. Culliton, and R. T. Oleander. “Controlled
Trial of Acupuncture for Severe Recidivist Alcoholism.”
Lancet (June 1989): 1435-1439.
Dorsman, Jerry. “Improving Alcoholism Treatment: an
Overview.” Behavioral Health Management (January-
February 1996): 26+.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Blood-brain barrier — A membrane that lines the
blood vessels in the brain, it prevents many dam-
aging substances from reaching the brain. Certain
small molecules are able to cross the barrier, in-
cluding water, oxygen, carbon dioxide, and alco-
hol.
Dependence — A state in which a person requires
a steady amount of a particular drug in order to
avoid experiencing symptoms of withdrawal.
Detoxification — The phase of treatment during
which a patient stops drinking and is monitored
and cared for while he or she experiences with-
drawal from alcohol.
Relapse — A return to a disease state after recovery
appeared to be occurring. In alcoholism, relapse
refers to a patient beginning to drink alcohol
again after a period of avoiding it.
Tolerance — A phenomenon whereby a drug user
becomes physically accustomed to a particular
quantity of alcohol (or dosage of a drug), and re-
quires ever-increasing quantities in order to obtain
the same effects.
Withdrawal — Those signs and symptoms experi-
enced by a person who has become physically de-
pendent on a drug, experienced upon decreasing
the drug's dosage or discontinuing its use.
Ianelli, Joseph. “When Alcoholism Hits Home.” American
Journal of Nursing (July 1997): 68+.
O'Brien, Charles P., and A. Thomas McLellan. “Addiction
Medicine.” Journal of the American Medical Association
(June 18, 1997): 1840+.
“Spotting a Drinking Problem.” Consumer Reports on Health
(September 1997): 106+.
ORGANIZATIONS
Al-Anon, Alanon Family Group, Inc. P.O. Box 862, Midtown
Station, New York, NY 10018-0862. (800) 356-9996.
http://www.recovery.org/aa.
National Alliance on Alcoholism and Drug Dependence, Inc.
12 West 21st St., New York, NY 10010. (212) 206-6770.
National Clearinghouse for Alcohol and Drug Information.
<http://www.health.org>.
OTHER
Alcohol Abuse and Alcoholism. MedicineNet, Inc. 1996-2004.
[cited May 28, 2004]. <http://www.medicinet.com>.
Alcoholism. Mayo Foundation for Medical Education and Re-
search. 1998-2004. Updated, July 3, 2002. [cited May 28,
2004], <http://www.mayoclinic.com>.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
FAQs on Alcohol Abuse and Alcoholism. National Institute on
Alcohol Abuse and Alcoholism (NIAAA). Updated,
March 2003. [cited May 28, 2004]. <http://www.maaa.
nih.gov/faq/q-a.htm>.
Katherine E. Nelson, N.D.
Alexander technique
Definition
The Alexander technique is a somatic method for
improving physical and mental functioning. Excessive
tension, which Frederick Alexander, the originator, rec-
ognized as both physical and mental, restricts movement
and creates pressure in the joints, the spine, the breathing
mechanism, and other organs. The goal of the technique
is to restore freedom and expression to the body and
clear thinking to the mind.
Origins
Frederick Matthias Alexander was born in 1869 in
Tasmania, Australia. He became an actor and Shake-
spearean reciter, and early in his career he began to suf-
fer from strain on his vocal chords. He sought medical
attention for chronic hoarseness, but after treatment with
a recommended prescription and extensive periods of
rest, his problem persisted.
Alexander realized that his hoarseness began about
an hour into a dramatic performance and reasoned that it
was something he did in the process of reciting that
caused him to lose his voice. Returning to his medical
doctor, Alexander told him of his observation. When the
doctor admitted that he didn’t know what Alexander was
doing to injure his vocal chords, Alexander decided to
try and find out for himself.
Thus began a decade of self-observation and discov-
ery. Using as many as three mirrors to observe himself in
the act of reciting, normal speaking, and later standing,
walking, and sitting, Alexander managed to improve his
coordination and to overcome his vocal problems. One
of his most startling discoveries was that in order to
change the way he used his body he had to change the
way he was thinking, redirecting his thoughts in such a
way that he did not produce unnecessary tension when
he attempted speech or movement. After making this dis-
covery at the end of the nineteenth century, Alexander
became a pioneer in body-mind medicine.
At first, performers and dancers sought guidance
from Alexander to overcome physical complaints and to
47
Alexander technique
Alexander technique
FREDERICK MATTHIAS
ALEXANDER 1869-1955
Frederick Matthias (F.M.) Alexander was born in
Australia where he began a career as a young actor.
While leading the theater life, he developed chronic
laryngitis. While tragic for a stage career, his lingering
ailment would lead to his discovery of the Alexander
Technique, which would ultimately help people around
the world rid their bodies of tension and stress.
At the age of 1 9, Alexander became frustrated with
a medical practitioner's inability to treat his hoarseness
and was determined to find the cause of his malady. Al-
though lacking any medical training, Alexander began
to meticulously observe his manner of coordination
while speaking and reciting with the use of strategically
placed mirrors. After following this method of study for
1 0 years, Alexander concluded that modern society was
causing individuals to severely misuse the human sys-
tem of locomotion, thus resulting in the dysfunction of
other systems of the body. His experiments and tech-
nique laid the groundwork in the early 1900s for good
habits of coordination or the proper use of the neuro-
muscular system.
Alexander left Australia for London in 1904. The
popularity of the Alexander Technique led him to work
with intellectuals such as George Bernard Shaw and Al-
dous Huxley. Alexander also taught extensively
throughout the United States.
As of 1 995, The Alexander Technique is taught in
26 countries, and there are nine affiliated societies
overseeing a profession of approximately 2,000 teach-
ers of the technique. Alexander's technique continues to
have a profound impact on the training of musicians,
actors, and dancers from around the world.
Beth A. Kapes
improve the expression and spontaneity of their perfor-
mances. Soon a great number of people sought help from
his teaching for a variety of physical and mental disorders.
Benefits
Because the Alexander technique helps students im-
prove overall functioning, both mental and physical, it
offers a wide range of benefits. Nikolaas Tinbergen, in
his 1973 Nobel lecture, hailed the “striking improve-
ments in such diverse things as high blood pressure,
breathing, depth of sleep, overall cheerfulness and men-
tal alertness, resilience against outside pressures, and the
refined skill of playing a musical instrument.” He went
48
on to quote a list of other conditions helped by the
Alexander technique: “rheumatism, including various
forms of arthritis, then respiratory troubles, and even po-
tentially lethal asthma; following in their wake, circula-
tion defects, which may lead to high blood pressure and
also to some dangerous heart conditions; gastrointestinal
disorders of many types, various gynecological condi-
tions, sexual failures, migraines and depressive states.”
Literature in the 1980s and 1990s went on to include
improvements in back pain, chronic pain, postural prob-
lems, repetitive strain injury, benefits during pregnancy
and childbirth, help in applying physical therapy and reha-
bilitative exercises, improvements in strain caused by com-
puter use, improvements in the posture and performance of
school children, and improvements in vocal and dramatic
performance among the benefits offered by the technique.
Description
The Alexander technique is primarily taught one-on-
one in private lessons. Introductory workshops or work-
shops for special applications of the technique (e.g., work-
shops for musicians) are also common. Private lessons
range from a half-hour to an hour in length, and are taught
in a series. The number of lessons varies according to the
severity of the student’s difficulties with coordination or to
the extent of the student’s interest in pursuing the improve-
ments made possible by continued study. The cost of
lessons ranges from $40-80 per hour. Insurance coverage is
not widely available, but discounts are available for partici-
pants in some complementary care insurance plans. Pre-tax
Flexible Spending Accounts for health care cover Alexan-
der technique lessons if they are prescribed by a physician.
In lessons teachers guide students through simple
movements (while students are dressed in comfortable
clothing) and use their hands to help students identify
and stop destructive patterns of tension. Tensing arises
from mental processes as well as physical, so discus-
sions of personal reactions or behavior are likely to arise
in the course of a lesson.
The technique helps students move with ease and
improved coordination. At the beginning of a movement
(the lessons are a series of movements), most people pull
back their heads, raise their shoulders toward their ears,
over-arch their lower backs, tighten their legs, and other-
wise produce excessive tension in their bodies. Alexan-
der referred to this as misuse of the body.
At any point in a movement, proper use can be es-
tablished. If the neck muscles are not over-tensed, the
head will carry slightly forward of the spine, simply be-
cause it is heavier in the front. When the head is out of
balance in the forward direction, it sets off a series of
stretch reflexes in the extensor muscles of the back. It is
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
skillful use of these reflexes, along with reflex activity in
the feet and legs, the arms and hands, the breathing
mechanism, and other parts of the body, that lessons in
the technique aim to develop.
Alexander found that optimal functioning of the
body was very hard to maintain, even for the short period
of time it took to complete a single movement. People,
especially adults, have very strong tension habits associ-
ated with movement. Chronic misuse of the muscles is
common. It may be caused by slouching in front of tele-
visions or video monitors, too much sitting or driving and
too little walking, or by tension associated with past trau-
mas and injuries. Stiffening the neck after a whiplash in-
jury or favoring a broken or sprained leg long after it has
healed are examples of habitual tension caused by injury.
The first thing a teacher of the Alexander technique
does is to increase a student’s sensory awareness of this
excessive habitual tension, particularly that in the neck
and spine. Next the student is taught to inhibit the ten-
sion. If the student prepares to sit down, for example, he
will tense his muscles in his habitual way. If he is asked
to put aside the intention to sit and instead to free his
neck and allow less constriction in his muscles, he can
begin to change his tense habitual response to sitting.
By leaving the head resting on the spine in its natural
free balance, by keeping eyes open and focused, not held
in a tense stare, by allowing the shoulders to release, the
knees to unlock and the back to lengthen and widen, a
student greatly reduces strain. In Alexander lessons stu-
dents learn to direct themselves this way in activity and
become skilled in fluid, coordinated movement.
Precautions
Side effects
The focus of the Alexander technique is educational.
Teachers use their hands simply to gently guide students
in movement. Therefore, both contraindications and po-
tential physiological side effects are kept to a minimum.
No forceful treatment of soft tissue or bony structure is
attempted, so damage to tissues, even in the case of er-
rors in teaching, is unlikely.
As students’ sensory awareness develops in the course
of Alexander lessons, they become more acutely aware of
chronic tension patterns. As students learn to release exces-
sive tension in their muscles and to sustain this release in
daily activity, they may experience tightness or soreness in
the connective tissue. This is caused by the connective tis-
sue adapting to the lengthened and released muscles and
the expanded range of movement in the joints.
Occasionally students may get light-headed during a
lesson as contracted muscles release and effect the circu-
latory or respiratory functioning.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Forceful contraction of muscles and rigid postures
often indicate suppression of emotion. As muscles re-
lease during or after an Alexander lesson, students may
experience strong surges of emotion or sudden changes
in mood. In some cases, somatic memories surface,
bringing to consciousness past injury or trauma. This can
cause extreme anxiety, and referrals may be made by the
teacher for counseling.
Research & general acceptance
Alexander became well known among the intellectual,
artistic, and medical communities in London, England dur-
ing the first half of the twentieth century. Among Alexan-
der’s supporters were John Dewey, Aldous Huxley, Bernard
Shaw, and renowned scientists Raymond Dart, G.E.
Coghill, Charles Sherrington, and Nikolaas Tinbergen.
Researchers continue to study the effects and appli-
cations of the technique in the fields of education, pre-
ventive medicine, and rehabilitation. The Alexander
technique has proven an effective treatment for reducing
stress, for improving posture and performance in school-
children, for relieving chronic pain, and for improving
psychological functioning. The technique has been
found to be as effective as beta-blocker medications in
controlling stress responses in professional musicians, to
enhance respiratory function in normal adults, and to
mediate the effects of scoliosis in adolescents and adults.
Training & certification
Before his death in 1955, F.M. Alexander formed
the Society for Teachers of the Alexander Technique
(STAT) in London, England. The Society is responsible
for upholding the standards for teachers of the technique.
In the late 1980s, due to rapid growth of the Alexander
teaching profession, STAT authorized replication of its
certification body in many countries worldwide.
The American Society for the Alexander Technique
(AmSAT) oversees the profession in the United States.
Teachers are board certified according STAT standards.
They must receive 1600 hours of training over three
years at an AmSAT approved training program. Alexan-
der Technique International (ATI), a second organization
for teachers in the United States, has varied standards for
teacher certification.
Resources
BOOKS
Caplan, Deborah. Back Trouble - A new approach to prevention
and recovery based on the Alexander Technique. Triad
Communications: 1987.
Dirnon, Theodore. THE UNDIVIDED SELF: Alexander Tech-
nique and the Control of Stress. North Atlantic Books: 1999.
49
Alexander technique
Alfalfa
KEY TERMS
Direction — Bringing about the free balance of the
head on the spine and the resulting release of the
erector muscles of the back and legs which estab-
lish improved coordination.
Habit — Referring to the particular set of physical
and mental tensions present in any individual.
Inhibition — Referring to the moment in an Alex-
ander lesson when the student refrains from be-
ginning a movement in order to avoid tensing of
the muscles.
Sensory awareness — Bringing attention to the sen-
sations of tension and/or release in the muscles.
Jones, Frank Pierce. Freedom To Change - The Development and
Science of the Alexander Technique. Mouritz: 1997, import-
ed (First published 1976 as Body Awareness in Action.)
PERIODICALS
Stern, Judith C. “The Alexander Technique:An Approach to
Pain Control !’ Lifeline (Summer 1992).
Tinbergen, Nikolaas. “Ethology and Stress Diseases.” England
Science 185 (1974):20-27.
ORGANIZATIONS
American Society for the Alexander Technique, 401 East Market
Street (P.O. Box 835) Charlottesville, VA 22902 USA. (800)
473-0620; or (804) 295-2840. Fax: 804-295-3947. alexan-
dertec@earthlink.net. <http://www.alexandertech.org.>
Alexander Technique International, 1692 Massachusetts Ave. ,3rd
Floor, Cambridge, MA 02138 USA. (888) 321-0856. Fax:
617-497-2615. ati@ati-net.com. <http://www.ati-net.com.>
OTHER
Alexander Technique Resource Guide, (includes list of teach-
ers) AmS AT Books, (800) 473-0620 or (804) 295-2840.
Nielsen, Michael. “A Study of Stress Amongst Professional
Musicians.” STAT Books London, 1994.
Reiser, Samuel. “Stress Reduction and Optimal Psychological
Functioning." Lecture given at Sixth International Mon-
treaus Congress on Stress, 1994.
Sandra Bain Cushman
Alfalfa
Description
Alfalfa is the plant Medicago sativa. There are many
subspecies. It is a perennial plant growing up to 30 in
50
(0.75 m) in height in a wide range of soil condition. Its
small flowers range from yellow to purple. Alfalfa is
probably native to the area around the Mediterranean
Sea, but it is extensively cultivated as fodder for live-
stock in all temperate climates.
Alfalfa is a member of the legume family. It has the
ability to make nutrients available to other plants both
through its very long, deep (6-16 ft [2-5 m]) root sys-
tem, and because it has a hosts beneficial nitrogen-fixing
bacteria. For these reasons it is often grown as a soil im-
prover or “green manure.” The medicinal parts of alfalfa
are the whole plant and the seeds. It is used both in West-
ern and traditional Chinese medicine. In Chinese it is
called zi mu. Other names for alfalfa include buffalo
grass, buffalo herb, Chilean clover, purple medick, pur-
ple medicle, and lucerne.
General use
Alfalfa has been used for thousands of years in many
parts of the world, as a source of food for people and live-
stock and as a medicinal herb. It is probably more useful
as a source of easily accessible nutrients than as a medici-
nal herb. Alfalfa is an excellent source of most vitamins,
including vitamins A, D, E, and K. Vitamin K is critical
in blood clotting, so alfalfa may have some use in im-
proving clotting. It also contains trace minerals such as
calcium, magnesium, iron, phosphorous, and potassi-
um. Alfalfa is also higher in protein than many other
plant foods. This abundance of nutrients has made alfalfa
a popular tonic for convalescents when brewed into tea.
In addition to using the seeds and leaves as food, al-
falfa has a long history of folk use in Europe as a diuretic
or “water pill.” It is also said that alfalfa can lower cho-
lesterol. Alfalfa is used as to treat arthritis, diabetes, di-
gestive problems, weight loss, ulcers, kidney and bladder
problems, prostate conditions, asthma, and hay fever.
Alfalfa is also said to be estrogenic (estrogen-like).
Alfalfa is not native to the United States and did not
arrive until around 1850. However, once introduced, it
spread rapidly and was adapted by Native Americans as
a food source for both humans and animals. The seeds
were often ground and used as a flour to make mush.
The leaves were eaten as vegetable. The main medical
use for alfalfa in the United States was as a nutritious tea
or tonic.
In China, alfalfa, or zi mu, and a closely related
species tooth-bur clover, Medicago hispida or nan mu xu
have been used since the sixth century. Alfalfa is a minor
herb in traditional Chinese medicine. It is considered to
be bitter in taste and have a neutral nature. Traditional
Chinese healers use alfalfa leaves to cleanse the digestive
system and to rid the bladder of stones.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
The root of alfalfa is used in Chinese medicine to re-
duce fever, improve urine flow, and treat jaundice, kid-
ney stones, and night blindness. Contrary to the West-
ern belief that alfalfa will aid in weight gain, Chinese
herbalists believe that extended use of alfalfa will cause
weight loss.
Alfalfa contains hundreds of biologically active
compounds, making it difficult to analyze and to ascribe
healing properties to any particular component. In addi-
tion to the nutrients mentioned above, alfalfa contains
two to three percent saponin glycosides. In test tube and
animal studies, saponin glycosides have been shown to
lower cholesterol, but there is no evidence that this cho-
lesterol-lowering effect occurs in humans. In addition,
saponin glycosides are known to cause red blood cells to
break open (hemolysis) and to interfere with the body’s
utilization of vitamin E.
No modern scientific evidence exists that alfalfa in-
creases urine output, effectively treats diabetes, aids kid-
ney or bladder disorders, improves arthritis, reduces ul-
cers, or treats respiratory problems. Similarly, there is no
scientific evidence that alfalfa either stimulates the ap-
petite or promotes weight loss. There is no evidence that
alfalfa has any estrogenic effect on menstruation. There
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
is evidence, however, that although for most people alfalfa
is harmless, for some people it can be dangerous to use.
Preparations
Although alfalfa is available as fresh or dried leaf, it
is most often taken as a capsule of powdered alfalfa or as
a tablet. When dried leaves are used, steeping one ounce
of dried leaves in one pint of water for up to 20 minutes
makes a tea. Two cups of this tea are drunk daily.
In traditional Chinese medicine, juice squeezed
from fresh alfalfa is used to treat kidney and bladder
stones. To treat fluid retention, alfalfa leaves are added to
a soup along with bean curd and lard.
Precautions
Although alfalfa is harmless to most people when
taken in the recommended quantities, people with the au-
toimmune disease systemic lupus erythematosus (SLE)
should not take any form of alfalfa. In a well-document-
ed study, people with latent SLE reactivated their symp-
toms by using alfalfa. In another study, monkeys fed al-
falfa sprouts and seeds developed new cases of SLE.
51
Alfalfa
Alisma
KEY TERMS
Diuretic — Any substance that increases the pro-
duction of urine.
Estrogenic — Having properties that mimic the
functions of the female hormone, estrogen.
People with other autoimmune diseases should stay
away from alfalfa as a precautionary measure. In addi-
tion, some allergic reactions have been reported to alfalfa
tablets contaminated with other substances.
Side effects
No side effects are reported in healthy people using
alfalfa in the recommended doses.
Interactions
There are no studies of the interactions of alfalfa and
traditional pharmaceuticals.
Resources
BOOKS
Chevallier. Andrew. Encyclopedia of Medicinal Plants. Lon-
don: Dorling Kindersley, 1996.
Peirce, Andrea. The American Pharmaceutical Association
Practical Grade to Natural Medicines. New York: William
Morrow and Company, 1999.
PDR for Herbal Medicines. Montvale, New Jersey: Medical
Economics Company, 1999.
Tish Davidson
Alisma
Description
Alisma, a member of the plant family Alismataceae,
is a herb commonly used in traditional Chinese medi-
cine (TCM). The medicinal part of the plant is the dried
root of Alisma plantago-aquatica . Alisma is also called
mad-dog weed, water plantain, American water plan-
tain, or northern water plantain. It belongs to a different
species from the edible plantain or cooking banana of the
Caribbean or the plantain that produces psyllium seed.
The Chinese name for alisma is ze xie.
Alisma is a perennial plant that grows aggressively
in shallow water and boggy spots in parts of Europe,
52
North America, and northern China. Its leaves take dif-
ferent shapes depending on whether the leaves grow
above or in the water. The plant rarely reaches a height
of more than 30 in (0.9 m). There are several subspecies
of Alisma plantago found throughout the world, but their
medicinal uses are the same.
General use
Alisma has been used for centuries in China. It is
also used today in North America and Europe. In the cat-
egories used by traditional Chinese medicine, which
classifies herbs according to energy level (hot, warm,
cool, or cold) as well as taste, alisma is said to have a
cold nature and a sweet, bland taste. It is used primarily
to treat conditions of damp heat associated with the kid-
ney, bladder, and urinary tract.
Alisma is a diuretic and is used to rid the body of
excess water. It has mild and safe tonic qualities that es-
pecially affect the kidney and bladder. It is often com-
bined with other herbs in general tonic formulas. It is
used to treat kidney stones, pelvic infections, nephritis,
and other urinary tract infections, as well as yellowish
discharges from the vagina. Alisma is also believed to
have an antibacterial action that helps control infection.
In China, alisma is also used to help rid the body of
phlegm, to reduce feelings of abdominal bloating, and to
treat diabetes. The herb is also widely used in Japan.
Outside of China, alisma leaves are sometimes used
medicinally. They can be applied externally to bruises
and swellings, or taken internally to treat kidney and uri-
nary tract inflammations. The roots are also used for kid-
ney and urinary tract disorders, as well as to lower blood
pressure and to treat severe diarrhea. A minor homeo-
pathic remedy can also be made from the root.
Modern scientific research shows that alisma does
act as a mild diuretic. In several studies done in Japan,
alisma extracts were shown to reduce artificially induced
swelling in the paws of rats. Studies using human sub-
jects have not been done, but test tube and animal studies
do seem to indicate that there is a scientific basis for
some of the traditional uses of alisma. There is also some
indication that alisma does have a mild antibacterial ef-
fect, but again, evidence in humans is anecdotal and by
observation rather than by controlled trials.
Preparations
Alisma roots are harvested before the plant blooms
and is dried for future use. Fresh root is toxic. Heating or
drying deactivates the poisonous compounds in the root.
If the leaves are used, they must be boiled for a long time
before using. Fresh leaves are also poisonous.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Diuretic — A medication or substance that increas-
es the production of urine.
Alisma is an ingredient in many common Chinese
preparations to improve kidney balance and general
health. These include rehmannia eight and rehmannia six
combination, lycium chrysanthemum and rehmannia
combination, rehmannia and schizandra, rehmannia and
cornus, rehmannia and magnetitum formula, immortal
long life pill, gentiana, and hoeln five. An extract of al-
isma root is commercially available. Some herbalists in-
dicate that a large dose is necessary for alisma to be
completely effective when treating infections, or that it
should be combined with other anti-infective herbs.
Precautions
Fresh alisma roots and leaves are poisonous. Dried
roots or cooked leaves are safe, even in fairly large doses.
However, the kidney infections that alisma is used to
treat can be serious. Anyone who suspects that they have
a kidney infection should see a medical practitioner.
Side effects
Some Chinese herbalists indicate that long-term use
of alisma can irritate the intestines.
Interactions
In China and Japan, alisma is often taken together
with antibiotics for kidney infections without any nega-
tive interactions. Since alisma is primarily an Asian herb,
there is no body of information on how it might interact
with most Western pharmaceuticals.
Resources
BOOKS
Molony, David. Complete Guide to Chinese Herbal Medicine.
New York: Berkeley Books, 1998.
PDR for Herbal Medicines. Montvale, New Jersey: Medical
Economics Company, 1999.
Teegaurden, Ron. The Ancient Wisdom of the Chinese Tonic
Herbs. New York: Warner Books, 1998.
ORGANIZATIONS
American Association of Oriental Medicine (AAOM). 433
Front Street, Catasauqua, PA 18032. (610) 266-2433.
Tish Davidson
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Allergic rhinitis see Hay fever
Allergies
Definition
Allergies are abnormal reactions of the immune sys-
tem that occur in response to otherwise harmless sub-
stances.
Description
Allergies are among the most common medical dis-
orders. It is estimated that 60 million Americans, or more
than one in every five people, suffer from some form of
allergy, with similar proportions throughout much of the
rest of the world. Allergy is the single largest reason for
school absence and is a major source of lost productivity
in the workplace.
An allergy is a type of immune reaction. Normally,
the immune system responds to foreign bodies, like
pollen or bacteria, by producing specific proteins called
antibodies that are capable of binding to identifying mol-
ecules (antigens) on the foreign body. This reaction be-
tween antibody and antigen sets off a series of reactions
designed to protect the body from infection. Harmless,
everyday substances trigger this same series of reactions.
This is the condition known as allergy, and the offending
substance is called an allergen.
Allergens enter the body through four main routes:
the airways, the skin, the gastrointestinal tract, and the
circulatory system.
• Airborne allergens cause the sneezing, runny nose, and
itchy, bloodshot eyes of hay fever (allergic rhinitis).
Airborne allergens can also affect the lining of the
lungs, causing asthma, or the conjunctiva of the eyes,
causing conjunctivitis (pink eye).
• Allergens in food can cause itching and swelling of the
lips and throat, cramps, and diarrhea. When absorbed
into the bloodstream, they may cause hives or more se-
vere reactions involving recurrent, non-inflammatory
swelling of the skin, mucous membranes, organs, and
brain (angioedema). Some food allergens may cause
anaphylaxis, a potentially life-threatening condition
marked by tissue swelling, airway constriction, and
drop in blood pressure.
• In contact with the skin, allergens can cause reddening,
itching, and blistering, called contact dermatitis. Skin
reactions can also occur from allergens introduced
through the airways or gastrointestinal tract. This type
of reaction is known as atopic dermatitis.
53
Allergies
Allergic rhinitis is commonly triggered by
exposure to household dust, animal fur,
or pollen. The foreign substance that
triggers an allergic reaction is called
an allergen.
The presence of an allergen causes the
body's lymphocytes to begin producing
IgE antibodies. The lymphocytes of an
allergy sufferer produce an unusually
large amount of IgE.
Pollen grains
Lymphocyte
In a future exposure to the same substance,
the antibodies on the mast cells bind to the
allergens, and the cells release their histamine.
SECOND EXPOSURE
Histamine travels to receptor sites in the nasal
passages. When histamine molecules enter the
sites they trigger dilation of the blood vessels,
swelling, irritation, and increased production
of mucus.
Antihistamines
D
C3
D
Antihistamine drugs block histamine molecules
from entering receptor sites, thus preventing or
reducing swelling, congestion and irritation.
The allergic response. (Illustration by Hans & Cassidy. The Gale Group.)
54
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• Injection of allergens, from insect bites and stings or
drug administration, can introduce allergens directly into
the circulation, where they may cause system-wide re-
sponses (including anaphylaxis), as well as the local re-
sponses like swelling and irritation at the injection site.
People with allergies are not equally sensitive to all
allergens. Allergies may get worse over time. For exam-
ple, childhood ragweed allergy may progress to year-
round dust and pollen allergy. On the other hand, a per-
son may lose allergic sensitivity. Infant or childhood
atopic dermatitis disappears in almost all people. More
commonly, what seems to be loss of sensitivity is instead
a reduced exposure to allergens or an increased tolerance
for the same level of symptoms.
Causes & symptoms
Causes
Immunologists separate allergic reactions into two
main types: immediate hypersensitivity reactions, which
are mainly mast cell-mediated and occur within minutes
of contact with allergen, and delayed hypersensitivity re-
actions, mediated by T cells (a type of white blood cells)
and occurring hours to days after exposure.
In the upper airways and eyes, immediate hypersen-
sitivity reactions cause the runny nose and itchy, blood-
shot eyes typical of allergic rhinitis. In the gastrointesti-
nal tract, these reactions lead to swelling and irritation of
the intestinal lining, which causes the cramping and diar-
rhea typical of food allergy. Allergens that enter the cir-
culation may cause hives, angioedema, anaphylaxis, or
atopic dermatitis.
Allergens on the skin usually cause delayed hyper-
sensitivity reaction. Roving T cells contact the allergen,
setting in motion a more prolonged immune response.
This type of allergic response may develop over several
days following contact with the allergen, and symptoms
may persist for a week or more.
THE ROLE OF INHERITANCE. While allergy to specif-
ic allergens is not inherited, the likelihood of developing
some type of allergy seems to be, at least for many peo-
ple. If neither parent has allergies, the chances of a child
developing allergy is approximately 10-20%; if one par-
ent has allergies, it is 30-50%; and if both have allergies,
it is 40-75%.
COMMON ALLERGENS. The most common airborne
allergens are the following:
• plant pollens
• animal fur and dander
• body parts from house mites (microscopic creatures
found in all houses)
• house dust >
• mold spores
S'
• cigarette smoke
• solvents
• cleaners
Common food allergens include the following:
• nuts, especially peanuts, walnuts, and Brazil nuts
• fish, mollusks, and shellfish
• eggs
• wheat
• milk
• food additives and preservatives
Common causes of contact dermatitis include the
following:
• poison ivy, oak, and sumac
• nickel or nickel alloys
• latex
Insects and other arthropods whose bites or stings
typically cause allergy include the following:
• bees, wasps, and hornets
• mosquitoes
• fleas
• scabies
Symptoms
Symptoms depend on the specific type of allergic re-
action. Allergic rhinitis is characterized by an itchy, runny
nose often with a scratchy or irritated throat due to post-
nasal drip. Inflammation of the thin membrane covering
the eye (allergic conjunctivitis) causes redness, irritation
and increased tearing in the eyes. Asthma causes wheez-
ing, coughing, and shortness of breath. Symptoms of
food allergies depend on the tissues most sensitive to the
allergen and whether it is spread systemically by the cir-
culatory system. Gastrointestinal symptoms may include
swelling and tingling in the lips, tongue, palate or throat;
nausea; cramping; diarrhea; and gas. Contact dermatitis
is marked by reddened, itchy, weepy skin blisters.
Whole body or systemic reactions may occur from
any type of allergen, but are more common following in-
gestion or injection of an allergen. Skin reactions include
the raised, reddened, and itchy patches called hives. A
deeper and more extensive skin reaction, involving more
extensive fluid collection, is called angioedema. Ana-
phylaxis, another reaction, is marked by difficulty
breathing, blood pressure drop, widespread tissue
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
55
Allergies
swelling, heart rhythm abnormalities, lightheadedness,
and in some cases, loss of consciousness.
Diagnosis
Allergies can often be diagnosed by a careful med-
ical history, matching the onset of symptoms to the ex-
posure to possible allergens. Allergy tests can be used to
identify potential allergens. These tests usually begin
with prick tests or patch tests, which expose the skin to
small amounts of allergen to observe the response. Reac-
tion will occur on the skin even if the allergen is normal-
ly encountered in food or in the airways. RAST testing is
a blood test that measures the level of reactive antibodies
in the blood. Provocation tests, most commonly done
with airborne allergens, present the allergen directly
through the route normally involved. Food allergen
provocation tests require abstinence from the suspect al-
lergen for two weeks or more, followed by ingestion of a
measured amount. Provocation tests are not used if ana-
phylaxis is a concern due to the patient’s medical history.
Treatment
Allergic rhinitis
The following can help to relieve the symptoms of
airborne allergies:
• Stinging nettle ( Urtica dioica ) has antihistamine and
anti-inflammatory properties. The common dose is 300
mg four times daily.
• Grape (Vitis vinifera ) seed extract has antihistamine
and anti-inflammatory properties. The usual dose is 50
mg three times daily.
• Ephedra ( Ephedra sinicia), also called ma huang, has
anti-inflammatory activity and is proven effective in treat-
ing allergies. Taken as a tea thrice daily or 12.5-25 mg in
capsule form. Ephedra should not be used for prolonged
periods of time, as it can raise blood pressure, cause rapid
heartbeat, and interfere with adrenal gland function.
• Licorice ( Glycyrrhiza glabra ) has cortisone-like activi-
ty which is anti-inflammatory, stimulates the adrenals,
and relieves allergy symptoms. Can be taken as a tea or
100-300 mg in capsule form. Long term use can result
in sodium retention or potassium loss.
• Chinese skullcap ( Scutellaria baicalensis ) has bron-
chodilator activity, is an anti-inflammatory, and pre-
vents allergic reactions. It is taken in combination with
other herbs.
• Ginkgo ( Ginkgo biloba) seeds are used in Chinese
medicine for wheezing and coughing.
• Echinacea ( Echinacea species) may have anti- inflam-
matory activity and boost the immune system.
56
• Khellin ( Ammi visnaga ) has bronchodilator activity.
• Cramp ( Viburnum opulus) bark has bronchodilator ac-
tivity.
• Traditional Chinese medicine treats allergic rhinitis
with various species. Patent combination medicines
are: Bu Zhong Yi Qi Wan (Tonify the Middle and Aug-
ment the Qi) and Yu Ping Feng San (Jade Windscreen)
are used for preventing allergies, and Bi Yan Pian
(Rhinitis Infusion) is often prescribed for syptoms af-
fecting the nose.
• The homeopathic remedies Rhus toxicodendron, Apis
mellifica, and Nux vomica have decongestant activities.
They are taken internally.
• Vitamin C has antihistamine and decongestant activities.
• Vitamins A and E are antioxidants and help to pro-
mote normal functioning of the immune system.
• Coenzyme Q 10 may help to promote normal function-
ing of the immune system.
• Zinc may boost the immune system.
• N-acetylcysteine may have decongestant activity.
• Acupuncture has been shown to be as effective as anti-
histamine drugs in treating allergic rhinitis. It is also
used to help prevent allergic reactions by strengthening
the immune system.
Skin reactions
A variety of herbal remedies, either applied topical-
ly or taken internally, can assist in the treatment of con-
tact dermatitis. A poultice made of jewelweed ( Impatiens
species) or chickweed (Stellaria media) can soothe the
skin. A cream or wash containing calendula (Calendula
officinalis), a natural antiseptic and anti-inflammatory
agent, can help heal the rash. Chinese herbal remedies
have been effective in treating atopic dermatitis. The fol-
lowing are homeopathic remedies to be taken internally:
• Apis ( Apis mellifica) for hives that feel better with cold
application and bee stings
• Poison ivy (Rhus toxicodendron) for hives that feel bet-
ter with hot applications and for poison ivy, oak, or
sumac rashes
• Stinging nettle (Urtica mens) for hives
• Marsh tea (Ledum) for itching insect bites
• Croton (Croton tiglium) oil for poison ivy, oak, or
sumac rashes
Food allergies
Food allergy may be managed by oral desensitiza-
tion. Children with allergy to milk, eggs, fish, or apples
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
who followed an oral desensitization procedure devel-
oped resistance to the allergenic food. Oral desensitiza-
tion exposes the patient to allergens in controlled, but in-
creasing, doses. Control subjects, who had avoided the
allergenic food during the study, were still sensitive.
Allopathic treatment
A large number of prescription and over-the-counter
drugs are available for treatment of immediate hypersen-
sitivity reactions. Most of these drugs work by decreas-
ing the ability of histamine to provoke symptoms. Other
drugs counteract the effects of histamine by stimulating
other systems or reducing immune responses in general.
ANTIHISTAMINES. Antihistamines block the hista-
mine receptors on nasal tissue, decreasing the effect of
histamine released by mast cells. They may be used after
symptoms appear, though they seem to prove more ef-
fective when used preventively. A wide variety of anti-
histamines are available.
DECONGESTANTS. Decongestants constrict blood
vessels to counteract the effects of histamine. Nasal
sprays and oral systemic preparations are available. De-
congestants are stimulants and may cause increased
heart rate and blood pressure, headaches, and agitation.
Use of nasal sprays for longer than several days can
cause loss of effectiveness and rebound congestion, in
which nasal passages become more severely swollen
than before treatment.
TOPICAL CORTICOSTEROIDS. Topical corticosteroids
reduce mucous membrane and skin inflammation and are
available by prescription. Allergies tend to become worse
as the season progresses and topical corticosteroids are
especially effective at reducing this seasonal sensitiza-
tion. As a result, they are best started before allergy sea-
son begins. A 2001 study revealed that steroid nasal
sprays work better for seasonal allergies on an as-needed
basis than do antihistamines. Side effects are usually
mild, but may include headaches, nosebleeds, and un-
pleasant taste sensations.
MAST CELL STABILIZERS. Cromolyn sodium prevents
the release of mast cell granules, thereby preventing the
release of histamine and other chemicals contained in
them. Cromolyn sodium is available as a nasal spray and
aerosol (a suspension of particles in gas).
BRONCHODILATORS. Because allergic reactions in-
volving the lungs cause the airways or bronchial tubes to
narrow, bronchodilators, which cause the smooth muscle
lining the airways to open, can be very effective. Bron-
chodilators include adrenaline, albuterol, and theo-
phylline. Other drugs, including steroids, are used to pre-
vent and control asthma attacks.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Immunotherapy >
n~
Immunotherapy, also known as desensitization or al- era
lergy shots, alters the balance of antibody types in the $
body. Injections involve gradually increasing amounts of
allergen, over several weeks or months, with periodic
boosters. Full benefits may take up to several years to
achieve and are not seen at all in about one in five pa-
tients. Individuals receiving all shots will be monitored
closely following each shot because of the small risk of
anaphylaxis, a condition that can result in difficulty
breathing and a sharp drop in blood pressure.
Possible future treatments
In late 2001, a reports stated that a monoclonal anti-
body called omalizumab might be effective in treating
seasonal allergies and preventing related asthma. By
blocking immunoglobulin E (IgE), an antibody that is
found in excessive amounts in those with hay fever, the
drug treats hay fever and helps prevent related asthma.
Trials on the drug continue, and other immune-based
medicines will likely accompany its ultimate release.
Treatment of contact dermatitis
Calamine lotion applied to affected skin can reduce ir-
ritation somewhat. Topical corticosteroid creams are more
effective, though overuse may lead to dry and scaly skin.
Treatment of anaphylaxis
The emergency condition of anaphylaxis is treated
with injection of adrenaline, also known as epinephrine.
People who are prone to anaphylaxis because of food or
insect allergies often carry an “Epi-pen” containing
adrenaline in a hypodermic needle. Prompt injection can
prevent a more serious reaction from developing.
Expected results
Allergies can improve over time, although they
often worsen. While anaphylaxis and severe asthma are
life-threatening, other allergic reactions are not. Learn-
ing to recognize and avoid allergy-provoking situations
allows most people with allergies to lead normal lives.
Prevention
By determining which allergens are causing the reac-
tions, most people can learn to avoid allergic reactions
from food, drugs, and contact allergens. Airborne aller-
gens are more difficult to avoid, although keeping dust
and animal dander from collecting in the house may limit
exposure. Vitamin C may prevent allergy symptoms. Cro-
molyn sodium can be used for allergy prevention.
57
Allium cepa
KEY TERMS
Allergen — A substance that provokes an allergic
response.
Allergic rhinitis — Inflammation of the mucous
membranes of the nose and eyes in response to an
allergen.
Anaphylaxis — Increased sensitivity caused by pre-
vious exposure to an allergen that can result in
blood vessel dilation and smooth muscle contrac-
tion. Anaphylaxis can result in sharp blood pres-
sure drops and difficulty breathing.
Angioedema — Severe non-inflammatory swelling
of the skin, organs, and brain that can also be ac-
companied by fever and muscle pain.
Antibody — A specific protein produced by the im-
mune system in response to a specific foreign par-
ticle called an antigen.
Antigen — A foreign particle to which the body re-
acts by making antibodies.
Asthma — A lung condition in which the airways
become narrow due to smooth muscle contraction,
causing wheezing, coughing, and shortness of
breath.
Atopic dermatitis — Infection of the skin as a result
of exposure to airborne or food allergens.
Conjunctivitis — Inflammation of the thin lining of
the eye called the conjunctiva.
Contact dermatitis — Inflammation of the skin as a
result of contact with a substance.
Histamine — A chemical released by mast cells that
activates pain receptors and causes cells to be-
come leaky.
Mast cells — A type of immune system cell that is
found in the lining of the nasal passages and eye-
lids and participates in the allergic response by re-
leasing histamine.
T cells — White blood cells that stimulate cells to
create and release antibodies.
Resources
BOOKS
Lawlor G.J., Jr, T.J. Fischer, and D.C. Adelman. Manual of Al-
lergy and Immunology. Boston: Little, Brown and Co.,
1995.
Weil. A. Natural Health, Natural Medicine: A Comprehensive
Manual for Wellness and Self-Care. Boston: Houghton
Mifflin, 1995.
Ying, Zhou Zhong and Jin Hui De. “Common Diseases of
Otorhinolaryngology and Stomatology.’" In Clinical Man-
ual of Chinese Herbal Medicine and Acupuncture. New
York: Churchill Livingston, 1997.
PERIODICALS
Harder, Patty A. “Homeopathic First-Aid for Allergic Reac-
tions.” Better Nutrition. 60 (June 1998): 42.
Patriarca, G., D. Schiavino, E. Nucera, G. Schinco, A. Milani,
and G.B. Gasbarrini. “Food Allergy in Children: Results
of a Standardized Protocol for Oral Desensitization." He-
pato-Gastroenterology. 45 (1998): 52-58.
Plaut, Marshall. “Immune-Based, Tageted Therapy for Allergic
Diseases.” JAMA. The Journal of the American Medical
Association. (December 19, 2001): 3005.
Siegel-Maier, Karyn. “Nettlesome Allergies! Natural Alterna-
tives to Treat Seasonal Sneezing.” Mother Earth News.
(September 1998): 24+ .
“Steroid Nasal Spray Better for Season Allergies than Antihista-
mines.” Immunotherapy Weekly (December 12, 2001): 12.
58
Belinda Rowland
Teresa Norris
Allergy elimination diet see Elimination diet
Allium cepa
Description
Allium cepa is the common onion. Although it is
usually thought of as a vegetable, A. cepa also has a long
history of medicinal use.
Onions are perennials that are cultivated for food
worldwide. There are many varieties. Most onion bulbs
are white, yellow, or red. The green stems and leaves are
hollow and can reach 3 ft ( 1 m) in height. The plants bear
small flowers that are usually white or purple. The fleshy
bulb that grows below the ground is used medicinally as
well as for food. Onions are members of the lily family.
General use
Onion has been used as a food source for almost as long
as humans have been keeping written records. Their useful-
ness has been discovered independently by many cultures on
several continents. Onions are mentioned in ancient Egypt-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Onion plant. (© PlantaPhile, Germany. Reproduced by permission.)
ian writings and were known in ancient Greece. In medieval
Europe, they were used unsuccessfully to ward off plague.
In North America, Native Americans used onion to
treat insect stings and relieve colds. It is also used in tra-
ditional Chinese medicine. Homeopaths make a tinc-
ture of onion to treat a variety of conditions including
cold, cough, diarrhea, facial paralysis, hay fever, her-
nia, laryngitis, pneumonia, and trauma.
Over the centuries, onion has been used for healing
both internally and externally. Internally, onion has been
recommended to treat colds, cough, bronchitis, whoop-
ing cough, asthma, and other respiratory problems. It is
believed to help loosen congestion in the lungs and ex-
pand the airways.
Onion is also used internally to relieve excess gas and
calm an upset stomach. A mixture of me (Ruta graveolens)
and onion is used to rid the digestive system of parasites.
Onion is also thought to stimulate the appetite.
Onion is believed to have a positive effect on the cir-
culatory system. It has been used as a diuretic to reduce
swelling. It is also thought to help reduce arteriosclerosis
by lowering blood cholesterol levels and preventing the
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
formation of blood clots. Onion has been used to treat
diabetes and is reputed to lower blood sugar levels.
Externally, fresh onion juice is used to prevent bac-
terial and fungal infections. It can be applied to wounds
and stings on the skin, used to remove warts, used to
stimulate hair growth, and even used to reduce unwanted
skin blemishes. Warm onion juice dropped in the ear is
said to help relieve earache. Baked onion is used to
draw pus from abscesses.
Modern scientific research supports many of the tra-
ditional uses for onion. Onion contains thiosulphinate, a
compound that is effective in killing many common bac-
teria, including Salmonella typhi , Pseudomonas aerigi-
nosa, and Escherichia coli. This finding supports the
folk use of onion to treat wounds and skin infections and
possibly its use for an upset stomach.
Even more supportive are small clinical studies on
humans that show that both fresh onions and commercial
onion extracts actually lower blood cholesterol levels,
lower blood pressure and help prevent the formation of
blood clots. Although these studies have been done on
only a small number of people, they are consistently sup-
ported by additional data from animal and test-tube stud-
59
Allium cepa
Aloe
ies. In addition, many of these properties have been found
in garlic (A. sativum) which is a close relative to onion.
In 1990, scientists detected the presence of a com-
pound in onion that partially blocks the development of in-
flammation. In addition, laboratory animals were protected
against induced asthma with fresh onion juice. Humans
with asthma have also shown reduced allergy-induced con-
striction of the airways when given an extract of onion.
These findings support the traditional folk administration
of onion to treat asthma and respiratory complaints.
Some test-tube and small animal studies suggest that
onion oil can stop the growth of tumors. Whether these
results are applicable to humans remains to be seen, but
in a 1989 study done in China, people who ate large
amounts of vegetables in the Allium family appeared to
have a significantly reduced rate of stomach cancer.
Onion has also been shown to contain antioxidants,
which are compounds that protect the body against free
radicals. Free radicals are highly reactive molecules that
destabilize other molecules and are associated with a
number of degenerative diseases.
The German Federal Health Agency’s Commission
E, established in 1978 to independently review and eval-
uate scientific literature and case studies pertaining to
herb and plant medications, has approved onion as an an-
tibacterial agent. Although many studies are promising,
more information is needed before this endorsement is
extended to other uses of onion. In general, however, it
appears that onion is a healthful vegetable that may con-
fer many medical benefits.
Preparations
Onion is a common vegetable, and can be served
cooked or raw. For medicinal purposes, onion is available
for internal use as a capsule or tablet containing dehydrated
onion or onion extract. A recent study of the antioxidant
activity of onion juice indicates that it is not affected by
heating or boiling.For external use, the juice of fresh onion
is used. A common dose is 1/4-1 cup of raw onions daily
or one teaspoon of juice three times a day. In folk medi-
cine, a cough syrup is made of raw onion liquid and honey.
Precautions
No special precautions are needed when taking
onion medicinally.
Side effects
Although no allergic reactions to the bulb of the onion
are reported, some people develop an allergic rash after han-
dling the leaves of the plant. In addition, windblown parti-
cles of onion leaves and skin have been shown to irritate the
eyes of farm workers employed to harvest the onions.
60
KEY TERMS
Antioxidant — An enzyme or other organic sub-
stance that is capable of counteracting the damag-
ing effects of oxidation in living tissue. Onion has
been found to contain antioxidants.
Diuretic — Any substance that increases the pro-
duction of urine.
Tincture — An alcohol-based extract prepared by
soaking plant parts.
Interactions
There are no studies of the interaction of onion and
conventional pharmaceuticals. However, given the long
and widespread use of onion as a vegetable, serious in-
teractions appear unlikely.
Resources
BOOKS
Chevallier. Andrew. Encyclopedia of Medicinal Plants. Lon-
don: Dorling Kindersley, 1996.
PDR for Herbal Medicines. Montvale. N. J.: Medical Econom-
ics Company, 1999.
Peirce, Andrea. The American Pharmaceutical Association
Practical Guide to Natural Medicines New York: William
Morrow and Company, 1999.
PERIODICALS
Hwang, Y. H., et al. “Suspended Onion Particles and Potential
Corneal Injury in Onion Harvesters.” Archives of Environ-
mental Health 57 (January-February 2002): 78-84.
Racchi.M., et al. “Antiradical Activity of Water-Soluble Compo-
nents in Common Diet Vegetables.” Journal of Agricultur-
al and Food Chemistry 50 (February 2002): 1272-1277.
Tish Davidson
Rebecca J. Frey, PhD
Allium sativa see Garlic
Aloe
Description
Appearance
Aloe vera , a member of the lily family, is a spiky,
succulent, perennial plant. It is indigenous to eastern and
southern Africa, but has been spread throughout many of
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
the warmer regions of the world, and is also popularly
grown indoors. There are about 300 identified species,
but Aloe vera (“true aloe”) is the most popular for med-
ical applications. It has also been known as Aloe vulgaris
(“common aloe”) and Aloe barbadensis. The plant has
yellow flowers and triangular, fleshy leaves with serrated
edges that arise from a central base and may grow to
nearly 2 ft (0.6 m) long. Each leaf is composed of three
layers. A clear gel, that is the part of the plant used for
topical application is contained within the cells of the
generous inner portion. Anthraquinones, which exert a
marked laxative effect, are contained in the bitter yellow
sap of the middle leaf layer. The fibrous outer part of the
leaf serves a protective function.
History
Aloe vera has been in use for thousands of years,
and is mentioned in records as long ago as 1750 B.c.
Use of the plant is thought to have originated in Egypt
or the Middle East. It was reputedly used in Egyptian
embalming procedures, as drawings of Aloe vera have
been found on cave walls in the region. Legend has it
that Aloe vera was one of Cleopatra’s secrets for keep-
ing her skin soft. Pliny and Dioscorides of ancient
Greece wrote of the healing effects of this plant. Addi-
tionally, Alexander the Great is said to have acquired
Madagascar so that he could utilize the Aloe vera grow-
ing there to treat soldiers’ wounds. It is also a remedy
which has long been used in the Indian practice of
Ayurvedic medicine.
In the United States, Aloe vera was in use by the
early 1800s, but primarily as a laxative. A turning point
occurred in the mid- 1930s, when a woman with chronic
and severe dermatitis resulting from x-ray treatments
was healed by an application of Aloe vera leaf gel. Suc-
cess with this patient encouraged trials with others suf-
fering from radiation burns. Evidence of the effective-
ness remained anecdotal until 1953, when Lushbaugh
and Hale produced a convincing study, using Aloe vera
to treat beta radiation lesions in rats. Other experimental
protocols have been carried out using animals since that
time, but there is little human research data to describe
the degree of effectiveness of Aloe vera treatment. Some
evidence suggests that it is especially helpful in the el-
derly and other people with impaired health or failing
immune systems.
Biologic components
Aloe vera contains a wealth of substances that are
biologically active. The laxative, and in large doses,
purgative, effects of Aloe vera latex are attributable to a
group of chemicals known as the anthraquinones. Aloin,
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Leaves of an aloe plant. (Photograph by Robert J. Huffman.
Field Mark Publications. Reproduced by permission.)
barbaloin, and aloe-emodin, and aloectic acid, are a few
of the anthraquinones contained in the latex layer. The
latest, and perhaps most exciting component discovered
in Aloe vera is a biologically active polysaccharide
known as acetylated mannose, or acemannan. This sub-
stance has been shown to be a highly effective immune
stimulant, with activity against the viruses causing the
flu, measles, and early stages of AIDS. It has been used
effectively against some veterinary cancers, most no-
tably sarcoma, and is being investigated as an agent to be
used to treat cancer in humans. Acemannan is one of
many saccharides contained in Aloe vera. Some of the
others are arabinose, cellulose, galactose, mannose, and
xylose. Prostaglandins are a third important set of com-
pounds, and are thought to play a major role in wound
healing. Aloe vera also contains fatty acids, enzymes,
amino acids, vitamins, minerals, and other substances.
The interaction of all these components produces a fa-
vorable environment for wound healing.
General use
Few botanicals are as well known or as highly
thought of as the Aloe vera plant. Throughout recorded
history, it has been used to keep skin beautiful and re-
store it to health. A frequent moisturizing ingredient in
cosmetics and hair care products, it also promotes the
healing of burns and superficial wounds, but should not
be used on deep or surgical wounds of punctures. Topi-
cal application has been successful in treatment of sun-
burn, frostbite, radiation injuries, some types of der-
matitis, psoriasis, cuts, insect stings, poison ivy, ulcera-
tions, abrasions, and other dermatologic problems. Heal-
ing is promoted by the anti-inflammatory components,
including several glycoproteins and salicylates, and sub-
stances that stimulate growth of skin and connective tis-
sue. Aloe vera contains a number of vitamins and miner-
61
Aloe
Aloe
als that are necessary to healing, including vitamin C,
vitamin E, and zinc. It also exerts antifungal and an-
tibacterial effects, and thus helps to prevent wound in-
fections. One study showed it to have a little more activ-
ity than the antiseptic silver sulfadiazine against a num-
ber of common bacteria that can infect the skin. It has
moisturizing and pain relieving properties for the skin
lesions, in addition to healing effects.
Aloe vera gel products may also be used internally.
They should not contain the laxative chemicals found in
the latex layer. There is some evidence that Aloe vera
juice has a beneficial effect on peptic ulcers, perhaps in-
hibiting the causative bacteria, Helicobacter pylori. It ap-
pears to have a soothing effect on the ulcer, and interferes
with the release of hydrochloric acid by the stomach.
Colitis and other conditions of the intestinal tract may
also respond favorably to the internal use of gel products.
Aloe vera has been shown to exert a stabilizing effect on
blood sugar in studies done on mice, indicating a possible
place for it in the treatment of diabetes. One study sug-
gested that giving Aloe vera extract orally to patients with
asthma who are not dependent on steroids could improve
symptoms. A health care provider should be consulted
about these uses. Other suggested, but insufficiently
proven, indications for oral Aloe vera gel include preven-
tion of kidney stones and relief of arthritis pain.
Aloe vera products derived from the latex layer are
taken orally for the laxative effect. They can cause
painful contractions of the bowel if taken in high doses.
Milder measures are recommended first.
The concentration of the immune stimulant aceman-
nan is variable in the natural plant, as well as gel and
juice products, but it is also available in a purified, stan-
dardized, pharmaceutical grade form. An injectable type
is used in veterinary medicine to treat fibrosarcoma and
feline leukemia, a condition caused by a virus in the
same family as AIDS.
Preparations
Commercial products
Choosing effective Aloe vera products can be chal-
lenging. Once a leaf is cut, enzymes start to break down
some of the long chain sugars which make Aloe vera gel
an effective healing product, so it is important for the
plant to have been properly handled and stabilized. Ask
for help in selecting a reputable company to buy from.
When shopping for a product to use for topical healing,
look for Aloe vera to be one of the first products listed to
ensure that it is not too dilute to be efficacious. Commer-
cial, stabilized gel products may not work as well as the
fresh gel, but cold processing is thought to best retain the
62
beneficial properties. The FDA does not regulate label-
ing of Aloe vera products.
Aloe vera juice is most often the form of the gel that
is used internally. At least half of the juice should be
Aloe vera gel. If laxative properties are not desired, be
sure that the juice does not contain latex. A product that
is made from the whole leaf does not necessarily contain
anthraquinones from the latex layer, as those are water-
soluble and can be separated out during processing. Cap-
sules and tinctures of the gel are also available. Oral
forms of the latex extract are generally capsules, as it is
extremely bitter.
Growing aloe at home
For common topical use, keeping an Aloe vera plant
at home is one of the easiest ways to get the freshest and
most concentrated gel. It is easy to cultivate, requiring
only good drainage, mild temperatures, and occasional
watering. Bring the plant inside if outside temperatures
are less than 40°F (4.4°C). It will tolerate either full or
partial sunlight, but will require more frequent watering
in full sun. Water it only when the soil has become dry.
To use the gel, break off a leaf and cut it lengthwise to
expose the inner layer. Scoop the gel out and apply gen-
erously to the area needing treatment. Discard whatever
gel is not used immediately, as it will degenerate quickly.
The inner portion of the leaf may also be applied directly
to a skin injury, and bound to it.
Precautions
Aloe vera gel is generally safe for topical use, but it
is best to apply it to a small area first to test for possible
allergic reaction. Stinging and generalized dermatitis
may result in individuals who are sensitive to it. The vast
majority of the warnings apply only to products contain-
ing anthraquinones, such as aloin and barbaloin (as well
as the numerous others), which are found in the latex
layer of the plant. Aloe vera latex should not be used in-
ternally by women who are pregnant or lactating, or by
children. This product can cause abortion or stimulate
menstruation. It may pass into the milk of breastfeeding
mothers. People who have abnormal kidney function,
heart disease, or gastrointestinal diseases are best ad-
vised to avoid any product containing Aloe vera latex or
anthraquinones. Prolonged, internal use in high doses
may produce tolerance so that more is required to obtain
the laxative effect. Be aware of the possibility that any
Aloe vera product for internal use that is supposed to
contain only the gel portion can become contaminated
by the anthraquinones of the latex layer. For this reason,
people who have a contraindication for using Aloe vera
latex should use caution when taking an Aloe vera gel
product internally.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
AIDS — Acronym for acquired immune deficiency
syndrome, the disease caused by human immun-
odeficiency viruses (HIV).
Aloe concentrate — Aloe gel from which the water
has been removed.
Aloe gel — Thick, undiluted substance from the
central portion of the aloe leaf.
Aloe juice — A product for oral use, which is com-
posed of at least 50% aloe gel.
Aloe latex — Bitter yellow sap from the middle leaf
layer.
Anthraquinone — A group of chemicals contained
in the latex of the Aloe plant and having strong
laxative properties.
Hyperglycemia — High blood sugar.
Side effects
Internal use of Aloe vera latex may turn the urine
red, and may also cause abdominal pain or cramps when
products containing anthraquinones are consumed.
Interactions
Chronic internal use of products containing Aloe
vera latex may increase the likelihood of potassium loss
when used concomitantly with diuretics or corticos-
teroids. It may possibly compound the risk of toxicity
when used with cardiac glycosides (both prescription
and herbal types) and antiarrhythmic drugs. Absorption
of other oral medications can be decreased. Aloe vera
latex should not be used with other laxative herbs, which
may also lead to excessive potassium loss.
Internal use of Aloe vera gel can cause changes in
blood sugar, so diabetics should monitor blood glucose
levels during use, particularly if insulin or other pharma-
ceuticals are being used to control hyperglycemia.
Topical Aloe vera may enhance the effect of topical
corticosteroids and allow a reduction in the amount of
the steroid being used.
Resources
BOOKS
Bratman, Steven and David Kroll. Natural Health Bible. Prima
Health, 1999.
Chevallier, Andrew. The Encyclopedia of Medicinal Plants. DK
Publishing Inc., 1996.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Jellin, J.M.. F. Batz, and K. Hitchens. Pharmacist’ s Letter/Pre-
scriber's Letter Natural Medicines Comprehensive Data-
base. Therapeutic Research Faculty, 1999.
Murray, Michael T. The Heating Power of Herbs. Prima Health,
1995.
Judith Turner
Alopecia see Hair loss
Alpha-hydroxy
Description
Alpha-hydroxy is a chemical compound derived
from fruit and milk sugars. Alpha-hydroxy acids (AHAs)
are use in topical skin care products to exfoliate, or
slough away, dead skin cells and promote collagen
growth. They can be useful in promoting smoother,
even-toned skin and may reduce the appearance of wrin-
kles and fine lines in some individuals.
AHAs are available in a number of different synthet-
ic and natural formulations. Lactic AHA is derived from
milk products, while glycolic AHA is derived from sug-
arcane. Other AHA compounds include citric acid (from
fruit) and malic acid (from apples).
General use
AHAs work by removing dead cells at the surface of
the skin. In higher concentrations, it promotes collagen
production, which may reduce the appearance of fine
lines and wrinkles in the skin. The acids penetrate deep
into the skin, where they actually begin to damage skin
cells. This skin damage triggers the production of colla-
gen, a fibrous protein and a building block of tissue and
skin, as the body attempts to repair the cell damage.
Cosmetic, over-the-counter preparations of alpha-
hydroxy must contain less than 10% of the compound
according to U.S. Food and Drug Administration (FDA)
regulations. This is a high enough concentration to pro-
mote exfoliation, but not potent enough to generate col-
lagen production. The concentration of AHA required to
produce this effect is only available with a prescription
from a dermatologist or licensed healthcare professional,
or through professionally administered treatments from a
licensed cosmetologist.
Guidelines recommended by the trade regulatory as-
sociation Cosmetic Ingredient Review have been adapted
by the U.S. FDA for consumer AHA products. The Cos-
metic Ingredient Review is a self-regulating agency es-
63
Alpha-hydroxy
Alpha-hydroxy
tablished by the Cosmetic, Toiletry, and Fragrance Asso-
ciation to set safety standards for ingredients used by the
cosmetic industry. Trained cosmetologists are permitted
to use AHA concentrations as high as 30%, provided
these products have a pH level of 3.0 or higher. Health-
care professionals such as dermatologists typically use
concentrations as high as 50-70%.
Preparations
AHA preparations are available in over the counter
and prescription gel, lotion, toner, and cream formula-
tions. An over-the-counter formula that contains between
5-8% AHA may be more effective. Because FDA regu-
lates these products as cosmetics and not drugs, the man-
ufacturer is not required to list the strength of AHA on
the package labeling. However, product ingredients must
be listed sequentially in the order of highest concentra-
tion, so products which list AHA compounds second or
third are usually more beneficial than those who list
them in the middle to end of the ingredient list.
The pH level of an AHA product is also important to
the product’s effectiveness. A higher pH level means the
product is less acidic and gentler on the skin, however, a
higher pH can also lessen the overall potency of the
product. The Cosmetic Ingredient Review guidelines for
AHA products specify that consumer AHA products
must have a pH of 3.5 or more.
Depending on their skin type, certain individuals
may find some carrier formulas (i.e., cream, gel, lotion,
toner) more effective than others. Those with dry skin
may find moisturizing AHA creams and lotions more ef-
fective, while individuals with oily skin may prefer a less
oily toner or gel.
Individuals who are prescribed AHA formulations
by a healthcare professional should follow their doctor’s
directions for use of the product.
Precautions
Buy only those AHA products that conform to the
Cosmetic Ingredient Review and FDA recommended
guidelines of 10% or less AHA with a 3.5 or higher pH
level.
Over-the-counter AHA preparations (those with less
than 10% AHA) are designated as cosmetics, rather than
drugs, by the U.S. FDA, and therefore do not have to un-
dergo the rigorous testing, review, and approval process
required of medical products. In addition, labeling for
cosmetics does not require a listing of the concentration
of ingredients, although some manufacturers provide this
information on their labeling voluntarily. Individuals
should try to purchase AHA products that provide de-
64
tailed ingredient and concentration information to ensure
they are purchasing true AHA ingredients in a therapeu-
tic concentration. In addition, if an individual experi-
ences a reaction to an AHA product, they can use de-
tailed labeling to decide if a lower concentration of the
product is available and may be right for them.
Individuals who are considering using AHA prod-
ucts for the first time, or who are switching the type of
AHA product they use, should perform a skin patch test
to check for skin sensitivity to the substance. A small,
dime sized drop of the AHA product should be applied
to a small patch of skin inside the elbow or wrist. The
skin patch should be monitored for 24 hours to ensure no
excessive redness, swelling, blistering, or rash occurs. If
a reaction does occur, the test can be repeated with an
AHA product with a lower alpha-hydroxy acid concen-
tration. Individuals who experience a severe reaction to a
skin patch test of AHA are advised not to use the prod-
uct. A dermatologist or other healthcare professional
may be able to recommend a suitable alternative.
AHA products may increase sun sensitivity. Individ-
uals using AHA products should use a high SPF (at least
15 SPF) sunscreen over the AHA formula to protect
against burning. Sunscreen should be applied no less
than 15 minutes after the AHA formula is applied to pre-
vent neutralizing the acids. Shading the face with a wide-
brimmed hat may also be useful. Results of a 1999 FDA
study on the use of AHA and UV damage showed that,
while AHA decreases the time required for skin to begin
to burn, discontinuing use of the AHA product returned
skin to normal within a week.
Exfoliative products should be used with care, as
over-exfoliation can cause damage to the skin. AHA
products should not be combined with other exfoliative
products such as facial scrubs, buff pads, or loofahs. In
addition, individuals should only use one AHA product
at a time.
Higher concentration prescription AHA products
have a great likelihood of producing side effects, so indi-
viduals taking them should contact their healthcare
provider immediately if they experience burning, red-
ness, or any other reaction to the product.
Individuals who experience adverse reactions to
AHA treatments should report them to both the manu-
facturer of the product and to the FDA’s Office of Cos-
metics and Colors. A patient’s dermatologist or health-
care provider can also make this report anonymously for
the patient. Although these products do not require FDA
approval for market release, FDA is responsible for mon-
itoring their safety and can initiate a product recall or re-
moval for a specific brand or formulation if enough ad-
verse effects occur to make these steps necessary.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Contact dermatitis — Inflammation and redness of
the skin caused by an irritating substance.
Exfoliate — To shed skin. In skin care, the term ex-
foliate describes the process of removing dead
skin cells.
pH — An abbreviation for potential of hydrogen. A
neutral pH is a pH of 7. Levels below 7 are con-
sidered acidic, and those above 7 alkaline. FDA
recommends that over-the-counter alpha-hydroxy
products have a pH of at least 3.5.
AHA chemical peels and other high concentration
AHA treatments should only be administered by a li-
censed cosmetologist, licensed dermatologist, or other
qualified healthcare professional.
Side effects
Possible side effects of AHA products include:
• Increased sun sensitivity. Individuals who use AHA are
often more sensitive to UV rays.
• Excessive redness and burning. In high concentrations
and/or with individuals with sensitive skin, AHA can
cause redness, burning, and even blistering.
• Swelling. AHA products can cause swelling of the skin
and/or eyes.
• Contact dermatitis. AHA can cause an allergic skin re-
action characterized by rash and itching in some indi-
viduals.
• Skin discoloration. Some cases of AHA-related skin
discoloration have been reported.
The FDA has sponsored a joint study with the Na-
tional Toxicology Program to further assess the long-
term consequences of AHA product use. Results of the
study were not yet available as of July 2000.
Interactions
There are no known interactions between alpha-hy-
droxy acid products and other medications and sub-
stances when administered in recommended strengths.
However, because over-the-counter AHA products are
considered cosmetics and not pharmaceuticals, existing
research on possible interactions is minimal.
Alpha-hydroxy products may enhance the effects of
other products or medications with similar therapeutic
properties.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Resources
BOOKS
Callan, Annette, ed. All About Skin Care. Oxford, UK: Oxford
University Press, 2000.
PERIODICALS
Kurtzweil, Paula. “Alpha Hydroxy Acids.” FDA Consumer. 32,
No. 2 (March/April 1998): 30-6.
ORGANIZATIONS
Cosmetic Ingredient Review. 1101 17th St. N.W. Suite 310,
Washington D.C. 20036-4702. (202) 331-0651. http://
www.cir-safety.org
U.S. Food and Drug Administration. Office of Consumer Af-
fairs. FDA (HFE-88), 5600 Fishers Lane, Rockville, MD
20857. (301) 827-5006. http://www.fda.gov. To report ad-
verse effects of a cosmetic product, call: (800) 270-8869.
Paula Ford-Martin
Alternate nostril breathing see Breath
therapy
Althea occicinal see Marsh mallow
Alzheimer's disease
Definition
Alzheimer’s disease (AD) is the most common form
of dementia, a neurologic disease characterized by loss
of mental ability severe enough to interfere with normal
activities of daily living, lasting at least six months, and
not present from birth. AD usually occurs in old age, and
is marked by a decline in cognitive functions such as re-
membering, reasoning, and planning.
Description
A person with AD usually has a gradual decline in
mental functions, often beginning with slight memory
loss, followed by losses in the ability to maintain employ-
ment, to plan and execute familiar tasks of daily living,
and to reason and exercise judgment. Communication
ability, mood, and personality may also be affected. Most
people who have AD die within eight years of their diag-
nosis, although that interval may be as short as one year
or as long as 20 years. AD is the fourth leading cause of
death in adults after heart disease, cancer, and stroke.
Between two and four million Americans have AD;
that number is expected to grow to as many as 14 million
by the middle of the twenty-first century as the popula-
tion as a whole ages. While a small number of people in
65
Alzheimer's disease
Alzheimer's disease
Diseased tissue from the brain of an Alzheimer’s patient
showing senile plaques within the brain’s gray matter.
(Photograph by Cecil Fox, Photo Researchers, Inc. Reproduced
by permission.)
their 40s and 50s develop the disease (called early-onset
AD), AD predominantly affects the elderly. AD affects
about 3% of all people between ages 65 and 74, about
19% of those between 75 and 84, and about 47% of
those over 85. Slightly more women than men are affect-
ed with AD, but this may be because women tend to live
longer, leaving a higher proportion of women in the most
affected age groups.
The cost of caring for a person with AD is consider-
able, and has been estimated at approximately $174,000
per person over the course of the disease. Most people
with AD are cared for at home; the cost of extended
nursing home care adds substantially to this estimate.
Causes & symptoms
The cause or causes of AD are unknown. Some
strong leads have been found through recent research,
and these have also given some theoretical support to
several new experimental treatments.
AD affects brain cells, mostly those in brain regions
responsible for learning, reasoning, and memory. Autop-
sies of persons with AD show that these regions of the
brain become clogged with two abnormal structures —
neurofibrillary tangles and senile plaques. Neurofibril-
lary tangles are twisted masses of protein fibers inside
nerve cells, or neurons. Senile plaques are composed of
parts of neurons surrounding a group of brain proteins
called beta-amyloid deposits. While it is not clear exact-
ly how these structures cause problems, some re-
searchers now believe that their formation is in fact re-
sponsible for the mental changes of AD, presumably by
interfering with the normal communication between
neurons in the brain.
What triggers the formation of plaques and tangles
is unknown, although there are several possible candi-
dates. Inflammation of the brain may play a role in their
development, and use of nonsteroidal anti-inflammatory
drugs (NSAIDs) seems to reduce the risk of developing
AD. Restriction of blood flow may be part of the prob-
lem, perhaps accounting for the beneficial effects of es-
trogen that increases blood flow in the brain, among its
other effects. Highly reactive molecular fragments called
free radicals damage cells of all kinds, especially brain
cells, which have smaller supplies of protective antioxi-
dants thought to protect against free radical damage.
Several genes have been implicated in AD, includ-
ing the gene for amyloid precursor protein, or APP, re-
sponsible for producing amyloid. Mutations in this gene
are linked to some cases of the relatively uncommon
early-onset forms of AD. In 2001, scientists discovered a
new rare mutation of the APP gene that might lead to
new understanding on how the disease develops and new
treatment possibilities. Other cases of early-onset AD are
caused by mutations in the gene for another protein,
called pre-senilin. AD eventually affects nearly everyone
with Down syndrome, caused by an extra copy of chro-
mosome 21. Other mutations on other chromosomes
have been linked to other early-onset cases.
Potentially the most important genetic link was dis-
covered in the early 1990s on chromosome 19. A gene
on this chromosome, called apoE, codes for a protein in-
volved in transporting lipids into neurons. ApoE occurs
in at least three forms — apoE2, apoE3, and apoE4. Each
person inherits one apoE from each parent, and therefore
can either have one copy of two different forms, or two
copies of one. Compared to those without ApoE4, people
with one copy are about three times as likely to develop
late-onset AD, and those with two copies are almost four
times as likely to do so. Despite this important link, not
everyone with apoE4 develops AD, and people without it
can still have the disease. Why apoE4 increases the
chances of developing AD is not known.
There are several risk factors that increase a per-
son’s likelihood of developing AD. The most significant
one is age; older people develop AD at much higher rates
than younger ones. Another risk factor is having a family
history of AD, Down syndrome, or Parkinson’s disease.
People who have had head trauma or hypothyroidism
may manifest the symptoms of AD more quickly. No
other medical conditions have been linked to an in-
creased risk for AD.
Many environmental factors have been suspected of
contributing to AD, but population studies have not borne
out these links. Among these have been pollutants in
drinking water, aluminum from commercial products, and
66
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
metal dental fillings. To date, none of these factors has
been shown to cause AD or increase its likelihood. Further
research may yet turn up links to other environmental cul-
prits, although no firm candidates have been identified.
The symptoms of AD begin gradually, usually with
short-term memory loss. Occasional memory lapses are
of course common to everyone, and do not by them-
selves signify any change in cognitive function. The per-
son with AD may begin with only the routine sort of
memory lapse — forgetting where the car keys are — but
progress to more profound or disturbing losses, such as
forgetting that he or she can even drive a car. Becoming
lost or disoriented on a walk around the neighborhood
becomes more likely as the disease progresses. A person
with AD may forget the names of family members, or
forget what was said at the beginning of a sentence by
the time he hears the end.
As AD progresses, other symptoms appear, includ-
ing inability to perform routine tasks, loss of judgment,
and personality or behavior changes. Some patients have
trouble sleeping and may suffer from confusion or agita-
tion in the evening (“sunsetting”). In some cases, people
with AD repeat the same ideas, movements, words, or
thoughts, a behavior known as perseveration. Some pa-
tients may exhibit inappropriate sexual behaviors. In the
final stages of the disease, people may have severe prob-
lems with eating, communicating, and controlling their
bladder and bowel functions.
The Alzheimer’s Association has developed a list of 10
warning signs of AD. A person with several of these symp-
toms should see a physician for a thorough evaluation:
• memory loss that affects job skills
• difficulty performing familiar tasks
• problems with language
• disorientation of time and place
• poor or decreased judgment
• problems with abstract thinking
• misplacing things
• changes in mood or behavior
• changes in personality
• loss of initiative
Other types of dementing illnesses, including some
that are reversible, can cause similar symptoms. It is im-
portant for the person with these symptoms to be evalu-
ated by a professional who can weigh the possibility that
his or her symptoms may have another cause. Approxi-
mately 20% of those originally suspected of having AD
turn out to have some other disorder; about half of these
cases are treatable.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Diagnosis
Diagnosis of AD is complex, and may require office
visits to several different specialists over several months
before a diagnosis can be made. While a confident provi-
sional diagnosis may be made in most cases after thor-
ough testing, AD cannot be definitively diagnosed until
autopsy examination of the brain for senile plaques and
neurofibrillary tangles.
The diagnosis of AD begins with a thorough physi-
cal exam and complete medical history. Except in the
disease’s earliest stages, accurate history from family
members or caregivers is essential. Since there are both
prescription and over-the-counter drugs that can cause
the same mental changes as AD, a careful review of the
patient’s drug, medicine, and alcohol use is important.
AD-like symptoms can also be provoked by other med-
ical conditions, including tumors, infection, and demen-
tia caused by mild strokes (multi-infarct dementia).
These possibilities must be ruled out as well through ap-
propriate blood and urine tests, brain magnetic resonance
imaging (MRI) or computed tomography scans (CT),
tests of the brain’s electrical activity (electroencephalo-
graphs or EEGs), or other tests.
In 2001, researchers demonstrated that postitron
emission tomography (PET) scans could help predict who
might develop memory impairment. Although PET scan-
ning is a relatively new and expensive technology, it is be-
coming more readily available. Several types of oral and
written tests are used to aid in the AD diagnosis and to fol-
low its progression, including tests of mental status, func-
tional abilities, memory, and concentration. Still, the neu-
rologic exam is normal in most patients in early stages.
One of the most important parts of the diagnostic
process is to evaluate the patient for depression and
delirium, since each of these can be present with AD, or
may be mistaken for it. (Delirium involves a decreased
consciousness or awareness of one’s environment.) De-
pression and memory loss are both common in the elder-
ly, and the combination of the two can often be mistaken
for AD. Depression can be treated with drugs, although
some antidepressants can worsen dementia if it is pre-
sent, further complicating both diagnosis and treatment.
A genetic test for the ApoE4 gene is available, but is
not used for diagnosis, because possessing even two
copies does not ensure that a person will develop AD.
Treatment
The mainstay of treatment for a person with AD con-
tinues to be the establishment of daily routines and good
nursing care, providing both physical and emotional sup-
port for the patient. Modifications of the home to increase
67
Alzheimer's disease
Alzheimer's disease
safety and security are often necessary. The caregiver also
needs support. Regular medical care by a practitioner
with a non-defeatist attitude toward AD is important so
that illnesses can be diagnosed and treated properly.
People with AD are also often depressed or anxious,
and may suffer from sleeplessness, poor nutrition, and
general poor health. Each of these conditions is treatable
to some degree. It is important for the person with AD to
eat well and continue to exercise. Professional advice
from a nutritionist may be useful to provide healthy,
easy-to-prepare meals. Finger foods may be preferable to
those requiring utensils to be eaten. Regular exercise (su-
pervised for safety if necessary) promotes overall health.
A calm, structured environment with simple tools that
support orientation (like calendars and clocks) may re-
duce anxiety and increase safety.
Diet and supplements
DIET. The incidence of AD is lower in countries
whose citizens have a diet that is lower in fats and calo-
ries. There have been a few reports that a diet rich with
fish improves mental function in patients with AD or de-
mentia. AD patients treated with essential fatty acids
showed greater improvement in mood and mental func-
tion than patients on placebo. Because of its disease-pre-
venting properties, red wine in moderation may be bene-
ficial to AD patients.
VITAMIN E. Studies have shown that AD patients
have lower blood levels of vitamin E than age matched
control subjects. A large, two year study of moderately
affected AD patients found that taking 2,000 IU of vita-
min E daily significantly delayed disease progression as
compared to patients taking placebo. This delay was
equivalent to that seen with patients taking the drug se-
legiline. Vitamin E is also thought to delay AD onset.
High levels of vitamin E put the patient at higher risk for
bleeding disorders.
THIAMINE (VITAMIN B,). Several small studies to
determine the effectiveness of thiamine (vitamin on
AD have been carried out. Daily doses of 3 g for two to
three months have improved mental function and AD as-
sessment scores. Other studies have shown that thiamine
had no effect on AD patients. Side effects include nau-
sea and indigestion.
COBALAMIN (VITAMIN B 12 ). Although results are
conflicting, some studies have found that AD patients
have lower levels of cobalamin (vitamin B 12 ) than oth-
ers. Some studies have shown that cobalamin supple-
mentation improves memory and mental function in AD
patients whereas other studies have found no effect.
ACETYL-L-CARNITINE. Acetyl-L-carnitine is similar
in structure to the neurotransmitter acetyl-choline. Stud-
68
ies have shown that 2 g or 3 g of acetyl-L-camitine daily
slows the progression of AD, especially in patients who
developed the disease before age 66. Patients who devel-
oped disease after 66 years of age worsened with treat-
ment. Side effects include increased appetite, body
odor, and rash.
DHEA. DHEA (dehydroepiandrosterone) is a steroid
hormone. There may be a link between decreasing levels
of DHEA in the elderly and development of AD. Studies
on the effect, if any, of DHEA on AD are needed. Side
effects include acne, hair growth, irritability, insomnia,
headache, and menstrual irregularity.
MELATONIN. Melatonin is a hormone that helps to
regulate mood and sleep cycles. The effect of melatonin
treatment on AD is unknown but it may be beneficial in
regulating sleep cycles. The usual dose is 3 mg taken one
to two hours before bedtime. Side effects are drowsiness,
confusion, headache, decreased sex drive, and decreased
body temperature.
Herbals and Chinese medicine
GINKGO. Ginkgo, the extract from the Ginkgo hilo-
ha tree is the most commonly used herbal treatment for
AD. Several studies have been performed to test the ef-
fectiveness of ginkgo for treating AD. The dose range
studied were 120-160 mg daily divided into three doses.
Although results have been mixed, the evidence suggests
that ginkgo is an effective treatment for patients with
mild to moderate AD. Side effects are not common but
include headache, allergic skin reaction, and gastroin-
testinal disturbance. Ginkgo also decreases blood coagu-
lation. Individuals with coagulation or platelet disorders
should use extreme caution and consult a physician be-
fore using ginkgo.
PHYTOESTROGENS. Phytoestrogens may be benefi-
cial in the treatment of AD based on the findings that
women with AD who are on hormone replacement thera-
py have improved mental function and mood. Estrogens
may prevent AD, therefore, phytoestrogens may have the
same effect. Phytoestrogens are mainly found in soy
products.
CLUBMOSS. Huperzine A is a compound isolated
from clubmoss ( Huperzia serrata). Studies have shown
that taking 0. 1-0.4 mg daily improves mental function in
AD patients. Side effects are nausea, muscle cramps,
vomiting, and diarrhea.
Therapies
Music therapy has been shown to be effective in
treating the depression, agitation, wandering, feelings of
isolation, and memory loss associated with AD. AD pa-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
tients have benefited from listening to favorite music or
participating in musical activity. Participation in a music
therapy group was more effective at improving memory
and decreasing agitation than being part of a verbal (talk-
ing) group.
A wide variety of other therapies have been benefi-
cial in the treatment of the psychologic symptoms of
AD. These include:
• Light therapy in the evening to improve sleep cycle dis-
turbances.
• Supportive therapy through touch, compliments, and
displays of affection.
• Sensory stimulation through massage and aromatherapy.
• Socio-environmental therapies use activities fitted to
previous interests, favorite foods, and pleasant sur-
roundings.
• Cognitive therapy to reduce negative perceptions and
learn coping strategies.
• Insight-oriented psychotherapy addresses the patient’s
awareness of his or her disease.
• Dance therapy.
• Validation therapy.
• Reminiscence therapy.
• Reality-oriented therapy.
Nursing care and safety
The nursing care required for a person with AD is
easy to learn. Caregivers will usually need to spend in-
creasing amounts of time grooming the patient as the dis-
ease progresses. The patient may require assisted feeding
early on to make sure that he or she is taking in enough
nutrients. Later on, as movement and swallowing become
difficult, a feeding tube may be placed into the stomach
through the abdominal wall. A feeding tube requires more
attention, but is generally easy to care for if the patient is
not resistant to its use. Incontinence becomes the most dif-
ficult problem to deal with at home, and is a principal rea-
son for pursuing nursing home care. In the early stages,
limiting fluid intake and increasing the frequency of toilet-
ing can help. Careful attention to hygiene is important to
prevent skin irritation and infection from soiled clothing.
In all cases, a person diagnosed with AD should not
be allowed to drive, because of the increased potential for
accidents and the increased likelihood of wandering very
far from home while disoriented. In the home, simple
measures such as grab bars in the bathroom, bed rails on
the bed, and easily negotiable passageways can greatly
increase safety. Electrical appliances should be un-
plugged and put away when not in use. Matches, lighters,
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
knives, or weapons should be stored safely out of reach.
The hot water heater temperature may be set lower to pre-
vent accidental scalding. A list of emergency numbers,
including the poison control center and the hospital emer-
gency room, should be posted by the phone.
Care for the caregiver
Family members or others caring for a person with
AD have an extremely difficult and stressful job that be-
comes harder as the disease progresses. It is common for
caregivers to develop feelings of anger, resentment, guilt,
and hopelessness, in addition to the sorrow they feel for
their loved one and for themselves. Depression is an ex-
tremely common consequence. Becoming a member of
an AD caregivers’ support group can be one of the most
important things a family member does, not only for him
or herself, but for the person with AD as well. The loca-
tion and contact numbers for AD caregiver support
groups are available from the Alzheimer’s Association;
they may also be available through a local social service
agency, the patient’s physician, or pharmaceutical com-
panies that manufacture the drugs used to treat AD.
Medical treatment for depression may be an important
adjunct to group support.
Outside help, nursing homes, and
governmental assistance
Most families eventually need outside help to relieve
some of the burden of around-the-clock care for a person
with AD. Personal care assistants, either volunteer or
paid, may be available through local social service agen-
cies. Adult daycare facilities are becoming increasingly
common. Meal delivery, shopping assistance, or respite
care may be available as well. Many families consider
nursing home care when AD advances to the late-stage.
Several federal government programs may ease the
cost of caring for a person with AD, including Social Se-
curity Disability, Medicare, and Supplemental Security
Income. Each of these programs may provide some as-
sistance for care, medication, or other costs, but none of
them will pay for nursing home care indefinitely. Medic-
aid is a state-funded program that may provide for some
or all of the cost of nursing home care, although there are
important restrictions. Details of the benefits and eligi-
bility requirements of these programs are available
through the local Social Security or Medicaid office, or
from local social service agencies.
Allopathic treatment
The only two drugs approved for AD, tacrine hy-
drochloride (Cognex) and donepezil hydrochloride (Ari-
cept), increase the brain levels of the neurotransmitter
69
Alzheimer's disease
Alzheimer's disease
acetylcholine, thereby increasing the communication ability
of the remaining neurons. These drugs can modestly in-
crease cognition and improve the ability to perform normal
activities of daily living. The most significant side effect of
tacrine is an increase in the liver enzyme alanine amino-
transferase (ALT). Patients taking tacrine must have a
weekly blood test to monitor their ALT levels. Other fre-
quent side effects include nausea, vomiting, diarrhea, ab-
dominal pain, indigestion, and skin rash. Donepezil has
two advantages over tacrine: fewer side effects and once
daily dosing. Donepezil does not appear to affect liver en-
zymes and the frequency of abdominal side effects is lower.
Estrogen, the female sex hormone, is widely pre-
scribed for post-menopausal women to prevent osteo-
porosis. Several preliminary studies have shown that
women taking estrogen have lower rates of AD, and
those who develop AD have a slower progression and
less severe symptoms.
Preliminary studies have also suggested a reduced
risk for developing AD in older people who regularly use
nonsteroidal anti-inflammatory drugs (NSAIDs), includ-
ing aspirin, ibuprofen (Advil), and naproxen (Aleve), al-
though not acetaminophen. A 2001 study reported that
those subjects who used NSAIDs for at least two years
were up to 80% less likely to develop Alzheimer’s. Fur-
ther study on the effects of NSAIDs on AD are underway.
Selegiline, a drug used in the treatment of Parkin-
son’s disease, appears to slow the development of AD.
Selegiline is thought to act as an antioxidant, preventing
free radical damage. However, it also acts as a stimulant,
making it difficult to determine whether the delay in
onset of AD symptoms is due to protection from free
radicals or to the general elevation of brain activity from
the stimulant effect.
Psychiatric symptoms, such as depression, anxiety,
hallucinations (seeing or hearing things that aren’t
there), and delusions (false beliefs) may be treated with
drugs if necessary.
Expected results
While Alzheimer’s disease may not be the direct
cause of death, the generally poorer health of a person
with AD increases the risk of life-threatening infection,
including pneumonia. In addition, other diseases com-
mon in old age (cancer, stroke, and heart disease) may
lead to more severe consequences in a person with AD.
On average, people with AD live eight years past their
diagnosis, with a range from 1-20 years.
Prevention
There is currently no sure way to prevent Alzheimer’s
disease, though some of the drug treatments discussed
70
KEY TERMS
Acetylcholine — One of the substances in the
body that helps transmit nerve impulses.
Dementia — Impaired intellectual function that in-
terferes with normal social and work activities.
Neurofibrillary tangle — Twisted masses of pro-
tein inside nerve cells that develop in the brains of
people with AD.
Neuron — A nerve cell.
Senile plaque — Structures composed of parts of
neurons surrounding brain proteins called beta-
amyloid deposits and found in the brains of peo-
ple with AD.
above may eventually be proven to reduce the risk of de-
veloping the disease. The most likely current candidates
are estrogen, phytoestrogens, NSAIDs, vitamin E, and se-
legiline. In 2001, researchers found preliminary indica-
tions that onest of Alzheimer’s might be tied to choles-
terol levels. Although results must be confirmed by other
scientists, lowering cholesterol in the diet might help pre-
vent onset of the disease.
Resources
BOOKS
Bridges, Barbara J., Therapeutic Caregiving: A Practical
Guide for Caregivers of Persons with Alzheimer’ s and
Other Dementia Causing Diseases. BJB Publishing 16212
Bothell Way S.E., Suite F171 Mill Creek, Washington
98012-1219.
Carrier, Louise, and Henry Brodaty. “Mood and Behaviour
Management.” In Clinical Diagnosis and Management of
Alzheimer’ s Disease. 2nd edition, edited by Serge Gauthi-
er. London: Martin Dunitz, 1999.
Larkin, Marilynn. When Someone You Love Has Alzheimer' s:
What you must know, what you can do, what you should
expect.. Dell, 1995.
Luskin, Frederic M., Ellen M. DiNucci, Kathryn A. Newell,
and William L. Haskell. “Complementary/Alternative
Therapies in Select Populations: Elderly Persons." In
Complementary! Alternative Medicine: An Evidence Based
Approach. Edited by John W. Spencer and Joseph J. Ja-
cobs. St. Louis: Mosby, 1999
Mace, Nancy L., and Peter V. Rabins. The 36- Hour Day. The
John Hopkins University Press, 1995.
PERIODICALS
Gottlieb, Scott R.“NSAIDs Can Lower Risk of Alzheimer’s.”
British Medical Journal 323 no. 7324 (December 1,
2001): 1269.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Mitka M.“PET and Memory Impairment.” JAMA, Journal of
the American Medical Association 286 no. 16 (October
24, 2001 ): 1961 .
Ott, Brian R.. and Norma J. Owens. “Complementary and Al-
ternative Medicines for Alzheimer’s Disease.” Journal of
Geriatric Psychiatry and Neurology 1 1 (1998): 163- 173.
“Alzheimer Chemical Engineers Suggest Alzheimer Onset Tied
to Cholesterol.” Pain and Central Nervous System Week
(December 24, 20011:3.
Stephenson Joan. “Alzheimer Treatment Target?” JAMA, Jour-
nal of the American Medical Association 286 no. 14 (Oc-
tober 10, 2001):1704.
“Wiser Now.” Better Directions. PO Box 35 Spencerville, MD
20868.(800) 999-0795.
ORGANIZATIONS
Alzheimer’s Association. 919 North Michigan Ave., Suite 1000
Chicago, IL 60611. (800) 272-3900 (312) 335-8882. http://
www.alz.org/.
National Institute of Aging, Alzheimer's Education, and Refer-
ral Center. (800) 438-4380.
OTHER
Alzheimer’s Disease Books and Videotapes. http://www.alzhei
mersbooks.com
Belinda Rowland
Teresa G. Odle
Amblyopia see Lazy eye
American elm see Slippery elm
American skullcap see Skullcap
Amino acids
Description
Amino acids are known as the building blocks of
protein, and are defined as the group of nitrogen-contain-
ing organic compounds composing the structure of pro-
teins. They are essential to human metabolism, and to
making the human body function properly for good
health. Of the 28 amino acids known to exist, eight of
them are considered “essential,” defined as those that can
be obtained only through food. These essential amino
acids are tryptophan, lysine, methionine, phenylalaine,
threonine, valine, leucine, and isoleucine. The “non-es-
sential” amino acids include arginine, tyrosine, glycine,
serine, glutmamic acid, aspartic acid, taurine, cycstine,
histidine, proline, alanine, and creatine, which is a com-
bination of arginine, glycine, and methionine.
The human body, minus water, is 75% amino acids.
All of the neurotransmitters (proteins) but one are com-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
posed of amino acids; and 95% of hormones are amino
acids. Amino acids are key to every human bodily func-
tion with every chemical reaction that occurs.
Amino acids occur naturally in certain foods, such as
dairy products, meats, fish, poultry, nuts, legumes, and eggs.
Those sources are considered more complete than vegetable
protein, such as beans, peas, and grains, also considered a
good — even if not complete — source of amino acids.
Amino acids became popular as dietary supplements
by the end of the twentieth century for various uses, in-
cluding fitness training, weight loss, and certain chronic
diseases. Claims exist in holistic medicine that indicate
amino acid supplements taken in the proper dosage can
aid also in fighting depression, allergies, heart disease,
gastrointestinal problems, high cholesterol, muscle
weakness, blood sugar problems, arthritis, insomnia,
bipolar illness, epilepsy, chronic fatigue syndrome,
autism, attention-deficit hyperactivity disorder
(ADHD), and mental exhaustion.
Description
Amino acid therapy as a supplemental aid to a healthy
diet joined the fitness craze in the United States by the end
of the 1990s. According to author Brenda Adderly in Better
Nutrition, in September of 1999, “The creation of new pro-
tein from amino acids and the breaking down of existing
protein into amino acids are ongoing processes in our bod-
ies. If, for example, you are working out and developing
certain muscles, amino acids come to the rescue with new
protein to build muscle cells,” Adderly noted. “Similarly,
when you eat a complete protein, such as meat or beans and
rice, the body breaks down the amino acids in that food for
later use.” Understanding the balance of amino acids in the
body can be often the first clue to understanding why a per-
son suffers many ailments, ranging from depression to
upset stomach to obesity. Deficiencies in the proper bal-
ance of amino acids is likely to occur in those with poor
diets. Because stress, age, infection, and various other fac-
tors including the amount of exercise a person does, can
also affect the levels of amino acids, people with healthy,
nutritious diets could also find that they also suffer deficien-
cies. Adderly adds that, “Not only are the symptoms of
amino acid deficiencies wide ranging, but there are no
RDAs (recommended daily allowances) or other guidelines,
to help us tell if we are least covering all the bases. Add to
that the complicated matter of keeping track of all 28 some
with names most of us have never even heard and the situa-
tion begins to seem overwhelming.”
Essential amino acids
The amino acids, which are derived only from food and
that the body cannot manufacture, perform various functions.
71
Amino acids
Amino acids
• Tryptophan. This is considered a natural relaxant,
helps alleviate insomnia; helps in the treatment of mi-
graine headaches; helps reduce the risk of artery and
heart spasms; and works with lysine to reduce choles-
terol levels.
• Lysine. Aids in proper absorption of calcium; helps
form collagen for bone cartilage and connective tis-
sues; aids in production of antibodies, hormones, and
enzymes. Research has indicated it also might be effec-
tive against herpes by creating the balance of nutrients
that slows the growth of the virus causing it. A defi-
ciency could result in fatigue, lack of concentration, ir-
ritability, bloodshot eyes, retarded growth, hair loss,
anemia, and reproductive problems.
• Methionine. Properties include providing the primary
source of sulfur that can prevent disorders of the hair,
skin, and nails; lowers cholesterol by increasing the
liver’s production of lecithin; reduces liver fat; protects
kidneys; and promotes hair growth.
• Phenylalaine. This serves the brain by producing nor-
epinephrine, the chemical that is responsible for trans-
mitting the signals between the nerve cells and the
brain; can maintain alertness; reduces hunger pains;
acts as an antidepressant; and improves memory.
• Threonine. Makes up a substantial portion of the colla-
gen, elastin, and enamel protein; serves the liver by pre-
venting buildup; aids the digestive and intestinal tracts
to function better; and acts as a trigger for metabolism.
• Valine. Promotes mental energy; helps with muscle co-
ordination; and serves as a natural tranquilizer.
• Leucine. Works with isoleucine to provide for the man-
ufacture of essential biochemical processes in the body
that are used for energy, increasing the stimulants to the
upper brain for greater mental alertness.
Roles of certain non-essential amino acids
• Glycine. Facilitates the release of oxygen for the
cell-making process; key role in manufacturing of hor-
mones and health of immune system.
• Serine. Source of glucose storage by the liver and mus-
cles; provides antibodies for immune system; synthe-
sizes fatty acid sheath around nerve fibers.
• Glutamic acid. Nature’s “brain food” that increases
mental prowess; helps speed the healing of ulcers; aids
in combatting fatigue.
Creatine in the spotlight
One of the most discussed amino acid supplements
available on the market is creatine monohydrate. The body
produces small amounts of creatine in the kidneys, liver,
72
and pancreas, making it a non-essential acid. With most
diets that include red meat or fish, also come a few grams
of creatine. It is stored in muscle cells and is used in activ-
ities, such as weight lifting and sprinting, providing the
necessary thrust of energy for such activities. But the nat-
ural supply of creatine produced by the body is quickly
depleted. After approximately 10 seconds, when muscle
fatigue becomes apparent, the daily production is used.
According to Timothy Gower, writing for Esquire in
February of 1998, “Scientists identified creatine 160-
odd years ago, but only in the 1980s did they figure out
that muscle cells can be ‘loaded’ with up to 30% more of
the compound than they normally carry. Since then, sev-
eral studies have shown that weight lifters primed on the
supplement tire less easily, allowing them to work out
longer.” Gower also noted that creatine users find that
the weight they add on is fat-free, whether that is lean
tissue or some is water weight, no one has yet deter-
mined, since muscle cells do fill with water during crea-
tine loading. Additionally, while it can add to the burst of
the energy a sprinter needs to perform well, creatine
does not do anything for the marathon runner going for
several hours.
Commercially available since 1993, the long-term
effects still remain unknown. One 2002 study did show
that creatine use improved rehabilitation for injured ath-
letes and another has shown that using the supplement
does not increase risk of injury. It should be noted that
some 20-30% of people researched showed no improve-
ment using creatine. One early report indicated that crea-
tine could be beneficial for some people in spurring me-
tabolism, burning calories and helping in weight loss.
Those reports were as yet inconclusive.
General use
Amino acid supplements to a healthy diet are used
for various purposes. The most common uses include:
sustaining strength in weight training to build muscles;
improving heart and circulatory problems or diseases,
particularly in the aging; the treatment of chronic fatigue
syndrome; treating depression and anxiety; treating eat-
ing disorders, such as bulimia and/or anorexia, along
with overeating; increasing memory; building up and
sustaining the body’s immune system in fighting bacteria
and viruses. It is important to note that, while the neces-
sity and role of all amino acids has been verified in the
maintenance of optimum health, research is not exten-
sive enough to provide indisputable verification of the
touted benefits of such supplements over the long term.
Nonetheless, some members of the scientific med-
ical community would seem to confirm what amino acid
proponents have long believed to be true. One such study
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
from the Journal of the American College of Cardiology
brought good news for the millions suffering from
chronic heart failure. Dr. Rainer Hambrecht and col-
leagues from the University of Leipzig, (Germany) test-
ed the amino acid L-arginine on 38 heart-failure patients.
Knowing that the human body converted it into nitric
oxide, a chemical that relaxes blood vessels, the re-
searchers gave one group 8 g of it daily for four weeks;
another group simply did forearm exercises; and a third
group combined the supplement with the exercise. The
people who took the supplement alone increased their
blood-vessel dilation by a factor of four, as did the exer-
cise group. Those who took both the supplement and
performed the exercise increased it by six. More recent
studies on arginine in 2002 found that the supplement
may help reduce risk of postoperative infections. Fur-
ther, arginine may enhance women’s sexual function.
Supplements are recommended by alternative med-
ical practitioners particularly for those who are not get-
ting a proper diet, especially vegetarians who might not
be getting a balance of complete protein, as well as ath-
letes, anyone under severe stress, and anyone whose al-
cohol intake level is moderate to high.
Preparations
Supplements of various amino acids are available
primarily in capsule, tablet, or powder form. A common
way of taking amino acids is in a “multiple” amino acid
gel cap. These contain sources of protein from gelatin,
soy, and whey. The market for supplements in wholesale,
retail, and internet sales was estimated to reach into the
millions of dollars, with literally hundreds available. In-
ternet sales were a fast-growing area particularly with
the use of such supplements as creatine powder publi-
cized by well-known Olympic stars and professional ath-
letes. Daily usage of creatine as evident from research
indicated that usage should be leveled at 5 g of powder
in a glass of orange juice, and could be taken up to four
times a day during peak athletic training. Maintenance
dosages were recommended at 5 g once a day.
Side effects
Because amino acids are naturally produced sub-
stances both in the human body and in the protein de-
rived from animal and dairy products, as well as being
present in food combinations such as beans and rice,
such supplements are not regulated by the United States
Food and Drug Administration (FDA), nor are there any
specified daily requirements, and they also do not show
up in either drug or urine tests. Amino acid supplements
might be classified as having no affect at all. Long-term
effects were not yet evident, however, due to the relative-
ly recent phenomenon of use.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Essential amino acids — Eight of the 28 amino
acids known to exist are termed essential for
adults, that are available only through food.
Non-essential amino acids — The remaining amino
acids that are produced in the human body.
Interactions
Interactions of amino acids with drugs has not been
sufficiently studied to determine yet if any adverse ef-
fects result from using amino acids with medications.
Resources
PERIODICALS
Adderly, Brenda. “Amino Acids.” Better Nutrition (September
1999). Available from http://web2.infotrac.galegroup.com.
“Amino acid screening.” Everything You Need to Know about
Medical Tests, Annual. Springhouse Corporation: 1996.
Available from http://web2.infotrac.com.
Antinoro, Linda. “Food and Herbs That Keep Blood Moving,
Prevent Circulatory Problems.” Environmental Nutrition
(February 2000).
“Arginine Seems to Benefit Both Immune and Sexual Re-
sponse.” RN (February 2002): 22.
Austin Nutritional Research. “Amino acids.” Reference Guide
for Amino Acids. 2000. Available from http://www.realtime.
net/anr/aminoacid.html.
Body Trends Fitness Products. "Amino acids.” bodytrends.com
commercial website. (2000). Available from http://www
bodytrends.com.
“Creatine Supplementation Speeds Rehabilitation.” Health and
Medicine Week (January 21, 2002): 6.
Davidson, Tish. “Amino acid disorders screening.” Gale Ency-
clopedia of Medicine. Edition 1. Detroit: 1999. Available
from http://web2.infotrac.galegroup.com.
Dolby, Victoria. “Anxiety? Send herbs, 5-HTP, and amino
acids to the rescue!” Better Nutrition (June 1998). Avail-
able from http://web2.infotrac.galegroup.com.
Gersten, Dennis J., M.D. “Amino Acids: Building Blocks of
Life, Building Blocks of Healing.” The Gersten Institute
for Integrative Medicine. (2000). Available from http://
www.imagery.com.
Gower, Timothy. “Eat Powder! Build Muscle! Burn Calories!”
Esquire (February 1998). Available from http://www.
brittannica.com.
Moyano, D.; Vilaseca, M.AA.; Artuch, R.; and, Lambruschini,
N. “Plasma Amino Acids in Anorexia Nervosa.” Nutrition
Research Newsletter (November 1998). Available from
http://web2.infotrac.com.
"Studies Say Creatine is OK.” Obesity, Fitness & Wellness
Week (January 12, 2002): 12.
73
Amino acids
Andrographis
Toews, Victoria Dolby. “6 Amino Acids Unleash the Energy.”
Better Nutrition (June 1999). Available from http://web2.
infotrac.com.
Totheroh, Gailon. "Amino Acid Therapy Pays Off.” Christian
Broadcasting Network (10 May 1999). Available from
http://www.cbn.com.
Tuttle, Dave. “Muscle’s little helper.” Men's Fitness (December
1998). Available from http://web2.infotrac.com.
Wernerman, Jan. “Documentation of clinical benefit of specific
amino acid nutrients.” The Lancet (5 September 1998).
Available from http://web2.infotrac.galegroup.com/itw.
Williams, Stephen. “Passing the Acid Test.” Newsweek (27
March 2000).
Jane Spehar
Teresa G. Odle
Amyotrophic lateral sclerosis see Lou
Gehrig's disease
An-mo see Chinese massage
Andrographis
Description
Andrographis is the herb of Andrographis panicula-
ta , a flowering plant in the Acanthaceae family. The
perennial grows wild in thickets throughout south Asia,
although it also may be cultivated. In summer and au-
tumn, clusters of small white flowers appear; it is har-
vested when the flowers begin to bloom. It is traditional-
ly valued as an herbal remedy in China, where it grows
in the Guangdong, Guangxi, Fujian, Yunnan, Sichuan,
Jiangsu, and Jianxi provinces.
In Mandarin, andrographis is called chuan xin lian,
Yi jian xi and Lan he lian, which translate directly as
“thread-the-heart lotus.” The Cantonese term is chyun
sam ling, and the Japanese call it senshinren. English
common names include green chiretta, heart-thread lotus
leaf, and kariyat. Its pharmaceutical names, used to dis-
tinguish it as a medicine, are Herba Andrographitis Pan-
iculatae or alternately Folium Andrographis.
General use
Practitioners of Chinese medicine believe that andro-
graphis affects the large intestine, lung, stomach, bladder,
and liver meridians, or energy pathways in the body. It is
thought to dispel heat (such as that associated with fever
or infection) and is used primarily as a broad-spectrum
antibiotic and immunostimulant for a variety of bacterial,
viral, and parasitic conditions, including influenza, in-
testinal infections, hepatitis, pneumonia, and infected
74
wounds. Andrographis ’s medicinal properties are consid-
ered very bitter, astringent, cold, dry, and stimulating.
Andrographis is considered most effective for con-
ditions associated with fever, inflammation, and the for-
mation of pus. It clears heat and relieves “fire toxicity”
manifest as sores and carbuncles on the skin. It is also
applied topically for snakebite and eczema. Under the
supervision of a qualified practitioner, it is used as a
uterine stimulant and abortive, to bring on miscarriage or
treat prolonged pregnancy or retained placenta.
Andrographis can also be used as an inexpensive
substitute for another Chinese herb, coptis ( huang lian).
Research on andrographis has generally been conduct-
ed in China and has focused on pharmacological investiga-
tion. Studies indicate that andrographis cultivated in the
plains of Shanghai has significant immune stimulating and
anti-infective qualities. In vitro, it inhibits the growth of
Diplococcus pneumoniae and other bacteria and delays the
deterioration of embryonic renal cells caused by a virus.
Major chemical ingredients include andrographan,
andrographolide, neoandrographolide, paniculide A, 14-
deoxy-1 1-oxyandrographolide, and beta-sitosterol.
Preparations
Andrographis is not generally available in American
health food stores, but it can be found at most Chinese
pharmacies and Asian groceries.
The standard dose ranges from 10-15 grams as a de-
coction (strong tea) or 2-5 milliliters as a tincture. Pow-
der doses range from 0.6 to 1.2 grams. Because the herb
is extremely bitter, it’s recommended that powder be
taken in capsule form.
Practitioners of Chinese medicine commonly com-
bine andrographis in patent formulas along with other
Chinese herbs. The following are the major herbs with
which it is combined and the symptoms for which the
combinations are prescribed.
• Pericarpium Citri Reticulatae (Citrus reticulata, Chen
pi) for cough associated with Lung heat.
• Herba et Radix Houttuyniae Cordatae ( Houttuynia
cordata, yu xing cao) and Semen Benincasae Hispidae
(Benincasa hispida, dong gua ren cao ) for Lung
abcess.
• Flos Lonicerae Japonicae ( Lonicera japonica, jin yin
hua) and Radix Platycodonis Grandiflori ( Platycodon
grandiflorum, jie geng) for early stages of a disease
with fever and sore throat.
• Herba Portulacae Oleraceae (Portulacca oleracea, ma
chi xian ) for dysentery.
• Radix et folium Polygoni Cuspidati (Polygonum cuspi-
datum, hu zhang) and Rhizoma Imperatae Cylindricae
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Cold — In Chinese pathology, the term defines a
condition that has insufficient warmth, either ob-
jective (hypothermia) or subjective (feeling cold).
Decoction — A strong tea brewed for 20-30 min-
utes.
Heat — In Chinese pathology, the term defines a
condition that has excessive heat, either objective
(fever, infection) or subjective (feeling hot).
Meridians — Energetic pathways inside the body
through which Qi flows; also called channels.
Patent formulas — Chinese herbal formulas that
were patented centuries ago and are believed to
be proven over centuries of use and study.
Tincture — A solution of medicinal substance in al-
cohol, usually more or less diluted. Herb tinctures
are made by infusing the alcohol with plant mate-
rial.
Qi — A Chinese medical term denoting active
physiological energy.
( Imperata cylindrical var. major , bai mao gen) for hot,
painful urinary disfunction.
Precautions
According to tradition, andrographis is never used in
cases of deficient, cold intestinal conditions. When used
long-term or in large doses, this bitter and cold herb may
damage stomach qi, causing gastric distress and loss of
appetite.
Andrographis is also capable of producing a miscar-
riage, and thus should be avoided by pregnant women un-
less otherwise directed by a knowledgeable practitioner.
Side effects
Gastric distress and loss of appetite have been noted
when the herb is taken in large doses.
Interactions
No interactions with pharmaceutical drugs have
been noted.
Resources
BOOKS
Bensky, D. and Gamble, Andrew. Chinese Herbal Medicine:
Materia Medica. Revised ed. Eastland Press, 1993.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Fan, W. A Manual of Chinese Herbal Medicine: Principles and
Practice for Easy Reference. Shambala, 1996.
Holmes. P. Jade Remedies: A Chinese Herbal Reference for the
West. Snow Lotus Press, 1996.
Hsu, Hong- Yen, et. al. Oriental Materia Medica: A Concise
Guide. Oriental Healing Arts Institute, 1986.
Erika Lenz
Androstenedione
Description
Androstenedione is a hormone that occurs naturally
in the body, and is one of those responsible for male
characteristics. It is a metabolite of DHEA, and as such,
a direct precursor to the male hormone testosterone. It is
found in some plant matter, notably pollen, and in the
gonads of all mammals.
General use
Supplementation with androstenedione increases
blood levels of testosterone, which among other things,
will lead to an increase in strength and muscle mass. As
such, it is mainly of interest to athletes and bodybuilders,
for whom it has the added benefits of increasing energy
levels, improving levels of nitrogen retention and shorten-
ing muscle recovery time. Androstenedione is safer than
anabolic steroids because it has a far gentler effect on the
body, and potential effects are milder and more transient.
Androstenedione is also taken to improve well
being, and to raise levels of mental alertness. In addition,
it is thought to have a positive effect on sexual perfor-
mance. As androstenedione also aids in the conversion of
fatty tissue to muscle, it could conceivably be considered
an aid to weight loss.
The German patent for androstenedione states that 50
mg administered orally raised testosterone levels from
140-183% above normal, which although impressive, is
considerably less than the increase associated with adminis-
tration of anabolic steroids. Also, it is a precursor, in that the
body retains some control over production of testosterone.
Preparations
When taken orally, androstenedione is metabolized
by a single enzyme into testosterone. Athletes generally
take between 50-300 mg daily, according to how much
time is spent exercising and how much physical im-
provement is required. Dosage is usually sublingual in
the form of a spray or capsules. The spray is felt to be far
75
Androstenedione
Androstenedione
more effective, due to imperfect absorption through the
digestive route.
Levels of testosterone in the blood will begin to rise
approximately 15 minutes after administration of an-
drostenedione supplements. They will remain so for
about three hours, with testosterone levels peaking
roughly 1—1.5 hours after administration.
Precautions
There is, as of July 2000, no reliable research to prove
the claims by supplement companies that androstenedione
is useful. Trials that have been conducted are limited in
size and scope, and generally do not satisfy the criteria set
for medical trials. Some experts warn that as a result of the
short time that androstenedione stays in the system, it is
unlikely to have any significant bodybuilding effects.
Androstenedione is not suitable for pregnant or lactat-
ing women, and should not be taken at all by children.
When taken by women, this supplement may cause hir-
suitism and virilization. Caution should be exercised when
males under the age of 25 years take androstenedione.
Those supplementing with androstenedione on a
regular basis are advised to have “cool down” periods
when the product is not taken. This can either be a cou-
ple of days a week, or one week per month.
Androstenedione is unsuitable for use by men with
prostate cancer or elevated PSA. It may also stimulate
prostate replication, enlarging the prostrate (benign
prostate hypertrophy or cancer). Many experts are skep-
tical of the claims made by supplement companies, be-
cause they say that natural bodily checks and balances
will work against this supplement to ensure that muscle
mass and strength do not exceed normal levels for the in-
dividual. Taking androstenedione at times other than pe-
riods of physical exertion is not recommended, because
of the possible effect on mood.
Because of the complex interaction of hormones
within the body, it is strongly advised that anyone con-
templating supplementing with androstenedione consult
a qualified practitioner.
Whereas anabolic steroids are illegal, androstene-
dione is considered a dietary supplement, and as such is
not governed by the same regulations.
As a result of trials conducted by them, the American
Medical Association issued a statement to the effect that
androstenedione does not raise serum testosterone levels,
and in addition, it may have undesirable side effects.
Side effects
Possible effects on the personality of this type of
hormone should be considered, as high levels of male
76
KEY TERMS
Anabolic steroids — Synthetic male hormones.
DHEA — Dehydroepiandrosterone, which is basi-
cally a male hormone.
Hirsuitism — The growth of excess hair on the
bodies of women, usually due to a hormone im-
balance.
PSA — Prostatic Specific Antigen, elevated levels of
which are a precondition to the development of
cancer of the prostate gland.
Sublingual — Taken underneath the tongue.
Transient — Of short duration.
Virilization — The development of male character-
istics in women.
hormones have been known to trigger aggressive behav-
ior in some cases, particularly when high doses of the
supplement are involved.
It is also possible that long-term use of androstene-
dione, which is not in accordance with medical recom-
mendations, may eventually have a negative effect on nat-
ural levels of testosterone, due to compensation on the
part of the pituitary gland. This means that, in the long
term, it is possible that supplementation with androstene-
dione may cause a reduction in levels of testosterone.
The androgen effect of androstenedione may cause
males to develop loss of head hair. Other side effects that
have been associated with androstenedione administra-
tion include blurred vision, development of breast-like
tissue, and the development of acne.
Interactions
This supplement should not be taken in conjunction
with other bodybuilding substances, particularly anabol-
ic steroids, unless under the direction of a physician.
Lysophosphatidyl choline, when taken in conjunction
with androstenedione, may enhance absorption.
In addition, manufacturers recommend saw palmet-
to to be taken in conjunction with androstenedione as it
can help reduce associated hair loss, and is useful in
controlling prostate enlargement.
Resources
OTHER
Betterbodz (1995-2000). [cited December 28, 2000], <http://
www.betterbodz.com/androsten edione.html/>
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Nutritionalsupplements.com (1998-2000). [cited December 28,
2000], <http://www.nutritionalsupplements.com/andro5.html/>
Patricia Skinner
Anemarrhena
Description
Anemarrhena ( Anemarrhena asphodeloides or Zhi
Mu) is a rare herb that grows wild in Japan and the
northern part of China. It has a 2,000-year history of use,
and written records of its use date from 200 a.d. It is an
attractive-looking plant that belongs to the lily family. At
the top of three-foot spikes, it has small, fragrant, white
six-petaled flowers that bloom at night. The medicinal
parts are the rhizomes (roots) and the stems. Rhizomes
that are large, hard, and round with pale-yellowish color
inside are best for medicinal use.
General use
Traditional Chinese medicine classifies this herb
as cold (or yin) and bitter. Yin and yang are the two op-
posite energies that complement one another. Yin condi-
tions are described as cold, damp, and deficient, while
yang is characterized by heat, dry, and excess. Anemar-
rhena is used to treat heat disorders, which are caused by
excessive yang or insufficient yin functions. When there
is excessive heat, dryness often follows. For example,
fever — an excessive internal heat symptom — is followed
by thirst, which is a sign of dryness. Traditional Chinese
medicine uses bitter and cold herbs such as anemarrhena
to clear the internal heat and provide moisture to the
lungs and the kidneys.
Because anemarrhena brings moisture and coolness,
it will bring relief to excessive internal heat and dryness
symptoms such as fever, thirst, irritability, racing pulse,
cough, bleeding gums, night sweat, insomnia, and hot
flashes. Anemarrhena has been used in herbal combina-
tions such as Zhi Bai Di Huang Wan to relieve symptoms
such as coughing, ulcers of the mouth, kidney dysfunc-
tion, urinary tract infection, insomnia, restlessness, geni-
tal herpes, and sterility.
Chronic bronchitis
Laboratory studies have shown that anemarrhena
can effectively eradicate infections caused by Staphylo-
coccus aureus, the bacterial strain that often causes lung
infections. Anemarrhena has been effectively used to
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
treat bronchitis as well as exacerbating symptoms of
chronic bronchitis such as chronic coughing.
Tuberculosis
Anemarrhena is also used to treat tuberculosis.
Here, however, laboratory results do not support its use.
When given as 2.5% powder, anemarrhena may slow
down disease progression, but overall it does not reduce
death rates in laboratory mice. At higher dosage (5%
powder), anemarrhena appears to be toxic. More mice
treated with anemarrhena died than in the control group.
Therefore, even though the herb can effectively reduce
the low-grade fever associated with tuberculosis, it is a
poor substitute for conventional antibiotics, which can
cure the disease and prevent death.
Urinary tract infections
Anemarrhena has been used to treat cystitis, an in-
fection of the bladder. Studies have shown that it is ef-
fective against Escherichia coli, which commonly causes
cystitis in women. Therefore, it may be effective against
urinary tract infections caused by this bacterial strain.
Other infections
There is little information available concerning the
use of anemarrhena in other types of infections. Howev-
er, laboratory studies show that anemarrhena has an-
tibacterial activity against Salmonella typhi and Vibrio
cholera, the bacteria that cause salmonella food poison-
ing and cholera, two common infections of the bowels.
Studies also show that anemarrhena may also be effec-
tive against fungal infections.
Oliguria
Anemarrhena provides moisture to dry internal or-
gans. Therefore, it is often used as diuretic to improve
kidney function.
Ulcers of the mouth and/or bleeding gums
Anemarrhena can restore moisture in these oral con-
ditions that exhibit excessive dryness and inflammation.
Diabetes
Because Chinese herbalists believe that yin deficien-
cy is the underlying cause of diabetes, they often use ane-
marrhena to treat this disease. In fact, there is scientific ev-
idence to support its use in the treatment of diabetes. Ani-
mal studies show that anemarrhena contains two pharma-
cologic agents, mangiferin and mangiferin-7-0-beta
glucoside, which appear to increase the effectiveness of
insulin and can lower blood glucose levels. Anemarrhena
77
Anemarrhena
Anemarrhena
has the greatest effect in mild to moderate diabetic condi-
tions. However, it does not affect glucose levels in nondia-
betic conditions. Anemarrhena may be combined with Shi
Gao (Gypsum) for additional hypoglycemic effects.
Chemotherapy and radiation side effects
Anemarrhena is often effective in relieving severe
adverse reactions associated with conventional
chemotherapy and radiation treatments in cancer pa-
tients. According to traditional Chinese medicine, x rays
used in radiation treatment and drugs used in chemother-
apy are considered “heat toxins.” These agents are very
toxic so that they can kill tumor cells. But they are also
toxic to the body, causing excessive build-up of heat in-
side the Lungs and damaging the Kidneys.
Menopausal symptoms
Another use of anemarrhena is to treat menopausal
symptoms such as insomnia, hot flashes, and irregular
periods.
High blood pressure
Anemarrhena is often used in combination with
phellodendron and rehmannia to treat high blood pres-
sure conditions in patients with symptoms of Liver-fire
deficiency (dizziness, headache, ringing in the ears,
back pain, insomnia, palpitations, dry eyes, and night
sweat). Recent studies in laboratory animals confirm that
this herb is effective in lowering blood pressure.
Preparations
The usual dosage of anamarrhena is 6-12 g per day.
It is available as a single ingredient or in combinations in
the following forms:
• Powder or pills. Should be taken with warm water on
an empty stomach.
• Decoction. A method often used in traditional Chinese
medicine to make an herbal preparation at home. Herbs,
usually in combination, are simply boiled down to a con-
centrated broth or tea to be taken internally.
Precautions
Anemarrhena should not be used under the follow-
ing conditions:
• watery diarrhea
• chronic loose bowel movements
• hypotension (low blood pressure). (Anemarrhena at
very high dosages can cause severe drops in blood
pressure levels)
78
Side effects
Animal studies show that anemarrhena, when ad-
ministered intravenously at only moderate dosage, can
cause breathing difficulty and a decrease in blood pres-
sure. High dosages reportedly can cause a severe drop in
blood pressure, respiratory arrest, and even death.
Interactions
Anemarrhena has been known to interact with:
• Iron supplements or multivitamin, multimineral sup-
plements containing iron. Therefore, patients should
take iron supplements at least two hours before or two
hours after the herb.
• Iron pots or pans. Patients should not use iron cooking
utensils to make decoctions as they may alter the chem-
istry of the herb.
Resources
BOOKS
Bensky, Dan, and Andrew Gamble, Chinese Herbal Medicine:
Materia Medica. Rev. ed. Seattle: Eastland Press, 1993.
Molony, David. The American Association of Oriental Medi-
cine’s Complete Guide to Chinese Herbal Medicine. New
York: Philip Lief Group, 1998.
PERIODICALS
Ichiki H., et al. “New Antidiabetic Compounds, Mangiferin
and Its Glucosides.” Biol Pharm Bull. 21 no. 12 (1998):
1389-1390.
Iida Y., et al. “Detection of Antifungal Activity in Anemarrhena
Asphodeloides in Sensitivity BCT Method and Isolation
of Its Active Compounds.” Journal ofAgric Food Chem.
Al no. 2 (Feb 1999): 584-587.
ORGANIZATIONS
American Association of Oriental Medicine (AAOM). 433
Front St., Catasauqua, PA 18032. (610) 266-1433. Fax:
(610) 264-2768. E-mail: AAOMI@aol.com. <http://www.
aaom.org. >
American Foundation of Traditional Chinese Medicine. 505
Beach Street, San Francisco, CA 94133. (415) 776-0502.
American Herbal Products Association. 8484 Georgia Ave.,
Suite 370, Silver Spring, MD 20910. (301) 588-1174.
<http://www.ahpa.org.>
National Center for Complementary and Alternative Medicine;
National Institute of Health. NCCAM Clearinghouse, PO
Box 8218, Silver Spring, MD 20907-8218. (888) 644-
6226. Fax: (301) 495-4957. E-mail: nccam-info@nccam.
nih.gov. <http://nccam.nih.gov.>
OTHER
Choate, Clinton J. “Diabetes: Modern Medicine and Tradition-
al Chinese Medicine-Part Three." HealingPeople.com.
<http://www.healingpeople.eom/ht/EN/articles/2000/3/15/
597.tmpl.>
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Diuretic — A substance that increases the forma-
tion and excretion of urine.
Energy — Includes nonmaterial (eg, Qi) as well as
material (eg, blood) vital forces that create and
sustain life.
Fire — An extremely high internal heat condition
characterized by severe dehydration, red eyes, red
face, constipation, insomnia, and agitation. Fire
often affects Lungs, Liver, and Stomach.
Oliguria — A condition in which the kidneys pro-
duce small amounts of urine.
Greacen, “Molly” Amelia. “The Use of Chinese Herbs and
Other Natural Modalities as Alternatives to Hormone Re-
placement Therapy.” Spanda Medical Company. <http://
spanda.com/articles/hormone.html.>
Rosenberg, Z'ev. “Treating the Undesirable Effects of Radiation
and Chemotherapy with Chinese Medicine.” HealingPeo-
ple.com. <http://www.healingpeople.com/ht/EN/articles/
1999/12/10/1 13.tmpL>
Mai Tran
Anemia
Definition
Anemia is a condition characterized by abnormally
low levels of healthy red blood cells or hemoglobin.
Description
The tissues of the human body need a regular supply of
oxygen to stay healthy. Red blood cells, which contain hemo-
globin that allows them to deliver oxygen throughout the
body, live for only about 120 days. When they die, the iron
they contain is returned to the bone marrow and used to cre-
ate new red blood cells. Anemia can develop when heavy
bleeding causes significant iron loss. It also occurs when
something happens to slow down the production of red blood
cells or to increase the rate at which they are destroyed.
Anemia can be mild, moderate, or severe enough to
lead to life-threatening complications. Over 400 different
types of anemia have been identified. Many of them are
rare. More common anemia types include:
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• iron deficiency anemia
• folic acid deficiency anemia
• vitamin B 12 deficiency anemia
• vitamin C deficiency anemia
• autoimmune hemolytic anemia
• hemolytic anemia
• sickle cell anemia
• aplastic anemia
• anemia of chronic disease
Causes & symptoms
Anemia is caused by bleeding, decreased red blood
cell production, or increased red blood cell destruction.
Poor diet can contribute to vitamin deficiency and iron
deficiency anemia, in which fewer red blood cells are
produced. Hereditary disorders and certain diseases can
cause increased blood cell destruction. However, exces-
sive bleeding is the most common cause of anemia, and
the speed with which blood loss occurs has a significant
effect on the severity of symptoms. Chronic blood loss
may be caused by:
• heavy menstrual flow
• hemorrhoids
• nosebleeds
• cancer
• gastrointestinal tumors
• diverticulosis
• polyposis
• stomach ulcers
• long-term alcohol abuse
Acute blood loss is usually the result of:
• childbirth
• injury
• ruptured blood vessel
• surgery
Iron deficiency anemia
Iron deficiency anemia is the most common form of
anemia in the world. In the United States, iron deficiency
anemia affects about 240,000 toddlers between one and
two years of age and 3.3 million women of childbearing
age. This condition is less common in older children and
in adults over 50, and it rarely occurs in teenage boys
and young men.
79
Anemia
Anemia
This illustration shows the microscope view of normal red
blood cells (left) and those in three different types of ane-
mia (from left), iron-deficiency anemia, megaloblastic ane-
mia, and sickle cell anemia. (Photograph by John Bavosi,
Custom Medical Stock Photo. Reproduced by permission.)
The onset of iron deficiency anemia is gradual. The
deficiency begins when the body loses more iron than it
gains from food and other sources. Because depleted
iron stores cannot meet the red blood cells’ needs, fewer
red blood cells develop. In this early stage of anemia, the
red blood cells look normal, but they are reduced in
number. Then the body tries to compensate for the iron
deficiency by producing more red blood cells, which are
characteristically small in size.
Weakness, fatigue, and a run-down feeling may be
signs of mild anemia. Other signs include skin that is
pasty or sallow, or lack of color in the creases of the
palm, gums, nail beds, or lining of the eyelids. Someone
who is weak, tires easily, is often out of breath, and feels
faint or dizzy may be severely anemic. Other symptoms
of anemia are:
• angina pectoris (chest pain)
80
• headache
• inability to concentrate and/or memory loss
• inflammation of the mouth (stomatitis) or tongue (glos-
sitis)
• insomnia
• irregular heartbeat
• loss of appetite
• nails that are dry, brittle, or ridged
• rapid breathing
• sores in the mouth, throat, or rectum
• sweating
• swelling of the hands and feet
• thirst
• tinnitus (ringing in the ears)
• unexplained bleeding or bruising
• pica (a craving to chew ice, paint, or dirt)
Folic acid deficiency anemia
Folic acid deficiency anemia is the most common
type of megaloblastic anemia, in which red blood cells
are bigger than normal. It is caused by a deficiency of
folic acid, a vitamin that the body needs to produce nor-
mal cells.
Folic acid anemia is especially common in infants
and teenagers. Although this condition usually results
from a dietary deficiency, it is sometimes due to an in-
ability to absorb enough folic acid from foods such as:
•eggs
• fish
• green vegetables
• meat
• milk and cheese
• mushrooms
• yeast
Smoking raises the risk of developing this condition
by interfering with the absorption of vitamin C, which the
body needs to absorb folic acid. Folic acid anemia can be
a complication of pregnancy, when a woman’s body
needs eight times more folic acid than it does otherwise.
Vitamin B n deficiency anemia
Less common in this country than folic acid anemia,
vitamin B 12 deficiency anemia is another type of mega-
loblastic anemia that develops when the body does not
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
absorb enough of this nutrient. Necessary for the creation
of red blood cells, B 12 is found in meat and vegetables.
Large amounts of B 12 are stored in the body, so this
condition may not become apparent until as long as four
years after B 12 absorption slows down or stops. The re-
sulting drop in red blood cell production can cause:
• loss of muscle control
• loss of sensation in the legs, hands, and feet
• soreness or burning of the tongue
• weight loss
• yellow-blue color blindness
The most common form of B 12 deficiency is perni-
cious anemia. Since most people who eat meat or eggs
get enough B 12 in their diets, a deficiency of this vitamin
usually means that the body is not absorbing it properly.
This can occur among people who have had intestinal
surgery or those who do not produce adequate amounts
of intrinsic factor, a chemical secreted by the stomach
lining that combines with B 12 to help its absorption in the
small intestine. Symptoms of pernicious anemia include
problems with movement or balance, a slick tongue, tin-
gling in the hands and feet, confusion, depression, and
memory loss. Pernicious anemia can also damage the
spinal cord. A doctor should be notified whenever symp-
toms of this condition occur.
Pernicious anemia usually strikes people 50-60 years
of age. Eating disorders or an unbalanced diet increases
the risk of developing pernicious anemia. So do diabetes
mellitus, gastritis, stomach cancer, stomach surgery, thy-
roid disease, and family history of pernicious anemia.
Vitamin C deficiency anemia
A rare disorder that causes the bone marrow to man-
ufacture abnormally small red blood cells, vitamin C de-
ficiency anemia results from a severe, long-standing di-
etary deficiency.
Hemolytic anemia
Some people are born with hemolytic anemia. Some
acquire this condition, in which infection or antibodies
destroy red blood cells more rapidly than bone marrow
can replace them.
Hemolytic anemia can enlarge the spleen and accel-
erate the destruction of red blood cells (hemolysis). Other
complications of hemolytic anemia may include pain,
shock, gallstones, and other serious health problems.
Thalassemias
An inherited form of hemolytic anemia, thalassemia
stems from the body’s inability to manufacture as much
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
normal hemoglobin as it needs. There are two categories
of thalassemia, depending on which of the amino acid
chains is affected. (Hemoglobin is composed of four
chains of amino acids.) In alpha-thalassemia, there is an
imbalance in the production of the alpha chain of amino
acids; in beta-thalassemia, there is an imbalance in the
beta chain. Alpha-thalassemias most commonly affect
blacks (25% have at least one gene); beta-thalassemias
most commonly affect people of Mediterranean and
Southeast Asian ancestry.
Characterized by production of red blood cells that
are unusually small and fragile, thalassemia only affects
people who inherit the gene for it from each parent (au-
tosomal recessive inheritance).
Autoimmune hemolytic anemia
Warm antibody hemolytic anemia is the most com-
mon type of this disorder. This condition occurs when
the body produces autoantibodies that coat red blood
cells. The coated cells are destroyed by the spleen, liver,
or bone marrow.
Warm antibody hemolytic anemia is more common
in women than in men. About one-third of patients who
have warm antibody hemolytic anemia also have lym-
phoma, leukemia, lupus, or connective tissue disease.
In cold antibody hemolytic anemia, the body attacks
red blood cells at or below normal body temperature.
The acute form of this condition frequently develops in
people who have had pneumonia, mononucleosis, or
other acute infections. It tends to be mild and short-
lived, and disappears without treatment.
Chronic cold antibody hemolytic anemia is most
common in women and most often affects those who are
over 40 and have arthritis. This condition usually lasts
for a lifetime, generally causing few symptoms. Howev-
er, exposure to cold temperatures can accelerate red
blood cell destruction, causing fatigue, joint aches, and
discoloration of the arms and hands.
Sickle cell anemia
Sickle cell anemia is a chronic, incurable condition
that causes the body to produce defective hemoglobin,
which forces red blood cells to assume an abnormal cres-
cent shape. Unlike normal oval cells, fragile sickle cells
cannot hold enough hemoglobin to nourish body tissues.
The deformed shape makes it hard for sickle cells to pass
through narrow blood vessels. When capillaries become
obstructed, a life-threatening condition called sickle cell
crisis is likely to occur.
Sickle cell anemia is hereditary. It almost always af-
fects people of African or Mediterranean descent. A
81
Anemia
Anemia
child who inherits the sickle cell gene from each parent
will have the disease, but a child who inherits the gene
from only one parent will carry the sickle cell trait, but
will not have the disease.
Aplastic anemia
Sometimes curable by bone marrow transplant, but
potentially fatal, aplastic anemia is characterized by de-
creased production of red and white blood cells and
platelets (disc-shaped cells that allow the blood to clot).
This disorder may be inherited or acquired as a result of
recent severe illness, long-term exposure to industrial
chemicals, or use of anticancer drugs and certain other
medications.
Anemia of chronic disease
Cancer, chronic infection or inflammation, and kid-
ney and liver disease often cause mild or moderate ane-
mia. Chronic liver failure generally produces the most
severe symptoms.
Diagnosis
Personal and family health history may suggest the
presence of certain types of anemia. Laboratory tests that
measure the percentage of red blood cells or the amount
of hemoglobin in the blood are used to confirm diagnosis
and determine which type of anemia is responsible for a
patient’s symptoms. X rays and examinations of bone
marrow may be used to identify the source of bleeding.
Treatment
Anyone who has anemia caused by poor nutrition
should modify his or her diet to include more vitamins,
minerals, and iron. Foods such as lean red meats, dried
beans and fruits, liver, poultry, and enriched breads and
cereals are all good sources of iron. In addition, eating
foods rich in vitamin C such as citrus fruits and juices
can promote the absorption of iron.
Patients diagnosed with iron-deficiency anemia
should undergo a thorough physical examination and
medical history to determine the cause of the anemia,
particularly if chronic or acute blood loss is suspected.
The cause of a specific anemia will determine the type of
treatment recommended.
Anemia due to nutritional deficiencies can usually
be treated at home with iron supplements or self admin-
istered injections of vitamin B 12 . People with folic acid
anemia should take oral folic acid replacements. Vitamin
C deficiency anemia can be cured by taking daily sup-
plements of vitamin C.
82
Many therapies for iron-deficiency anemia focus on
adding iron-rich foods to the diet or on techniques to
improve circulation and digestion. Iron supplementa-
tion, especially with iron citrate (less likely to cause
constipation), can be given in combination with herbs
that are rich in iron. Some examples of iron-rich herbs
are dandelion ( Taraxacum officinale ), parsley (Pet-
roselinum crispum ), and nettle ( Urtica dioica). The
homeopathic remedy ferrum phosphoricum (iron sul-
fate) can also be helpful.
An iron-rich herbal tonic can also be made using the
following recipe:
• Soak one-half ounce of yellow dock root and one-half
ounce dandelion root in 1 qt of boiled water for 4-8
hours.
• Simmer until the amount of liquid is reduced to 1 cup.
• Remove from heat and add one-half cup black strap
molasses, mixing well.
• Store in refrigerator: take one-quarter cup daily.
Other herbal remedies known to promote digestion
are prescribed to treat iron-deficiency anemia. Gentian
(■ Gentiana luted) is widely used in Europe to treat ane-
mia and other nutritionally-based disorders. The bitter
qualities of gentian help stimulate the digestive system,
making iron and other nutrients more available for ab-
sorption. This bitter herb can be brewed into tea or pur-
chased as an alcoholic extract (tincture).
Other herbs recommended to promote digestion in-
clude:
• anise ( Pimpinella anisum)
• caraway (Carum carvi )
• cumin ( Cuminum cyminum)
• linden (Tilia spp.)
• licorice ( Glycyrrhiza glabra)
Traditional Chinese treatments for anemia include:
• acupuncture to stimulate a weakened spleen
• asian ginseng ( Panax ginseng) to restore energy
• dong quai ( Angelica sinensis) to control heavy men-
strual bleeding
• a mixture of dong quai and Chinese foxglove ( Rehman -
nia glutinosa) to clear a sallow complexion
• astragalus ( Astragalus membranaceus) to treat pallor
and dizziness
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Allopathic treatment
Surgery may be necessary to treat anemia caused by
excessive loss of blood. Transfusions of red blood cells
may be used to accelerate production of red blood cells.
Medication or surgery may also be necessary to con-
trol heavy menstrual flow, repair a bleeding ulcer, or re-
move polyps (growths or nodules) from the bowels.
Patients with thalassemia usually do not require
treatment. However people with a severe form may re-
quire periodic hospitalization for blood transfusions
and/or bone marrow transplantation.
Sickle cell anemia
Treatment for sickle cell anemia involves regular
eye examinations, immunizations for pneumonia and in-
fectious diseases, and prompt treatment for sickle cell
crises and infections of any kind. Psychotherapy or
counseling may help patients deal with the emotional
impact of this condition.
Vitamin B , 2 deficiency anemia
A life-long regimen of B 12 shots is necessary to con-
trol symptoms of pernicious anemia. The patient may be
advised to limit physical activity until treatment restores
strength and balance.
Aplastic anemia
People who have aplastic anemia are especially sus-
ceptible to infection. Treatment for aplastic anemia may
involve blood transfusions and bone marrow transplant
to replace malfunctioning cells with healthy ones.
Anemia of chronic disease
There is no specific treatment for anemia associated
with chronic disease, but treating the underlying illness
may alleviate this condition. This type of anemia rarely
becomes severe. If it does, transfusions or hormone treat-
ments to stimulate red blood cell production may be pre-
scribed.
Hemolytic anemia
There is no specific treatment for cold-antibody he-
molytic anemia. About one-third of patients with warm-
antibody hemolytic anemia respond well to large doses
of intravenous and oral corticosteroids, which are gradu-
ally discontinued as the patient’s condition improves. Pa-
tients with this condition who do not respond to medical
therapy must have the spleen surgically removed. This
operation controls anemia in about half of the patients on
whom it is performed. Immune-system suppressants are
prescribed for patients whose surgery is not successful.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Expected results
Folic acid and iron deficiency anemia
It usually takes three to six weeks to correct folic
acid or iron deficiency anemia. Patients should continue
taking supplements for another six months to replenish
iron reserves and should have periodic blood tests to
make sure the bleeding has stopped and the anemia has
not recurred.
Pernicious anemia
Although pernicious anemia is considered incurable,
regular B 12 shots will alleviate symptoms and reverse
complications. Some symptoms will disappear almost as
soon as treatment begins.
Aplastic anemia
Aplastic anemia can sometimes be cured by a bone
marrow transplant. If the condition is due to immunosup-
pressive drugs, symptoms may disappear after the drugs
are discontinued.
Sickle cell anemia
Although sickle cell anemia cannot be cured, effec-
tive treatments enable patients with this disease to enjoy
longer, more productive lives.
Thalassemia
People with mild thalassemia (alpha thalassemia
trait or beta thalassemia minor) lead normal lives and do
not require treatment. Those with severe thalassemia
may require bone marrow transplantation. Genetic thera-
py is being investigated and may soon be available.
Hemolytic anemia
Acquired hemolytic anemia can generally be cured
when the cause is removed.
Prevention
Inherited anemia cannot be prevented. Genetic
counseling can help parents cope with questions and
concerns about passing on disease-causing genes to their
children.
Avoiding excessive use of alcohol, eating a balanced
diet that contains plenty of iron-rich foods, and taking a
daily multivitamin can help prevent anemia.
Methods of preventing specific types of anemia in-
clude:
83
Anemia
Angelica
KEY TERMS
Aplastic — Exhibiting incomplete or faulty devel-
opment.
Diabetes mellitus — A disorder of carbohydrate
metabolism brought on by a combination of
hereditary and environmental factors.
Hemoglobin — An iron-containing pigment of red
blood cells composed of four amino acid chains
(alpha, beta, gamma, delta) that delivers oxygen
from the lungs to the tissues of the body.
Megaloblast — A large erythroblast (a red marrow
cell that synthesizes hemoglobin).
• Avoiding lengthy exposure to industrial chemicals and
drugs known to cause aplastic anemia.
•Not taking medication that has triggered hemolytic
anemia and not eating foods that have caused hemoly-
sis (breakdown of red blood cells).
• Receiving regular B 12 shots to prevent pernicious ane-
mia resulting from gastritis or stomach surgery.
Resources
BOOKS
Fauci, Anthony S. et al., eds. Harrison's Principles of Internal
Medicine. New York: McGraw-Hill, 1998.
Tierney, Lawrence M., Jr. Current Medical Diagnosis & Treat-
ment, 1998. Stamford, Conn.: Appleton & Lange, 1998.
Paula Ford-Martin
Angelica
Description
Angelica is a genus of plants in the parsley family
used in both Western healing and traditional Chinese
medicine. Usually the dried root is used medicinally.
The most common angelica used in Western healing is
the European species, Angelica archangelica. Occasion-
ally the North American species, A. atropurpurea, is
used in the same way as A. archangelica. Other names
for Western Angelica are European angelica, garden an-
gelica, purple angelica, Alexander’s archangel, master-
wort, wild angelica, and wild celery.
Western angelica grows to a height of about 4.5 ft
(1.5 m) in dappled sun. It has white to yellow flowers,
84
and very large three-part leaves. The root is long and fi-
brous and is poisonous if used fresh. The plant has a
strong, tangy odor and taste.
There are at least 10 species of angelica used in tra-
ditional Chinese medicine. The most frequently used
species is A. sinensis , which in Chinese is called dong
quai (alternate spellings are dang gui , tang kwei, and tang
gui). Other Chinese species include A. pubescens, called
in Chinese du Into, and A. dahurica , called in Chinese bai
zhi. The descriptions of the medicinal uses of Chinese an-
gelica in this article refer only to A. sinensis or dong quai.
Chinese angelica is a perennial that grows to a
height of 3 ft ( 1 m) in moist, fertile soil at high altitudes
in China, Korea, and Japan. It has a purple stem and um-
brella-like clusters of flowers. The root is used medici-
nally and as a spice.
The species of angelica used in Western healing
have different properties than those used in Eastern med-
icine, so they will be treated separately here. The reader
should not assume that any properties or benefits as-
cribed to Western angelica also apply to Chinese angeli-
ca or vice versa.
General use
Western angelica
Western angelica, or A. archangelica , is said to have
been named after an angel who revealed the herb to a Eu-
ropean monk as a curative. It has a long history of folk use
in Europe, Russia, and among Native American tribes.
The leaves of angelica are prepared as a tincture or
tea and used to treat coughs, colds, bronchitis, and other
respiratory complaints. They are considered gentler in
action than preparations made from the root. The root is
the most medically active part of the plant. It is used as
an appetite stimulant and to treat problems of the diges-
tive system and liver. It is said to relieve abdominal
bloating and gas, indigestion, and heartburn.
Angelica will induce sweating and is also used to
treat conditions such as arthritis and rheumatism. In addi-
tion, it is used as a diuretic. Externally, angelica is applied
as an ointment to treat lice and some skin disorders.
In addition to medicinal use, an essential oil derived
from the plant is used in making perfumes and as a food
flavoring. Oil from the seeds imparts the distinctive fla-
vor to the Benedictine liqueur. Sometimes candied leaves
and stalks are used as sweets.
Despite its widespread folk use, angelica can present
some serious health hazards. The root is poisonous when
fresh and must be dried thoroughly before use. All members
of the genus contain compounds called furocoumarins that
can cause a person exposed to the sun or other source of ul-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
traviolet rays to develop severe sunburn and/or rash (photo-
dermis). In addition, in animal studies, furocoumarins have
been found to cause cancer and cell damage even without
exposure to light. The essential oil contains safrole, the can-
cer-causing substance that caused the United States Food
and Drug Administration (FDA) to ban the herb sassafras.
Despite these health concerns, the German Federal
Health Agency’s Commission E, established in 1978 to
independently review and evaluate scientific literature
and case studies pertaining to herb and plant medica-
tions, has approved preparations containing angelica root
as a treatment for bloating and as an appetite stimulant.
Chinese angelica
Chinese angelica, or dong quai , is considered in tra-
ditional Chinese medicine (TCM) to have a warm nature
and a sweet, acrid, and bitter taste. The main use of an-
gelica in TCM is to regulate the female reproductive or-
gans and treat irregularities of the menstrual cycle, espe-
cially deficient bleeding. Chinese herbalists also use this
herb to treat irregular periods, menstrual cramps, and in-
fertility. The root is one component of Four Things
Soup, a widely used woman's tonic in China.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Dong quai is one of the best known herbs in China,
and is one of the traditional Chinese herbs that is in-
creasingly familiar in the West. In addition to treating
women’s complaints, Chinese angelica is used in general
blood tonics to improve conditions such as anemia. Be-
cause angelica is considered to be a warming herb, it is
also used to aid circulation and digestion. Other uses are
to treat headache, constipation, rheumatism, high blood
pressure, and ulcers.
Dong quai contains several active compounds called
coumarins. These compounds are well documented as
agents that dilate (open up) the blood vessels, stimulate
the central nervous system, and help control spasms. It is
likely that these compounds do act on the uterus, support-
ing the use of dong quai for some women’s problems.
Animal and test-tube studies indicated that dong
quai may combat allergies by altering the immune sys-
tem response. Other animal studies suggest that the herb
is a mild diuretic.
Unfortunately, dong quai, like Western angelica,
contains compounds that can cause a person exposed to
the sun or other source of ultraviolet rays to develop se-
vere sunburn and/or rash. These problems become more
severe when using the concentrated essential oil or puri-
85
Angelica
Angina
KEY TERMS
Decoction — Decoctions are made by boiling an
herb, then straining the solid material out for the
resulting liquid.
Diuretic — A diuretic is any substance that increas-
es the production of urine.
Tincture — An alcohol-based extract prepared by
soaking plant parts.
fied forms of the herb. The essential oil also contains saf-
role, a known carcinogen.
Preparations
Angelica root is harvested in the fall, then dried for
future use. The leaves of Western angelica can be made
into a tea ( 1 teaspoon powdered leaves to one cup of boil-
ing water steeped up to 20 minutes), a tincture, or a cream
for external use. The root can be made into a tincture or a
decoction. The essential oil can be combined with other
oils for external use as a massage oil for arthritis.
Dong quai is used in many common Chinese formu-
las and as a component of many medicinal soups.
Precautions
Children or pregnant women should not take angelica.
In light of its potential for causing health problems, com-
plete avoidance of the herb may be considered desirable.
Side effects
In addition to increasing the risk of photodermis, an-
gelica is considered to be a mild laxative and may cause
mild diarrhea.
Interactions
No studies exist on interactions between angelica
and conventional pharmaceuticals. Given the history of
its long use in traditional Chinese medicine, it appears
unlikely that there are any significant interactions with
other commonly used Chinese herbs.
Resources
BOOKS
Chevallier. Andrew. Encyclopedia of Medicinal Plants. Lon-
don: Dorling Kindersley, 1996.
PDR for Herbal Medicines. Montvale, New Jersey: Medical
Economics Company, 1999.
86
Molony, David. Complete Guide to Chinese Herbal Medicine.
New York: Berkeley Books, 1998.
Peirce, Andrea. The American Pharmaceutical Association
Practical Guide to Natural Medicines. New York: William
Morrow and Company, 1999.
Teegaurden. Ron. The Ancient Wisdom of the Chinese Tonic
Herbs. New York: Warner Books, 1998.
Weiner, Michael and Janet Weiner. Herbs that Heat. Mill Val-
ley, CA: Quantum Books, 1999.
ORGANIZATIONS
American Association of Oriental Medicine (AAOM). 433
Front Street, Catasauqua, PA 18032. (610) 266-2433.
OTHER
Plants for the Future “Angelica archangelica.” <www.metalab.
unc.edu.>
Plants for the Future "Angelica sinensis.” <www.metalab.unc.
edu.>
Tish Davidson
Angelica archangelica see Angelica
Angelica sinensis see Dong quai
Angina
Definition
Angina is pain, discomfort, or pressure in the chest
that is caused by ischemia, an insufficient supply of oxy-
gen-rich blood to the heart muscle. It is sometimes also
characterized by a feeling of choking, suffocation, or crash-
ing heaviness. This condition is also called angina pectoris.
Description
Often described as a muscle spasm and choking sen-
sation, the term angina is used primarily to describe chest
(thoracic) pain caused by insufficient oxygen to the heart
muscle. An episode of angina is not an actual heart attack,
but rather pain that results when the heart muscle tem-
porarily receives too little blood. This temporary condition
may be the result of demanding activities such as exercise
and does not necessarily indicate that the heart muscle is
experiencing permanent damage. In fact, episodes of angi-
na seldom cause permanent damage to heart muscle.
Angina can be subdivided into two categories: angi-
na of effort and variant angina.
Angina of effort
Angina of effort is a common disorder caused by the
narrowing of the arteries (a condition called atherosclero-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
sis) that supply oxygen-rich blood to the heart muscle. In
the case of angina of effort, the coronary arteries can pro-
vide the heart muscle (myocardium) adequate blood dur-
ing rest but not during periods of exercise, stress, or ex-
citement. The resulting pain is relieved by resting or by
administering nitroglycerin, a medication that relaxes the
heart muscle, opens up the coronary blood vessels, and
lowers the blood pressure — all of which reduce the heart’s
need for oxygen. Patients with angina of effort have an in-
creased risk of heart attack (myocardial infarction).
Variant angina
Variant angina is uncommon and occurs indepen-
dently of atherosclerosis, which may incidentally be pre-
sent. Variant angina occurs at rest and is not related to
excessive work by the heart muscle. Research indicates
that variant angina is caused by coronary artery muscle
spasm that does not last long enough or is not intense
enough to cause an actual heart attack.
Causes & symptoms
Angina is usually caused by an underlying obstruc-
tion to the coronary artery due to atherosclerosis. In
some cases, it is caused by spasm that occurs naturally or
as a result of ingesting cocaine. In rare cases, angina is
caused by a coronary embolism or by a disease other
than atherosclerosis that places demands on the heart.
Most episodes of angina are brought on by physical
exertion, when the heart needs more oxygen than is
available from the blood nourishing the heart. Emotional
stress, extreme temperatures, heavy meals, cigarette
smoking, and alcohol can also cause or contribute to an
episode of angina.
Angina causes a pressing pain or sensation of heavi-
ness, usually in the chest area under the breast bone
(sternum). It is occasionally experienced in the shoulder,
arm, neck, or jaw regions. In most cases, the symptoms
are relieved within a few minutes by resting or by taking
prescribed angina medications.
Diagnosis
Physicians can usually diagnose angina based on the
patient’s symptoms and the precipitating factors. Howev-
er, other diagnostic testing is often required to confirm or
rule out angina, or to determine the severity of the under-
lying heart disease.
Electrocardiogram (ECG)
An electrocardiogram is a test that records electrical
impulses from the heart. The resulting graph of electrical
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
activity can show if the heart muscle isn’t functioning
properly as a result of a lack of oxygen. Electrocardio-
grams are also useful in investigating other possible ab-
normal features of the heart, such as arrhythmia (irregu-
lar heartbeat).
Stress test
For many individuals with angina, the results of an
electrocardiogram while at rest will not show any abnor-
malities. Because the symptoms of angina occur during
stress, the heart’s function may need to be evaluated
under the physical stress of exercise. The stress test
records information from the electrocardiogram before,
during, and after exercise in search of stress-related ab-
normalities. Blood pressure is also measured during the
stress test and symptoms are noted. In some cases a more
involved and complex stress test (for example, thallium
scanning) is used to picture the blood flow in the heart
muscle during the most intense exercise and after rest.
Angiogram
The angiogram, which is a series of x rays of the
coronary artery, has been noted as the most accurate diag-
nostic test to indicate the presence and extent of coronary
disease. In this procedure, a long, thin, flexible tube
(catheter) is inserted into an artery located in the forearm
or groin. This catheter is passed further through the artery
into one of the two major coronary arteries. A dye is in-
jected through the catheter to make the heart, arteries, and
blood flow clearer on the x ray. A fluoroscopic film, or
series of “moving” x rays, shows the blood flowing
through the coronary arteries. This will reveal any possi-
ble narrowing that can cause a decrease in blood flow to
the heart muscle and associated symptoms of angina.
Treatment
Controlling existing factors that place the individual at
risk is the first step in addressing artery disease that causes
angina. These risk factors include cigarette smoking, high
blood pressure, high cholesterol levels, and obesity.
Once the angina has subsided, the cause should be
determined and treated. Atherosclerosis, a major associ-
ated cause, requires diet and lifestyle adjustments, pri-
marily including regular exercise, reduction of dietary
sugar and saturated fats, and increase of dietary fiber.
In recent years, several specific cholesterol-lowering
treatments have gained the attention and interest of the
public. One of the most recent popular treatments is garlic
( Allium sativum). Some studies have shown that garlic can
reduce total cholesterol by about 10% and LDL (bad) cho-
lesterol by 15%, and can raise HDL (good) cholesterol by
87
Angina
Angina
10%. Other studies have not shown significant benefit. Al-
though its effect on cholesterol is not as great as the effect
achieved by medications, garlic may help in relatively
mild cases of high cholesterol, without causing the side ef-
fects associated with cholesterol-reducing drugs.
A 1999 study published in the American Journal of
Clinical Nutrition found that red yeast extract can signifi-
cantly reduce cholesterol when it’s taken in conjunction
with a low-fat diet. Red yeast extract, available in the Unit-
ed States under the trade name Cholestin, has been used in
Chinese medicine to treat heart maladies for hundreds of
years. The effectiveness of the extract depends on the pa-
tient’s cholesterol level and medical history, so individuals
should consult with their healthcare professionals before
taking the supplement. Additional herbal remedies that
may help lower cholesterol include oats ( Avena sativa), al-
falfa ( Medicago sativa ), fenugreek (Trigonella foenum-
graecum ), Korean ginseng ( Panax ginseng), myrrh
(Commiphora molmol ), and turmeric (Curcuma longa).
Yarrow (Achillea millefolium ), linden (Tilia eu-
ropaea), and hawthorn (Crataegus spp.) are sometimes
recommended for controlling high blood pressure, a risk
factor for heart disease. In particular, hawthorn extract
appears to benefit the aging heart. A 2001 report of a Eu-
ropean study reported that patients using hawthorn ex-
tract showed improvements in exercise tolerance, fa-
tigue, and shortness of breath.
Tea (Camellia sinensis) — especially green tea — is
high in antioxidants, and studies have shown that it may
help prevent atherosclerosis. Other antioxidants, includ-
ing vitamin A (beta carotene), vitamin C, vitamin E,
and selenium, can also limit the damage to the walls of
blood vessels by oxidation, which may be lead to the for-
mation of atherosclerotic plaque.
Vitamin and mineral supplements that reduce, re-
verse, or protect against coronary artery disease include
chromium, calcium and magnesium, B-complex vita-
mins, L-carnitine, and zinc. Yoga and other bodywork,
massage, aromatherapy, and music therapy may also
help reduce angina symptoms by promoting relaxation
and stress reduction.
Traditional Chinese medicine may recommend
herbal remedies (such as a ginseng and aconite combina-
tion), massage, acupuncture, and dietary modification.
Exercise and a healthy diet, including cold-water fish as a
source of essential fatty acids, are important components
of a regimen to prevent angina and heart disease.
Allopathic treatment
Angina is often controlled by medication, most
commonly with nitroglycerin. This drug relieves symp-
88
toms of angina by increasing the diameter of the blood
vessels that carry blood to the heart muscle. Nitroglyc-
erin is taken whenever discomfort occurs or is expected.
It may be taken sublingually, by placing the tablet under
the tongue. Or it may be administered transdermally, by
placing a medicated patch directly on the skin.
In addition, beta-blockers or calcium channel block-
ers may be prescribed to decrease the heart’s rate and
workload. In late 2001, a study reported that the drug
Nicorandil had become the first to demonstrate a reduc-
tion in risk of angina and to improve symptoms in patients
with chronic stable angina. Guidelines released late in
2000 promoted use of lopidogrel to help prevent recurring
events. A study group that used clopidogrel and aspirin
showed a significant decrease in cardiovascular death,
nonfatal heart attack, and stroke compared to patients in a
control group that received a placebo and aspirin.
When conservative treatments are not effective in
reducing angina pain and the risk of heart attack remains
high, physicians may recommend angioplasty or surgery.
In coronary artery bypass surgery, a blood vessel (often a
long vein surgically removed from the leg) is grafted
onto the blocked artery to bypass the blocked portion.
This newly formed pathway allows blood to flow ade-
quately to the heart muscle.
Another procedure used to improve blood flow to
the heart is percutaneous tranluminal coronary angio-
plasty, usually called coronary or balloon angioplasty. In
this procedure, the physician inserts a catheter with a
tiny balloon at the end into a forearm or groin artery. The
catheter is then threaded up into the coronary arteries,
and the balloon is inflated to open the vessel in narrowed
sections. Other techniques to open clogged arteries are
under development and in limited use, including the use
of lasers, stents, and other surgical devices.
Expected results
The prognosis for a patient with angina depends on
the general health of the individual as well as on the ori-
gin, type, and severity of the condition. A person can im-
prove his or her prognosis by seeking prompt medical at-
tention and learning the pattern of his or her angina, such
as what causes the attacks, what they feel like, how long
episodes usually last, and whether medication relieves
the attacks. Medical help should be sought immediately
if patterns of the symptoms change significantly or if
symptoms resemble those of a heart attack.
Prevention
In most cases, the best prevention involves changing
habits to avoid bringing on attacks of angina. A heart-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Atherosclerosis — Progressive narrowing and hard-
ening of the arteries caused by the buildup of
plaque on the artery walls, which results in re-
stricted blood flow.
Ischemia — Decreased blood supply to an organ or
body part, often resulting in pain.
Myocardial infarction — A blockage of a coronary
artery that cuts off the blood supply to part of the
heart. In most cases, the blockage is caused by
fatty deposits.
Myocardium — The thick middle layer of the heart
that forms the bulk of the heart wall and contracts
as the organ beats.
healthy lifestyle includes eating right, exercising regularly,
maintaining an appropriate weight, not smoking, drinking
in moderation, controlling hypertension, and managing
stress. Most healthcare professionals can provide valuable
advice on proper diet, weight control, smoking cessation,
blood cholesterol levels, and blood pressure.
Resources
BOOKS
American Heart Association. 2000 Heart and Stroke Statistical
Update. Dallas: American Heart Association, 1999.
Hoffmann, David. The Complete Illustrated Herbal. New York:
Barnes & Noble, 1999.
PERIODICALS
Jancin, Bruce. “Nicorandil Relieves Stable Angina, Cuts
Events.” Interna! Medicine News 34, no. 24 (December
15,2001): 11.
Pinkowish, Mary Desmond. ‘‘Acute Coronary Syndromes: Re-
cent Treatment Advances." Patient Care 35, no. 22 (No-
vember 30, 2001): 12.
Walsh, Nancy. ‘‘Hawthorn Extract Limits CHF, Mild Heart Ail-
ments." Internal Medicine News 34. no. 19 (October 1,
2001): 9.
ORGANIZATIONS
American Heart Association. National Center. 7272 Greenville
Avenue. Dallas, Texas 75231. (800) AHA-USA1. <http://
www.americanheart.org>.
National Heart, Lung, and Blood Institute Information Center.
P.O. Box 30105. Bethesda, MD 20824. (301) 251-1222.
<http://www.nhlbi.nih.gov/health/infoctr/index.htm>.
Paula Ford-Martin
Teresa G. Odle
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Animal-assisted therapy see Pet therapy
Anise
Description
Anise, Pimpinella anisum, is a slow-growing annual
herb of the parsley family (Apiaceae, formerly Umbellif-
erae). It is related to other plants prized for their aromatic
fruits, commonly called seeds, such as dill, cumin, car-
away, and fennel. It is cultivated chiefly for its licorice-
flavored fruits, called aniseed. Although it has a licorice
flavor, anise is not related to the European plant whose
roots are the source of true licorice. It has been used as a
medicinal and fragrant plant since ancient times.
The plant reaches from 1-3 ft (0.3-1 m) in height
when cultivated, and has finely divided feather-like
bright green leaflets. The name Pimpinella (from the
Latin dipinella) refers to the pinnately divided form of
the leaves. The plant bears white to yellowish-white
flowers in compound umbels (umbrella-like clusters).
When ripe, the fruits are 0.125 in (3 mm) long and oval-
shaped with grayish-green coloring.
While the entire plant is fragrant and tastes strongly
of anise, it is the aniseed fruit that has been highly val-
ued since antiquity. Seed maturation usually occurs one
month after pollination, when the oil content in the dried
fruit is about 2.5%. Steam distillation of the crushed
aniseed yields from 2.5 to 3.5% of a fragrant, syrupy, es-
sential, or volatile, oil, of which anethole, present at
about 90%, is the principal aromatic constituent. Other
chemical constituents of the fruit are creosol, alpha-
pinene, dianethole, and photoanethole.
In addition to its medicinal properties, anise is wide-
ly used for flavoring curries, breads, soups, cakes, can-
dies, desserts, nonalcoholic beverages, and liqueurs such
as anisette. The essential oil is valuable in perfumes and
soaps and has been used in toothpastes, mouthwashes,
and skin creams.
Anise is endemic to the Middle East and Mediter-
ranean regions, including Egypt, Greece, Crete, and Turkey.
It was cultivated and used by ancient Egyptians, and used in
ancient Greece and Rome, when it was cultivated in Tus-
cany. Its use and cultivation spread to central Europe in the
Middle Ages, and today it is cultivated on a commercial
scale in warm areas such as southern Europe, Asia, India,
North Africa, Mexico, and Central and South America.
General use
The medicinal properties of anise come from the
chemicals that are present in the fruits. The anethole in
89
Anise
Anise
anise helps to relieve gas and settle an upset stomach. The
use of anise to season foods, especially meat and vegetable
dishes, in many parts of the world may have originated as a
digestive aid. The Romans ate aniseed cake at the end of
rich meals to prevent indigestion. The chemicals creosol
and alpha-pinene act as expectorants, loosening mucus and
making it easier to cough up. The estrogenic action of
anise is from the chemicals dianethole and photoanethole,
which act in a way similar to estrogen. The anise fruits and
the essential oil of anise contain these chemicals and can
be used medicinally. Aniseed can also be used to make an
herbal tea which can help relieve physical complaints.
As a medicinal plant, anise has been used as an antibac-
terial, an antimicrobial, an antiseptic, an antispasmodic, a
breath freshener, a carminative, a diaphoretic, a digestive
aid, a diuretic, an expectorant, a mild estrogenic, a mild
muscle relaxant, a parasiticide, a stimulant, and a stomachic.
Anise may be helpful in the following conditions:
• Anemia. Anise promotes digestion, which may help
improve anemia due to inefficient absorption of iron.
• Asthma. Essential oil of anise may be inhaled through
the nose to help ease breathing and relieve nasal con-
gestion.
90
• Bad breath. It can be used in mouthwash or tea to
sweeten breath.
• Bronchitis. Aniseed may be used as an expectorant and
essential oil of anise may be inhaled through the nose
to help ease breathing.
• Catarrh. Drinking aniseed tea soothes mucous mem-
branes.
• Cold. Aniseed can be used as an expectorant and drink-
ing aniseed tea soothes the throat.
• Colic. Drinking anise tea or using essential oil can alle-
viate gas.
• Cough. Can be used as an expectorant, especially for
hard, dry coughs where expectoration is difficult.
• Croup. Aniseed can be used to alleviate a persistent
cough in a child.
• Emphysema. Essential oil of anise may be inhaled
through the nose to help ease breathing and relieve
nasal congestion and tea with aniseed will soothe mu-
cous membranes.
• Gas and gas pains. Drinking aniseed tea helps relieve
gas, gas pains, and flatulence.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• Menopause. Aniseed tea can help alleviate menopausal
symptoms.
• Morning sickness. Tea made from anise can help alle-
viate morning sickness during pregnancy.
• Nursing. Aniseed tea can help a nursing mother’s milk
come in.
• Sore throat. Drinking aniseed tea alleviates pain of
sore throat.
Preparations
Aniseeds. May be added to foods when cooking to
flavor and aid digestion, or may be taken whole in doses
of 1-3 tsp of dried anise seeds per day.
Tea. One tsp of crushed aniseeds can be steeped in a
cup of hot water, then combined with fennel and car-
away to help relieve gas and gas pains. To help relieve a
cough, coltsfoot, marsh mallow, hyssop, and licorice
can be added to the tea. Infants should only receive 1 tsp
of boiled, prepared tea.
Essential oil. Preparations of essential oil of anise
can be used for inhalation. The essential oil may be
taken orally at a dose of 0.01 oz (0.3 g) per day. In addi-
tion, the liqueur anisette, which contains anise essential
oil, may be administered in hot water to help relieve
problems in the bronchial tubes, such as bronchitis and
spasmodic asthma. One to three drops of essential oil ad-
ministered on sugar may help relieve colic.
Precautions
Persons allergic to anise or anethole, its main ingre-
dient, should avoid using aniseed or its essential oil. It is
also possible to develop an allergic sensitivity to anise.
Care should be taken to monitor the quantity of aniseed
oil given to infants. A 2002 report noted an infant
brought to the emergency department with seizures as a
result of multiple doses of aniseed oil tea.
Side effects
Although anise is generally considered safe, the side
effects of its estrogenic property have not been fully
studied. Anise oil may induce nausea, vomiting,
seizures, and pulmonary edema if it is ingested in suffi-
cient quantities. Also, contact of the skin with the con-
centrated oil can cause irritation.
It is important to note that Japanese Star Anise is not
the same herb — it is poisonous.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Anemia — Condition in which the blood is defi-
cient in red blood cells, in hemoglobin, or in total
volume.
Antiseptic — A substance that checks the growth or
action of microorganisms especially in or on liv-
ing tissue.
Antispasmodic — A substance capable of preven-
tion or relieving spasms or convulsions.
Carminative — A substance that expels gas from
the alimentary canal to relieve colic or griping.
Catarrh — Inflammation of a mucous membrane,
especially of the nose and air passages.
Diaphoretic — A substance that increases perspira-
tion.
Diuretic — A substance that increases the flow of
urine.
Estrogenic — A substance that promotes estrus, the
state in which a woman is capable of conceiving.
Expectorant — A substance that promotes the dis-
charge or expulsion of mucus.
Parasiticide — A substance destructive to parasites.
Stomachic — A stimulant or tonic for the stomach.
Interactions
No interactions have been reported.
Resources
BOOKS
Foster, Gertrude B. and Rosemary F. Louden. Park’s Success
with Herbs. Greenwood, S. C.: G. W. Park Seed Co., 1980.
Grieve, M. A Modern Herbal: The Medicinal, Culinary, Cos-
metic and Economic Properties, Cultivation and Folk-lore
of Herbs, Grasses, Fungi, Shrubs, & Trees with All Their
Modern Scientific Uses. New York: Harcourt, Brace and
Co., 1931.
Reader’s Digest Editors. Magic and Medicine of Plants. Pleas-
antville, N.Y.: Reader’s Digest Association, 1986.
Simon, James E., Alena F. Chadwick and Lyle E. Craker.
Herbs: An Indexed Bibliography, 1971-1980: The Scien-
tific Literature on Selected Herbs, and Aromatic and Med-
icinal Plants of the Temperate Zone. Hamden, Conn.: Ar-
chon Books, 1984.
PERIODICALS
Tuckler, V., et al. “Seizure in an Infant from Aniseed Oil Toxic-
ity.” Clinical Toxicology (August 2002): 689.
91
Anise
Ankylosing spondylitis
OTHER
Herb Society of America, http://www.herbsociety.org/anise.htm/
(July 12, 2000).
“Herbs." Department of Horticulture, Pennsylvania State Uni-
versity. http://garden.cas.psu.edu/vegcrops/herbs/Pimpinel
laanisum.html/ (July 12, 2000).
One Planet, http://www.oneplanetnatural.com/anise.htm/ (July
12, 2000).
“Pimpinella anisurn.” http://webmd.lycos.com/content/article/
1677.57580/ (July 12,2000).
Melissa C. McDade
Teresa G. Odle
Ankylosing spondylitis
Definition
Ankylosing spondylitis (AS) is a systemic disorder that
refers to inflammation of the joints in the spine. AS is the
primary disease in an entire group of conditions known as
seronegative spondylarthropathies. It is also known as
rheumatoid spondylitis or Marie-Striimpell disease (among
other names). AS is an autoimmune disease, as are most
forms of arthritis. By definition, other joints, in addition to
the spine, can also be affected, including the shoulders,
hips, knees, and feet. Tissues in the eye can also be affected.
Description
A form of arthritis, AS is characterized by chronic
inflammation, causing pain and stiffness of the back,
progressing to the chest and neck. Eventually, the whole
back may become curved and inflexible if the bones
fuse, which is known as “bamboo spine.” Other condi-
tions associated with AS include reactive arthritis, psori-
atic arthritis, spondylitis of inflammatory bowel dis-
ease, and undifferentiated spondy arthropathy. AS may
involve multiple organs, such as the:
• eye (causing an inflammation of the iris, or iritis)
• heart (causing aortic valve disease)
• lungs
• skin (causing a scaly skin condition, or psoriasis)
• gastrointestinal tract (causing inflammation within the
small intestine, called ileitis, or inflammation of the
large intestine, called colitis).
Less than 1% of the population has AS; however,
20% of AS sufferers have a relative with the disorder.
Causes & symptoms
Genetics, in the form of a gene named HLA-B27,
can play an important role in the disease, but the precise
92
cause of AS remains unknown. According to information
from the Spondylitis Association of America, HLA-B27
is a perfectly normal gene found in 8% of the general
population. Generally speaking, no more than 2% of
people born with this gene will eventually get spondyli-
tis. The gene itself does not cause spondylitis, but people
with HLA-B27 are more susceptible to getting spondyli-
tis. To date, 15 subtypes of HLA-B27 have been identi-
fied. The most common subtypes in the United States
being B27.05, and then after that B27.02. The way in
which HLA-B27 interacts with some other proteins
seems to be very important to the cause of AS, but fur-
ther research must be conducted to find out exactly how.
According to information published in 1997 from The
Arthritis Cure, by Dr. Jason Theodosakis, M.D., M.S.,
M. P. H., and others, research was being conducted re-
garding the possibility that a certain type of infection
could be the trigger for the onset of AS.
Symptoms of AS include:
• low back and hip pain and stiffness
• duration of symptoms longer than three months
• difficulty expanding the chest
• early morning stiffness improved by a warm shower or
light exercise
• pain in the neck, shoulders, knees, and ankles
• low-grade fever
• fatigue
• weight loss
AS occurs most often in males between 16 and 35
years of age. Initial symptoms are uncommon after the
age of 30, although the diagnosis may not be established
until after that age. The incidence of AS in African
Americans is about 25% of incidence among Cau-
casians, but is rarely seen in that population.
Some naturopathic healers link the cause of AS to
its autoimmune origins in food allergies and abnormal
bowel function, sometimes referred to as “leaky gut”
syndrome. According to this theory, food allergies com-
bine with the leaky gut and, according to the Healing-
WithNutrition website, from a 1986 article in the Britain
Journal of Rheumatology, “..result in the increased circu-
lation of gut-derived antigens into other areas of the
body. The body produces antibody-antigen complexes
(immune complexes) characteristic of RA (rheumatoid
arthritis) to battle these gut-derived foreign antigens;
but these antibody-antigens are thought to also cross-
react with antigens in the joint tissues. In other words,
the antibodies formed to attack the (leaky gut) microbes
also cross-react and attack joint collagen.”
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Diagnosis
Doctors usually diagnose the disease simply by the
patient’s report of pain and stiffness. Doctors also review
spinal and pelvic x rays since involvement of the hip and
pelvic joints is common and may be the first abnormality
seen on the x ray. The doctor might also order a blood
test to determine the presence of HLA-B27 antigen if
the x rays have not clearly determined the diagnosis. If
the gene is present, it could facilitate the accuracy of the
possible AS diagnosis. When a diagnosis is made, pa-
tients may be referred to a rheumatologist, a doctor who
specializes in treating arthritis. Patients may also be re-
ferred to an orthopedic surgeon, a doctor who can surgi-
cally correct joint or bone disorders.
Treatment
To reduce inflammation, various herbal remedies,
including white willow ( Salix alba), yarrow ( Achillea
millefolium), and lobelia ( Lobelia Inflata), may be help-
ful. Acupuncture, performed by a trained professional,
has helped some patients manage their pain. Homeopath-
ic practitioners may prescribe such remedies as Bryonia
and Rhus toxicodendron for pain relief.
A key alternative treatment for AS is massage ther-
apy. Reported benefits include a decrease in pain, in-
crease in circulation, lymph flow improvement, and in-
crease in range of motion. The major benefit of this ther-
apy could be that it provides further motivation for a reg-
ular excerise program, considered the most beneficial of
all treatments for AS.
Diets of various regimens have been offered that in-
clude supplements of fatty acids and antioxidants, as
with other arthritis diets. Naturopaths and some medical
doctors have theorized that certain foods should be elim-
inated from the diet in order to alleviate symptoms. Pos-
sible problem foods include wheat, corn, milk and other
dairy products, beef, tomatoes, potatoes, and peppers.
Tobacco has also been thought to aggravate the condi-
tion. Various reports have surfaced in many books and
articles that indicate a diet high in fiber and fresh fruits
and vegetables — minus those listed above — and low in
sugar, meat, refined carbohydrates, and animal fats
might help in the treatment of the symptoms, particularly
with pain or swelling.
Allopathic treatment
Nonsteroidal anti-inflammatory drugs (NSAIDs),
like naproxen (Naprosyn) or indomethacin (Indocin) are
used to relieve pain and stiffness. In severe cases, sul-
fasalazine (Azulfidine), another drug to reduce inflam-
mation, or methotrexate (Rheumatrex), an immune-sup-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
pressing drug, are recommended. In cases where chronic
therapy is needed, potential drug side effects must be
taken into consideration. Corticosteroid drugs are effec-
tive in relieving symptoms, but are usually reserved for
severe cases that do not improve when NSAIDs are used.
To avoid potential side effects, treatment with corticos-
teroids is usually limited to a short amount of time with a
gradual weaning from the drug.
In April 2002, a study published revealed that a drug
already approved for patients with rheumatoid arthritis
was successful in helping most AS patients as well. In-
fliximab helped alleviate pain and improved functioning
in more than 80 % of patients in a clinical trial. The drug
worked rapidly and reduced disease activity by more
than half in about 50% of patients. Some serious side ef-
fects did occur, so researchers continued to test the drug
and seek Food and Drug Administration (FDA) approval
for Infliximab for AS patients. In the same year, scien-
tists were testing another drug called Etanercept that also
showed promising results in preliminary trials.
Physical therapists prescribe exercises to prevent a
stooped posture and breathing problems when the spine
starts to fuse and ribs are affected. Back braces may be
used to prevent continued deformity of the spine and
ribs. Only in severe cases of deformity is surgery per-
formed to straighten and realign the spine, or to replace
knee, shoulder, or hip joints. Because it is a major and
complicated procedure, with a potential for complica-
tions, this surgery is recommended cautiously even in se-
vere cases.
Expected results
There is no cure for AS, and the course of the dis-
ease is unpredictable. Generally, AS progresses for about
10 years, then levels off. Most patients can lead normal
lives with treatment to control symptoms. Claims that
homeopathic remedies have cured them have not been
verified.
Prevention
There is no known way to prevent AS. With twenty-
first century advances in gene therapy, the possibility ex-
ists for further determination of the factor that HLA-B27
gene plays in its manifestation, and what role it could
play in preventing it for future generations.
Resources
BOOKS
Brewer Jr., Earl J., and Kathy Cochran Angel. The Arthritis
Sourcebook. Los Angeles: Lowell House, 1993.
Swezey, Robert L. Straight Talk on Spondylitis. Spondylitis As-
sociation of America, 1994.
93
Ankylosing spondylitis
Anorexia nervosa
KEY TERMS
Ankylosing — When bones of a joint are fused,
stiff, or rigid.
HLA-B27 — An antigen or protein marker on cells
that may indicate ankylosing spondylitis.
Immune suppressing — Anything that reduces the
activity of the immune system.
Inflammation — A reaction of tissues to disease or
injury, often associated with pain and swelling.
Spondylitis — An inflammation of the spine.
Taurog, Joel D., and Peter E. Lipsky. "Ankylosing Spondylitis,
Reactive Arthritis, and Undifferentiated Spondy-
loarthropathy.” In Harrison's Principles of Internal Medi-
cine, edited by Anthony S. Fauci, et al. New York: Mc-
Graw-Hill, 1998.
PERIODICALS
Babayev, Marietta and Leonard Bleicher. “Low Back Pain in an
Elderly Man.” The Journal of Musculoskeletal Medicine
(April 2000).
Breban, M., B. Gombert, et al. “Thalidomide: A New Use in
Ankylosing Spondylitis?” Rheumatoid Arthritis Research
News (April 1999).
“Etanercept for ‘Rapid Improvement’ in Joint Disease.”
Chemist & Druggist (May 18, 2002): 24.
Feldtkeller, et al. “Impact of Sex on Inheritance of Ankylosing
Spondylitis.” The Lancet (March 25, 2000).
“Infliximab Highly Effective Therapy.” Immunotherapy Weekly
(May 8, 2002): 3.
Nuki, George. “Ankylosing Spondylitis, HLA B27, and Be-
yond.” The Lancet (14 March 1998). Available from http://
web2 . inf otrac . galegroup .com .
Sussman, Sharon. “Now He’s Blind.” Discover (June 1999).
Yacyshyn, Elaine A. and Marc D. Cohen. “Ankylosing
Spondylitis: Early Detection and Management.” The Jour-
nal of Musculoskeletal Medicine (December 1999).
ORGANIZATION
Arthritis Foundation. 1330 West Peachtree St., Atlanta, GA
30309. (404) 872-7100. http://www.arthritis.org.
National Institute of Arthritis and Musculoskeletal and Skin
Diseases Information Clearinghouse. 1 AMS Circle,
Bethesda, MD 29892-3675. (301) 495-4484.
Spondylitis Association of America. PO Box 5872, Sherman
Oaks, CA 91413. (800) 777-8189.
OTHER
Harris, Brian. The Ankylosing Spondylitis Site. http://www.
asweb.com/ (2000).
Healing WithNutrition. http://www.HealingWithNutrition.com/
(2000).
94
Matsen III, Frederick, ed. “Ankylosing Spondylitis.” http://
www.orthop.washington.edu/bonejoint/azzzzzzzl_l.html/
(December 2000).
Penn State University, Department of Orthopaedics and Reha-
bilitation, M. S. Hershey Medical Center. Adult Spin
Surgery Service, http://www.psu.edu/ortho/ (December
2000).
The Spondylitis Association of America. http://www.spondy
litis.org/ (December 2000).
Jane Spear
Teresa G. Odle
Anorexia nervosa
Definition
Anorexia nervosa is an eating disorder characterized
by unrealistic fear of weight gain, self-starvation, and
conspicuous distortion of body image. The name comes
from two Latin words that mean “nervous inability to
eat.” In females who have begun to menstruate, anorexia
nervosa is usually marked by amenorrhea, or skipping at
least three menstrual periods in a row. The fourth edition
of the Diagnostic and Statistical Manual of Mental Dis-
orders, or DSM-IV (1994), defines two subtypes of
anorexia nervosa — a restricting type, characterized by
strict dieting and exercise without binge eating — and a
binge-eating/purging type, marked by episodes of com-
pulsive eating with or without self-induced vomiting and
the use of laxatives or enemas. DSM-IV defines a binge
as a time-limited (usually under two hours) episode of
compulsive eating in which the individual consumes a
significantly larger amount of food than most people
would eat in similar circumstances.
Description
Anorexia nervosa was not officially classified as a
psychiatric disorder until the third edition of DSM in
1980. It is, however, a growing problem among adoles-
cent females and its incidence in the United States has
doubled since 1970. The rise in the number of reported
cases reflects a genuine increase in the number of per-
sons affected by the disorder, not simply earlier or more
accurate diagnosis. Estimates of the incidence of anorex-
ia range between 0.5-1% of Caucasian female adoles-
cents. Over 90% of patients diagnosed with the disorder
as of 1998 were female. It was originally thought that
only 5% of anorexics are male, but that estimate is being
revised upward. The peak age range for onset of the dis-
order is 14-18 years, although there are patients who de-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
velop anorexia as late as their 40s. In the 1970s and
1980s, anorexia was regarded as a disorder of upper- and
middle-class women, but that generalization is also
changing. More recent studies indicate that anorexia is
increasingly common among women of all races and so-
cial classes in the United States.
Anorexia nervosa is a serious public health problem
not only because of its rising incidence, but also because
it has one of the highest mortality rates of any psychi-
atric disorder. Moreover, the disorder may cause serious
long-term health complications, including congestive
heart failure, sudden death, growth retardation, dental
problems, constipation, stomach rupture, swelling of the
salivary glands, loss of kidney function, osteoporosis,
anemia and other abnormalities of the blood.
Causes & symptoms
Anorexia is a disorder that results from the interac-
tion of cultural and interpersonal as well as biological
factors. While the precise cause of the disease is not
known, it has been linked to the following:
Social influences
The rising incidence of anorexia is thought to reflect
the present idealization of thinness as a badge of upper-
class status as well as of female beauty. In addition, the
increase in cases of anorexia includes “copycat” behav-
ior, with some patients developing the disorder from imi-
tating other girls.
The onset of anorexia in adolescence is attributed to
a developmental crisis caused by girls’ changing bodies
coupled with society’s overemphasis on women’s looks.
The increasing influence of the mass media in spreading
and reinforcing gender stereotypes has also been noted.
Occupational goals
The risk of developing anorexia is higher among
adolescents preparing for careers that require attention to
weight and/or appearance. These high-risk groups in-
clude dancers, fashion models, professional athletes (in-
cluding gymnasts, skaters, long-distance runners, and
jockeys), and actresses.
Genetic and biological influences
Women whose biological mothers or sisters have the
disorder appear to be at increased risk.
Psychological factors
A number of theories have been advanced to explain
the psychological aspects of the disorder. No single ex-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
The body of a woman with anorexia. (Photograph by Biopho-
to Associates/Science Source. Photo Researchers, Inc. Repro-
duced by permission.)
planation covers all cases. Anorexia nervosa has been in-
terpreted as:
• A rejection of female sexual maturity. This rejection is
variously interpreted as a desire to remain a child, or as
a desire to resemble men as closely as possible.
• A reaction to sexual abuse or assault.
• A desire to appear as fragile and non-threatening as
possible. This hypothesis reflects the idea that female
passivity and weakness are attractive to men.
• Overemphasis on control, autonomy, and independence.
Some anorexics come from achievement-oriented fami-
lies that stress physical fitness and dieting. Many
anorexics are perfectionists and “driven” about school-
work and other matters in addition to weight control.
• Evidence of family dysfunction. In some families, a
daughter’s eating disorder serves as a distraction from
marital discord or other family tensions.
95
Anorexia nervosa
Anorexia nervosa
• Inability to interpret the body’s hunger signals accurate-
ly due to early experiences of inappropriate feeding.
Male anorexics
Although anorexia nervosa is still considered a dis-
order that largely affects women, its incidence in the
male population is rising. Less is known about the caus-
es of anorexia in males, but some risk factors are the
same as for females. These include certain occupational
goals and increasing media emphasis on external appear-
ance in men. Moreover, homosexual males are under
pressure to conform to an ideal body weight that is about
20 pounds lighter than the standard “attractive” weight
for heterosexual males.
Diagnosis
Diagnosis of anorexia nervosa is complicated by a
number of factors. One is that the disorder varies some-
what in severity from patient to patient. A second factor
is denial, which is regarded as an early sign of the disor-
der. Most anorexics deny that they are ill and are usually
brought to treatment by a family member.
Anorexia is usually diagnosed by pediatricians or
family practitioners. Anorexics develop emaciated bod-
ies, dry or yellowish skin, and abnormally low blood
pressure. There is usually a history of amenorrhea (failure
to menstruate) in females, and sometimes of abdominal
pain, constipation, or lack of energy. The patient may
feel chilly or have developed lanugo, a growth of downy
body hair. If the patient has been vomiting, she may have
eroded tooth enamel or Russell’s sign (scars on the back
of the hand). The second step in diagnosis is measure-
ment of the patient’s weight loss. DSM-IV specifies a
weight loss leading to a body weight 15% below normal,
with some allowance for body build and weight history.
The doctor will rule out other physical conditions
that can cause weight loss or vomiting after eating, in-
cluding metabolic disorders, brain tumors (especially hy-
pothalamus and pituitary gland lesions), diseases of the
digestive tract, and a condition called superior mesen-
teric artery syndrome. Persons with this condition some-
times vomit after meals because the blood supply to the
intestine is blocked. The doctor will usually order blood
tests, an electrocardiogram, urinalysis, and bone densito-
metry (bone density test) in order to exclude other dis-
eases and to assess the patient's nutritional status.
The doctor will also need to distinguish between
anorexia and other psychiatric disorders, including de-
pression, schizophrenia, social phobia, obsessive-com-
pulsive disorder, and body dysmorphic disorder. Two di-
agnostic tests that are often used are the Eating Attitudes
Test (EAT) and the Eating Disorder Inventory (EDI).
96
Treatment
Alternative treatments should serve as complemen-
tary to a conventional treatment program. Alternative
therapies for anorexia nervosa include diet and
nutrition, herbal therapy, hydrotherapy, aromathera-
py, Ayurveda, and mind/body medicine.
Nutritional therapy
A naturopath or nutritionist may recommend the fol-
lowing:
• avoiding sweets or baked goods
• following a nutritious and well-balanced diet (when pa-
tients resume eating normally)
• gaily multivitamin and mineral supplements
• zinc supplements. (Zinc is an important mineral needed
by the body for normal hormonal activity and enzymat-
ic function)
Herbal therapy
The following herbs may help reduce anxiety and
depression which are often associated with this disorder:
• chamomile ( Matricaria recutita)
• lemon balm (Melissa officinalis )
• linden (Tilia spp.) flowers
Aromatherapy
Essential oils of herbs such as bergamot, basil,
chamomile, clary sage and lavender may help stimulate ap-
petite, relax the body and fight depression. They can be dif-
fused into the air, inhaled, massaged or put in bath water.
Relaxation techniques
Relaxation techniques such as yoga, meditation
and t’ai chi can relax the body and release stress, anxiety
and depression.
Hypnotherapy
Hypnotherapy may help resolve unconscious is-
sues that contribute to anorexic behavior.
Other alternative treatments
Other alternative treatments that may be helpful in-
clude hydrotherapy, magnetic field therapy, acupuncture,
biofeedback, Ayurveda and Chinese herbal medicine.
Allopathic treatment
Treatment of anorexia nervosa includes both short-
term and long-term measures, and requires assessment
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
by dietitians and psychiatrists as well as medical special-
ists. Therapy is often complicated by the patient’s resis-
tance or failure to carry out treatment plan.
Hospital treatment
Hospitalization is recommended for anorexics with
any of the following characteristics:
• weight of 40% or more below normal, or weight loss
over a three-month period of more than 30 pounds
• severely disturbed metabolism
• severe binging and purging
• signs of psychosis
• severe depression or risk of suicide
• family in crisis
Hospital treatment includes individual and group
therapy as well as refeeding and monitoring of the pa-
tient's physical condition. Treatment usually requires
two to four months in the hospital. In extreme cases, hos-
pitalized patients may be force-fed through a tube insert-
ed in the nose (nasogastric tube) or by over-feeding (hy-
peralimentation techniques).
Outpatient treatment
Anorexics who are not severely malnourished can be
treated by outpatient psychotherapy. The types of treat-
ment recommended are supportive rather than insight-ori-
ented, and include behavioral approaches as well as indi-
vidual or group therapy. Family therapy is often recom-
mended when the patient’s eating disorder is closely tied
to family dysfunction. Self-help groups are often useful
in helping anorexics find social support and encourage-
ment. Psychotherapy with anorexics is a slow and diffi-
cult process; about 50% of patients continue to have seri-
ous psychiatric problems after their weight has stabilized.
Medications
Anorexics have been treated with a variety of med-
ications, including antidepressants, anti-anxiety drugs,
selective serotonin reuptake inhibitors, and lithium car-
bonate. The effectiveness of medications in treatment
regimens is still debated. However, at least one study of
Prozac showed it helped the patient maintain weight
gained while in the hospital.
Expected results
Figures for long-term recovery vary from study to
study, but the most reliable estimates are that 40-60% of
anorexics will make a good physical and social recovery,
and 75% will gain weight. The long-term mortality rate
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Amenorrhea — Absence of menstruation in a fe-
male who has begun to have menstrual periods.
Binge eating — A pattern of eating marked by
episodes of rapid consumption of large amounts
of food, usually food that is high in calories.
Body dysmorphic disorder — A psychiatric disor-
der marked by preoccupation with an imagined
physical defect.
Hyperalimentation — A method of refeeding
anorexics by infusing liquid nutrients and elec-
trolytes directly into central veins through a
catheter.
Lanugo — A soft, downy body hair that develops
on the chest and arms of anorexic women.
Purging — The use of vomiting, diuretics, or laxa-
tives to clear the stomach and intestines after a
binge.
Russell's sign — Scraped or raw areas on the pa-
tient's knuckles, caused by self-induced vomiting.
Superior mesenteric artery syndrome — A condi-
tion in which a person vomits after meals due to
blockage of the blood supply to the intestine.
for anorexia is estimated at around 10%, although some
studies give a lower figure of 3-4%. The most frequent
causes of death associated with anorexia are starvation,
electrolyte imbalance, heart failure, and suicide.
Prevention
Short of major long-term changes in the larger soci-
ety, the best strategy for prevention of anorexia is the
cultivation of healthy attitudes toward food, weight con-
trol, and beauty (or body image) within families.
Resources
BOOKS
"Anorexia Nervosa.” In Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition. Washington, DC: The
American Psychiatric Association, 1994.
Baron, Robert B. “Nutrition.” In Current Medical Diagnosis &
Treatment edited by Lawrence M. Tierney, Jr., et al. Stam-
ford, CT: Appleton & Lange, 1998.
The Burton Goldberg Group. Alternative Medicine: The Defin-
itive Guide. Fife, WA: Future Medicine Publishing, 1995.
Cassell, Dana K., with Felix E. F. Larocca. The Encyclopedia
of Obesity and Eating Disorders. New York: Facts on File,
Inc., 1994.
97
Anorexia nervosa
Anthroposophical medicine
Herzog, David B. “Eating Disorders.” In The New Harvard
Guide to Psychiatry. Edited by Armand M. Nicholi, Jr.,
Cambridge, MA, and London, UK: The Belknap Press of
Harvard University Press, 1988.
Kaplan, David W., and Kathleen A. Mammel. “Adolescence.”
In Current Pediatric Diagnosis & Treatment. Edited by
William W. Hay, Jr., et al. Stamford, CT: Appleton &
Lange, 1997.
Mitchell, James E. “Anorexia Nervosa: Medical and Physiolog-
ical Aspects.” In Handbook of Eating Disorders. Edited
by Kelly D. Brownell and John P. Foreyt. New York: Basic
Books, Inc., 1986.
The Medical Advisor: The Complete Guide to Alternative &
Conventional Treatments. Richmond, VA: TimeLife Edu-
cation, 1997.
“Physical Conditions in Adolescence: Anorexia Nervosa.” In
The Merck Manual of Diagnosis and Therapy, vol. II.
Edited by Robert Berkow, et al. Rahway, NJ: Merck Re-
search Laboratories, 1992.
Pipher, Mary. Reviving Ophelia: Saving the Selves of Adoles-
cent Girls. New York: Ballantine Books, 1994.
ORGANIZATIONS
American Anorexia/Bulimia Association. 418 East 76th St.,
New York, NY 10021. (212) 734-1114.
National Institute of Mental Health Eating Disorders Program,
Building 10, Room 3S231. 9000 Rockville Pike, Bethes-
da, MD 20892. (301) 496-1891.
OTHER
Eating Disorders Home Page, <http://ccwf.cc. utexas.edu:80/
jackson/UTHealth/eating.html.>
Mai Tran
Anthroposophical medicine
Definition
Anthroposophical medicine (AM), or anthroposophi-
cally extended medicine, is a system of healing based on
the spiritual science that was developed by Rudolph Steiner.
Origins
Rudolph Steiner (1861-1925) was a philosopher and
teacher who founded anthroposophy ( anthropos meaning
human and sophy meaning wisdom), which is a worldwide
spiritual movement that seeks to apply a scientific ap-
proach to spiritual perception. Steiner, from Austria, be-
lieved that everyone has spiritual powers that can be acti-
vated by exercises in mental concentration and
meditation. During his lifetime, he was an active teacher,
attracting many followers to his spiritual ideas. Steiner
98
founded several schools, wrote nearly 30 books, and gave
more than 6,000 lectures around the world on subjects in-
cluding education, medicine, agriculture, social issues, sci-
ence and art. His ideas have remained influential. The Wal-
dorf school system, which he began, educates thousands of
young people each year. Many health food stores carry
products produced by Steiner’s system of agriculture called
biodynamic farming, which considers the health and purity
of the soil, water, and air to be of central importance.
Anthroposophical medicine is based on Steiner’s
concept that spiritual awareness is the foundation of in-
dividual health and of the health of society. Steiner be-
lieved that many of the oldest systems of healing, such as
traditional Chinese medicine. Ayurvedic medicine,
and Tibetan medicine, were based on a spiritual percep-
tion of the world that modern science has lost. Steiner
wanted medicine to get back in touch with spirituality,
and at the same time keep and use wisely the gains that
science and technology have made. Thus, conventional
medicine needed to be extended beyond physical science
to include a holistic spiritual science.
Steiner formally began application of his philosophy
in a series of 20 lectures in the early spring of 1920 to
the medical community of a town in Switzerland. It was
the first such course for physicians and medical students.
He and Dutch medical doctor Ita Wegman co-authored a
foundational work for physicians wanting to expand
their practice according to anthroposophic principles.
Anthroposophical medicine is still in its early stages.
Steiner believed that it would take many years for his med-
ical ideas to be fully applied. There are thousands of anthro-
posophical doctors and researchers practicing in Europe,
where the main school was founded. In America, practition-
ers can be found in several large cities, but the overall num-
ber of anthroposophical physicians is very small.
Benefits
Anthroposophical medicine can be used to treat any
health condition. It is particularly recommended for pre-
ventive care, infections, inflammatory conditions such
as arthritis, and the treatment of cancer and chronic de-
generative diseases associated with aging. It is also rec-
ommended for pediatric (child) care, with its avoidance
of toxic drugs, and is beneficial for children’s conditions
such as attention-deficit hyperactivity disorder
(ADHD) and developmental problems.
Description
The anthroposophical concept of the body
Anthroposophical physicians have a different view
of the body and health than the conventional scientific
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
model. Human beings are made up of four levels (“four-
foldness”) of being. The first level is the physical body.
The second level is the life or etheric body, which corre-
sponds to the Chinese idea of chi and the Ayurvedic idea
of prana. The third level is the soul, or astral body, and
the fourth level is the spirit. AM doctors believe that all
levels of being influence a patient’s health.
The physical body is made up of a three-fold sys-
tem, including the “sense-nerve” system that comprises
the head and nervous system, supporting the mind and
the thinking process. Second is the “metabolic-limb”
system that includes the digestive system for elimina-
tion, energetic metabolism, and voluntary movement
processes, all supporting aspects of human behavior that
express the will. Finally, the rhythmic system that in-
cludes the heart and lungs in the chest, is responsible for
balancing the head and digestive systems. According to
AM, these systems tend to oppose each other in func-
tioning and characteristics, similar to the Chinese con-
cept of yin and yang. For instance, the digestive system
is associated with heat and helps to dissolve elements in
the body, while the head system is associated with cool-
ing and helps in the formation of elements in the body.
Illness is caused when the systems of the body become
out of balance. AM involves a broad understanding of
the three bodily systems, and the illnesses associated
with each system and its imbalance. This model provides
practitioners a means for therapeutic insight now recog-
nized as mind-body relationships in health and disease.
In anthroposophical medicine, illness is considered a
significant event in a person’s life, and not just a chance
occurrence. One role of the doctor is to understand, and
help the patient understand, the significance of the illness
on all levels of being. Conventional medicine tends to
suppress illness, using drugs to block the symptoms. AM
doctors believe that true healing must first bring an illness
out in order to heal it, and that healing requires change
and development in the patient on several levels.
AM also asserts, as did the early healer Paracelsus,
that every illness has a cure that can be found in nature.
Paracelsus is the pseudonym for a Swiss-born alchemist
and physician who lived from 1493-1541. Nature and
the human body are made up of the plant, animal, and
mineral kingdoms, and thus AM doctors use medicines
that are made from plants, animals (usually in the form
of organ extracts), and minerals. AM remedies are usual-
ly given in homeopathic doses, which are very diluted,
non-toxic solutions.
Treatment by an anthroposophical physician
All anthroposophical physicians are conventionally
trained M.D.s, as Steiner believed that conventional train-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
ing was a necessary first step. However, a visit to an an-
throposophical physician may be different than a visit to a
regular doctor. Anthroposophical doctors, first of all, tend
to spend much more time with their patients, particularly
during the initial visit. Every patient is considered unique,
and AM doctors use the first visit to get a broad under-
standing of patients and their medical histories. To diag-
nose illnesses, AM doctors may use modern diagnostic
tools, but also rely on intuition and an understanding of the
patient. Part of training of AM doctors involves improving
their powers of perception in order to understand illnesses.
Diagnosis is considered a very important process; Steiner
believed that if the diagnosis of a problem is done correct-
ly, then the therapeutic (healing) work is much easier. After
a problem is thoroughly diagnosed, treatment will be rec-
ommended. AM doctors attempt to treat a patient on all
four levels of being. For the physical body, remedies will
be prescribed. There are hundreds of uniquely formulated
medications, similar to homeopathies, as well as botanical
medicines. AM doctors try to minimize the use of antibi-
otics, drugs, and vaccinations.
Anthroposophical medicine also uses allied thera-
pies, which are additional therapies that Steiner recom-
mended to heal patients on other levels than the physical.
These include massage therapy and a movement thera-
py called eurythmy. Eurythmy is a system of movements
designed to help patients give expression to inner spiritu-
al movements. Psychotherapy may also be recommend-
ed to help heal some conditions. AM doctors may apply
allied therapies themselves, or refer patients to other
healers. The length of treatment with AM depends on the
patient and condition. The cost of treatment varies with
the practitioner, and is comparable to treatment by con-
ventional M.D.s. AM medications are less expensive
than conventional drugs. Because AM practitioners are
trained medical doctors, insurance policies often cover
their fees, although consumers should be aware of their
policy restrictions.
Preparations
AM doctors may give new patients packages of ma-
terials before treatment, which include thorough ques-
tionnaires and explanations of AM. Anthroposophical
physicians encourage patients to prepare for treatment
by becoming willing to take responsibility for their con-
dition and health, and to change their behaviors and
lifestyles in the interest of healing.
Side effects
AM medications are safe and non-toxic. During
treatment, some patients may experience what doctors
call “healing crises.” During these, patients may tem-
99
Anthroposophical medicine
Antioxidants
KEY TERMS
Ayurvedic medicine — System of healing originat-
ing in ancient India.
Chi — Universal life energy as defined by tradition-
al Chinese medicine. Also known as qi.
Homeopathy — System of healing using minute, di-
luted doses of remedies that would otherwise pro-
duce symptoms of the treated disease. Prepared
from plant, animal, mineral and human sources,
they are tailored for individualized treatment.
Yin and yang — Two opposite and complimentary
characteristics used to describe the universe and
phenomena, defined by traditional Chinese medi-
cine.
porarily experience a worsening of symptoms as part of
the healing process, including fever, headaches, nausea,
weakness, muscle soreness, and other symptoms.
Research & general acceptance
Active research in AM is being regularly conducted
in Europe, mainly in Germany, Holland, Switzerland, and
France. Several research organizations performing patient-
centered research have shown promising results with the
AM cure for cancer, which utilizes the herbal remedy
mistletoe extract, and for other conditions. Other research
has shown that AM is less expensive than conventional
medical treatment, with 50% fewer illness days than when
treated by conventional practitioners. Current research
studies appear in the quarterly Journal of Anthroposophi-
cal Medicine , as well as in European publications.
Training & certification
Currently, there is no course for the certification of
AM practitioners, although every AM doctor is required
to obtain training as a certified M.D. Afterwards, physi-
cians may specialize in AM by taking a series of courses
or by interning with specialists. The Physicians Associa-
tion for Anthroposophic Medicine (PAAM) is the largest
association in North America. The organization for non-
M.D. health professionals interested in anthroposophical
medicine is Artemesia, The Association for Anthropo-
sophical Renewal of Healing.
Resources
BOOKS
Bott, Victor. Anthroposophical Medicine. Hudson, New York:
Anthroposophic Press, 1985.
100
Steiner, Rudolph. Introducing Anthroposophic Medicine. Hud-
son, New York: Anthroposophical Press, 1998.
ORGANIZATIONS
Anthroposophic Press. RR 4 Box 94 A-l. Hudson, NY 518-
851-2054.
Artemesia, The Association for Anthroposophical Renewal of
Healing. 1923 Geddes Avenue, Ann Arbor, MI 48104,
(734) 930-9462.
Gilpen Street Holistic Center. Dr. Philip Incao, M.D., 1624
Gilpen Street, Denver, CO 80218, (303) 321-2100.
Physicians Association for Anthroposophic Medicine (PAAM).
1923 Geddes Avenue. Ann Arbor, MI 48104, (734) 930-
9462.
Douglas Dupler
Antioxidants
Description
Antioxidants are a broad group of compounds that
destroy single oxygen molecules, also called free radi-
cals, in the body, thereby protecting against oxidative
damage to cells. They are essential to good health and
are found naturally in a wide variety of foods and plants,
including many fruits and vegetables. Many antioxi-
dants, either singly or in combination, are also available
as over-the-counter nutritional supplements in tablet or
capsule form. The most commonly used antioxidants are
vitamin C, vitamin E, and beta carotene. Others in-
clude grape seed extract, vitamin A, selenium, and
coenzyme Q 10 . It is unknown whether or not supplemen-
tal antioxidants provide the same benefits as those occur-
ring naturally in foods, however.
General use
In brief, antioxidants destroy free radicals in the
body. Free radicals are byproducts of oxygen metabo-
lism that can damage cells and are among the causes of
many degenerative diseases, especially diseases associat-
ed with aging. They are also associated with the aging
process itself. As a person ages, cell damage accumu-
lates, and supplementing the diet with extra antioxidant-
rich foods can help slow the oxidative damage done to
cells. Scientific studies validate the role of antioxidants
in preventing many diseases. Although studies have
shown lower rates of cancer and heart disease in people
who eat a recommended amount of fruits and vegetables,
recent clinical studies have shown that supplementation
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
of diet with antioxidant vitamin therapy does not lower
risk of cardiovascular disease or certain other diseases.
Many herbs and medicinal plants are good natural
sources of antioxidants. These include carrots, tomatoes,
yams, leafy greens, blueberries, billberries, ginkgo bilo-
ba, garlic, and green tea, to name a few. A diet rich in
vitamin C, vitamin E, and beta carotene may help reduce
the risk of some cancers, heart disease, cataracts, and
strokes.
Vitamin A
A study by the University of Arizona found that vita-
min A has a protective affect against many types of cancer,
according to Dr. Michael Colgan in his book, The New
Nutrition. Vitamin A is a fat-soluble antioxidant found in
animal products but can be made by the body from its pre-
cursor, beta carotene. Foods rich in vitamin A are liver,
eggs, and fortified dairy products. Vitamin A helps bones
and teeth develop, and promotes vision. As an antioxidant,
it protects cell membranes and fatty tissue, helps repair
damage caused by air pollutants, and boosts the immune
system. A deficiency of this vitamin can result in dry skin,
brittle hair, vision problems, blindness, and increased sus-
ceptibility to respiratory infections.
Vitamin C
Probably the most widely used of all vitamin supple-
ments, vitamin C is a powerful antioxidant that has a myr-
iad of functions and helps strengthen the immune system.
It became famous in the 1970s when Nobel Prize-winning
scientist Linus Pauling advocated daily mega doses (8-10
grams) of vitamin C to prevent and ease the symptoms of
the common cold. Many clinical studies that show vita-
min C is superior to over-the-counter medicines in reduc-
ing the symptoms, duration, and severity of colds. As an
antioxidant, vitamin C may help fight cardiovascular dis-
ease by protecting the linings of arteries from oxidative
damage. In 2002, debate still continued on the vitamin’s
effects on heart disease. One study revealed that Vitamins
C and E helped reduce arteriosclerosis (hardening of the
arteries) following heart transplants. Yet another study
demonstrated that vitamin therapy had not effect on pre-
venting heart disease. There is some evidence and re-
search that vitamin C can help prevent cancer. Studies
have shown it is also beneficial in protecting the body
against the effects of smoking and air pollutants.
Vitamin E
Vitamin E is a potent antioxidant by itself, but its ef-
fectiveness is magnified when taken with other antioxi-
dants, especially vitamin C, selenium, and beta carotene.
Some scientific evidence indicates that vitamin E helps
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
promote cardiovascular health. Past studies have demon-
strated higher vitamin E intake is associated with de-
creased incidence of heart disease in both men and women.
In fact, the combination of Vitamin C and E can slow pro-
gression of cardiovascular disease following heart trans-
plant. In 2002, researchers stated that the vitamin combina-
tion might also be useful in other organ transplants. In ad-
dition, Harvard Medical School reported in the same year
that Vitamin E might play a role in helping people live
longer, citing its role in strengthening the immune system.
Carotenoids
This class of antioxidants includes beta carotene,
lutein, and lycopene. They are found in a variety of
fruits and vegetables such as carrots, pumpkins, kale,
spinach, tomatoes, and pink grapefruit. Research evi-
dence suggests carotenoids lower the risk of heart dis-
ease and some types of cancer, and strengthen the im-
mune system. Lycopene, which is concentrated in the
prostate gland, is believed to protect the prostate from
cancer. Lutein is thought to prevent macular degenera-
tion, a major cause of blindness, or stop its progression.
Beta carotene increases the lungs’ defense system in
smokers or those exposed to other air-borne pollutants. It
also has been used as an immune system stimulator in
people with AIDS. In 2002, a report revealed that more
than 90% of ophthalmologists and optometrists surveyed
believe that lutein helps prevent eye disease.
Bioflavonoids
Bioflavonoids are a group of about 5,000 com-
pounds that act as antioxidants. They occur in fruits, veg-
etables, green tea, soy products, herbs, and spices. A
combination of bioflavonoids has a synergistic effect
when taken with vitamin C. They have been shown to be
beneficial in treating a variety of conditions, including
allergies, arthritis, diabetes, hypertension, and viral in-
fections. One group of bioflavonoids found to be a pow-
erful antioxidant is oligomeric proanthocyanidins
(OPCs), also known generically as pycnogenol. Ex-
tremely high concentrations of OPCs are found in mar-
itime pine bark ( Finns maritima) extract, grape seed ex-
tract, and grape and peanut skins. Due primarily to its
much lower cost, grape seed extract is the most com-
monly used OPC. Procyanidins, a group of compounds
found in the extract, are thought to increase the effective-
ness of other antioxidants, especially vitamin C and vita-
min E, by helping them regenerate after neutralizing free
radicals in the blood and tissue.
Other antioxidants
The other widely used antioxidants are selenium, coen-
zyme Q 10 , and certain amino acids. Selenium, especially
101
Antioxidants
Antioxidants
when teamed with vitamin E, may help protect against
lung, colon, prostate, and rectum cancers. The antioxidant
benefits of coenzyme Q 10 may include slowing the aging
process, boosting the immune system, and preventing ox-
idative damage to the brain. Some still suggest its use to
treat a variety of cardiovascular diseases. Amino acids that
have strong antioxidant effects include alpha lipoic acid,
cysteine, glutathione, and N-acetyl cysteine (NAC).
Preparations
Bottled antioxidant formulae are available in a single
pill or as part of a multivitamin. The usual dosages of an-
tioxidants taken individually can vary widely. The United
States Department of Agriculture (USDA) has established
recommended daily allowance, but these may be conserv-
ative amounts for preventing diseases. For instance, the
USDA recommendation for vitamin C is 60 mg a day but
natural healthcare practitioners commonly recommend
500 mg a day or more. The dosage may also depend on
whether it is being taken to treat or prevent a specific con-
dition. With that in mind, the common daily dosages for
specific antioxidants are: vitamin A, 5,000-15,000 IU;
beta carotene, 15,000-25,000 IU; vitamin C, 250-1,500
mg; vitamin E, 30-400 IU; selenium, 50-400 micrograms;
bioflavonoids, 100-500 mg; grape seed extract, 150-200
mg; coenzyme Q 10 , 90-150 mg; alpha lipoic acid, 20-50
mg or 300-600 mg for elevated blood sugar levels; glu-
tathione, 100 mg; N-acetyl cysteine, 600 mg.
Precautions
Vitamin C: May interfere with some laboratory tests,
including urinary sugar spilling for diabetics. Vitamin A:
Can be toxic in high doses of more than 15,000 IU per day
or chronic doses for months, and may cause birth defects if
taken in high doses during pregnancy. In 2002, one study
showed that consistent Vitamin A intake could increase the
risk of hip fractures in postmenopausal women, but the
study was not representative of all women, and more study
on the upper limits of safe Vitamin A consumption for
women in their 40s and 50s is needed. Vitamin E: Danger-
ous in very high doses. Carotenoids: No known precau-
tions are indicated for normal doses. Bioflavonoids: No
known precautions are indicated for normal doses. Seleni-
um: No precautions indicated at normal doses, but a physi-
cian should be consulted before taking daily doses of more
than 200 micrograms. Coenzyme Q 10 : No known precau-
tions are indicated for normal dosage. Amino acids: There
are no known precautions indicated for alpha lipoic acid,
cysteine, glutathione, or NAC.
Side effects
Vitamin C: Individual tolerances vary. High doses
may cause cramps, diarrhea, ulcer flare-ups, kidney
102
stones, and gout in some people. Vitamin A: High doses
can lead to headaches, nausea, hair loss, and skin le-
sions; may cause bone disease in people with chronic
kidney failure. Vitamin E: Usually no adverse side ef-
fects in doses of up to 400 mg a day, high doses may ele-
vate blood pressure and lead to blood-clotting problems.
Carotenoids: No known side effects occur with normal
dosage. Bioflavonoids: No known negative side effects
in normal doses. Selenium: No reported adverse side ef-
fects with normal dosage of 200 micrograms, higher
doses may cause dizziness and nausea. Coenzyme Q 10 :
No adverse side effects have been reported. Amino acids:
There are no known side effects associated with normal
doses of alpha lipoic acid, cysteine, glutathione, or NAC.
Interactions
Vitamin C: No known common adverse interactions
with other drugs. Vitamin A: Women taking birth control
pills should consult with their doctors before taking extra
vitamin A. Vitamin E: Should not be used by persons
taking anti-coagulation drugs. Carotenoids: No known
negative interactions with other drugs. Bioflavonoids:
No known adverse interactions with other drugs. Coen-
zyme Q 10 : No negative drug interactions yet reported.
Amino acids: There are no adverse reactions yet reported
between alpha lipoic acid, cysteine, glutathione, or NAC
and other medications.
Resources
BOOKS
Balch, Dr. James F. The Super Antioxidants: Why They Will
Change the Face of Health Care in the 21st Century. M.
Evans and Co., 1998.
Colgan, Dr. Michael. The New Nutrition. Cl Publications,
1996.
Challem, Jack, editor. All About Antioxidants. Avery Publishing
Group, 1999.
Hendler, Dr. Sheldon Saul The Doctors' Vitamin and Mineral
Encyclopedia. Simon and Shuster, 1990.
Moss, Ralph W. Antioxidants Against Cancer. Equinox Press,
2000 .
Murray, Michael T. Natural Alternatives to Over-the-Counter
and Prescription Drugs. William Morrow and Co., 1994.
Packer, Lester, et al. The Antioxidant Miracle: Your Complete
Plan For Total Health and Healing. John Wiley and Sons,
1999.
Smythies, John R. Every Person's Guide to Antioxidants Rut-
gers University Press, 1998.
PERIODICALS
Abramowiez, Dr. Mark, editor. “Vitamin Supplements.” The
Medical Letter ( July 31, 1998): 75- 77.
“Antioxidant Vitamin E Reported to Strengthen Immune Sys-
tem.” Obesity, Fitness & Wellness Week (March 2, 2002):
12 .
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Atherosclerosis — A buildup of fatty substances in
the inside of arteries, resulting in the restriction of
blood flow and hardening of the vessels.
Macular degeneration — An eye disease resulting
in a loss of central vision in both eyes while pe-
ripheral vision is preserved.
Oxidation — The loss of electrons from a molecule
by their bonding to an oxygen molecule, render-
ing the donor molecule positive in charge and the
recipient oxygen negative in charge (free radical).
Sinusitis — An inflammation or infection in the
sinus cavities in the head.
Fang, James C., et al. “Effect of Vitamins C and E on Progres-
sion of Transplant- Associated Arteriosclerosis: A random-
ized Trial.” The Lancet (March 30, 2002): 1108.
Kiningham, Robert.“The Value of Antioxidant Vitamin Supple-
ments.” American Family Physician (Sept. 1, 1999): 742.
Koch Kubetin, Sally. “Antioxidants Fall Short.” OB GYN News
(February 1, 2002): 29.
Langer, Stephen. “Antioxidants: Our Knights in Shining
Armor.” Better Nutrition (May 1997): 46- 50.
"Lutein Helps Protect Eyes, Doctors Say in Survey.” Ophthal-
mology Times (March 15, 2002): 29.
Raloff, Janet. “The Heart-Healthy Side of Lycopene.” Science
News (Nov. 29, 1997): 348.
Scheer, James F. "Twelve Key Antioxidants: May Their Force
Be With You.” Better Nutrition (Jan. 1999): 58.
Schindler, Martha.“The Magnificent Seven.” Vegetarian Times
(Feb. 1999): 86.
“Simvastatin Yes, Antioxidant No n Two Important New Stud-
ies.” Clinical Cardiology Alert (January 2002): 1.
Tyler, Varro E.“The Miracle of Anti- Aging Herbs.” Prevention
(Nov. 1999): 105.
“Vitamin A Intake Levels Reaffirmed as Safe and Beneficial.”
Medical Letter on the CDC & FDA (January 27, 2002): 14.
Ken R. Wells
Teresa G. Odle
Anxiety
Definition
Anxiety is a bodily response to a perceived threat or
danger. It is triggered by a combination of biochemical
changes in the body, the patient's personal history and
memory, and the social situation.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
It is important to distinguish between anxiety as a
feeling or experience and an anxiety disorder as a psy-
chiatric diagnosis. A person may feel anxious without
having an anxiety disorder. Also, a person facing a clear
and present danger or a realistic fear is not usually con-
sidered to be in a state of anxiety. In addition, anxiety
frequently occurs as a symptom in other categories of
psychiatric disturbance.
Description
Anxiety is related to fear, but it is not the same
thing. Fear is a direct, focused response to a specific
event or object of which an individual is consciously
aware. Most people will feel fear if someone points a
loaded gun at them or if they see a tornado forming on
the horizon. They also will recognize that they are afraid.
Anxiety, on the other hand, is often unfocused, vague,
and hard to pin down to a specific cause.
Sometimes anxiety experienced in the present may
stem from an event or person that produced pain and
fear in the past. In this experience, the anxious individual
may not be consciously aware of the original source of
the feeling. Anxiety has an aspect of remoteness that
makes it hard for people to compare their experiences.
Whereas most people will be fearful in physically dan-
gerous situations, and can agree that fear is an appropri-
ate response in the presence of danger, anxiety is often
triggered by objects or events that are unique and specif-
ic to an individual. An individual might be anxious be-
cause of a unique meaning or memory being stimulated
by present circumstances, not because of some immedi-
ate danger.
Causes & symptoms
Anxiety is characterized by the following symp-
toms:
• Somatic. These physical symptoms include headaches,
dizziness or lightheadedness, nausea and/or vomiting,
diarrhea, tingling, pale complexion, sweating, numb-
ness, difficulty in breathing, and sensations of tightness
in the chest, neck, shoulders, or hands. These symptoms
are produced by the hormonal, muscular, and cardiovas-
cular reactions involved in the fight-or-flight reaction.
• Behavioral. Behavioral symptoms of anxiety include
pacing, trembling, general restlessness, hyperventilation,
pressured speech, hand wringing, and finger tapping.
• Cognitive. Cognitive symptoms of anxiety include re-
current or obsessive thoughts, feelings of doom, mor-
bid or fear-inducing thoughts or ideas, and confusion or
inability to concentrate.
103
Anxiety
Anxiety
• Emotional. Emotional symptoms include feelings of
tension or nervousness, feeling “hyper” or “keyed up,”
and feelings of unreality, panic, or terror.
Anxiety can have a number of different causes. It is
a multidimensional response to stimuli in the person’s
environment, or a response to an internal stimulus (for
example, a hypochondriac’s reaction to a stomach rum-
bling) resulting from a combination of general biological
and individual psychological processes.
Physical triggers
In some cases, anxiety is produced by physical re-
sponses to stress or by certain disease processes or med-
ications.
THE AUTONOMIC NERVOUS SYSTEM (ANS). The ner-
vous system of human beings is hard-wired to respond to
dangers or threats. These responses are not subject to
conscious control and are the same in humans as in
lower animals. They represent an evolutionary adapta-
tion to animal predators and other dangers that all ani-
mals — including primitive humans — had to cope with.
The most familiar reaction of this type is the fight-
or-flight reaction to a life-threatening situation. When
people have fight-or-flight reactions, the level of stress
hormones in their blood rises. They become more alert
and attentive, their eyes dilate, their heartbeats increase,
their breathing rates increase, and their digestion slows
down, making more energy available to the muscles.
This emergency reaction is regulated by a part of the
nervous system called the autonomic nervous system, or
ANS. The ANS is controlled by the hypothalamus, a spe-
cialized part of the brainstem that is among a group of
structures called the limbic system. The limbic system
controls human emotions through its connections to
glands and muscles; it also connects to the ANS and
higher brain centers, such as parts of the cerebral cortex.
One problem with this arrangement is that the lim-
bic system cannot tell the difference between a real
physical threat and an anxiety-producing thought or idea.
The hypothalamus may trigger the release of stress hor-
mones from the pituitary gland even when there is no ex-
ternal danger.
A second problem is caused by the biochemical side
effects of too many false alarms in the ANS. When a per-
son responds to a real danger, his or her body relieves it-
self of the stress hormones by facing up to the danger or
fleeing from it. In modern life, however, people often
have fight-or-flight reactions in situations where they can
neither run away nor lash out physically. As a result, their
bodies have to absorb all the biochemical changes of hy-
perarousal rather than release them. These biochemical
104
changes can produce anxious feelings as well as muscle
tension and other physical symptoms of anxiety.
DISEASES AND DISORDERS. Anxiety can be a symp-
tom of certain medical conditions. For example, anxiety
is a symptom of certain endocrine disorders that are
characterized by overactivity or underactivity of the thy-
roid gland. Cushing’s syndrome, in which the adrenal
cortex overproduces cortisol, is one such disorder. Other
medical conditions that can produce anxiety include res-
piratory distress syndrome, mitral valve prolapse, por-
phyria, and chest pain caused by inadequate blood sup-
ply to the heart (angina pectoris).
MEDICATIONS AND SUBSTANCE USE. Numerous
medications may cause anxiety-like symptoms as a side
effect. They include birth control pills, some thyroid or
asthma drugs, some psychotropic agents, corticos-
teroids, antihypertensive drugs, nonsteroidal anti-inflam-
matory drugs (such as flurbiprofen and ibuprofen), and
local anesthetics. Caffeine can also cause anxiety-like
symptoms when consumed in sufficient quantity.
Withdrawal from certain prescription drugs — pri-
marily beta-blockers and corticosteroids — can cause anx-
iety. Withdrawal from drugs of abuse, including LSD, co-
caine, alcohol, and opiates, can also cause anxiety.
Childhood development and anxiety
Researchers in early childhood development regard
anxiety in adult life as a residue of childhood memories
of dependency. Humans learn during the first year of life
that they are not self-sufficient and that their basic sur-
vival depends on others. It is thought that this early expe-
rience of helplessness underlies the most common anxi-
eties of adult life, including fear of powerlessness and
fear of not being loved. Thus, adults can be made anx-
ious by symbolic threats to their sense of competence or
significant relationships, even though they are no longer
helpless children.
Symbolization
The psychoanalytic model gives a lot of weight to
the symbolic aspect of human anxiety; examples include
phobic disorders, obsessions, compulsions, and other
forms of anxiety that are highly individualized. Because
humans mature slowly, children and adolescents have
many opportunities to connect their negative experiences
to specific objects or events that can trigger anxious feel-
ings in later life. For example, a person who was fright-
ened as a child by a tall man wearing glasses may feel
panicky years later, without consciously knowing why, by
something that reminds him of that person or experience.
Freud thought that anxiety results from a person’s in-
ternal conflicts. According to his theory, people feel anx-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
ious when they feel tom between moral restrictions and
desires or urges toward certain actions. In some cases, the
person’s anxiety may attach itself to an object that repre-
sents the inner conflict. For example, someone who feels
anxious around money may be pulled between a desire to
steal and the belief that stealing is wrong. Money be-
comes a symbol for the inner conflict between doing
what is considered right and doing what one wants.
Phobias
Phobias are a special type of anxiety reaction in
which the person concentrates his or her anxiety on a
specific object or situation and then tries to avoid. In
most cases, the person’s fear is out of proportion to its
“cause.” It is estimated that 10-11% of the population
will develop a phobia in their lifetime. Some phobias —
agoraphobia (fear of open spaces), claustrophobia (fear
of small or confined spaces), and social phobia, for ex-
ample — are shared by large numbers of people. Others
are less common or are unique to the patient.
Social and environmental stressors
Because humans are social creatures, anxiety often
has a social dimension. People frequently report feelings
of high anxiety when they anticipate or fear the loss of
social approval or love. Social phobia is a specific anxi-
ety disorder that is marked by high levels of anxiety or
fear of embarrassment in social situations.
Another social stressor is prejudice. People who be-
long to groups that are targets of bias have a higher risk
of developing anxiety disorders. Some experts think, for
example, that the higher rates of phobias and panic dis-
order among women reflects their greater social and
economic vulnerability.
Several controversial studies indicate that the in-
crease in violent or upsetting pictures and stories in news
reports and entertainment may raise people’s anxiety lev-
els. Stress and anxiety management programs often rec-
ommend that patients cut down their exposure to upset-
ting stimuli.
Environmental or occupational factors can also
cause anxiety. People who must live or work around sud-
den or loud noises, bright or flashing lights, chemical va-
pors, or similar nuisances that they cannot avoid or con-
trol may develop heightened anxiety levels.
Diagnosis
Diagnosing anxiety is difficult and complex because
of the variety of possible causes and because each per-
son’s symptoms arise from highly personalized and indi-
vidualized experiences. When a doctor examines an anx-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
ious patient, he or she will first rule out physical condi-
tions and diseases that have anxiety as a symptom. The
doctor will then take the patient’s history to see if pre-
scription drugs, alcohol or drug abuse, caffeine, work en-
vironment, or other external stressors could be triggering
the anxiety. In most cases, the most important source of
diagnostic information is the patient’s psychological and
social history. The doctor may administer several brief
psychological tests, including the Hamilton Anxiety Scale
and the Anxiety Disorders Interview Schedule (ADIS).
Treatment
Meditation and mindfulness training can benefit
patients with phobias and panic disorder. Hydrother-
apy, massage therapy, and aromatherapy are useful to
some anxious patients because they can promote general
relaxation of the nervous system. Essential oils of
lavender, chamomile, neroli, sweet marjoram, and
ylang-ylang are commonly recommended by aromather-
apists for stress relief and anxiety reduction.
Relaxation training, which is sometimes called anxi-
ety management training, includes breathing exercises
and similar techniques intended to help the patient pre-
vent hyperventilation and relieve the muscle tension as-
sociated with the fight-or-flight reaction. Yoga, aikido,
tai chi, and dance therapy help patients work with the
physical, as well as the emotional, tensions that either
promote anxiety or are created by the anxiety.
Homeopathy and traditional Chinese medicine
(TCM) approach anxiety as a symptom of a holistic im-
balance. Homeopathic practitioners select a remedy based
on other associated symptoms and the patient’s general
constitution. Homeopathic remedies for anxiety include
ignatia, gelsemium, aconite, pulsatilla, arsenicum
album, and coffea cruda. These remedies should be pre-
scribed by a homeopathic healthcare professional.
Chinese medicine regards anxiety as a disruption of qi ,
or energy flow, inside the patient’s body. Acupuncture
and/or herbal therapy are standard remedies for rebalancing
the entire system. Reishi ( Ganoderma lucidum or Ling-Zhi)
is a medicinal mushroom prescribed in TCM to reduce anx-
iety and insomnia. However, because reishi can interact
with other prescription drugs and is not recommended for
patients with certain medical conditions, individuals should
consult their healthcare practitioner before taking the reme-
dy. Other TCM herbal remedies for anxiety include the
cordyceps mushroom (also known as catepillar fungus)
and Chinese green tea. In addition, there are numerous
TCM formulas that combine multiple herbs for use as an
anxiety treatment, depending on the individual problem.
Herbs known as adaptogens may also be prescribed
by herbalists or holistic healthcare providers to treat anxi-
105
Anxiety
Anxiety
ety. These herbs are thought to promote adaptability to
stress, and include Siberian ginseng ( Eleutherococcus sen-
ticosus), ginseng ( Panax ginseng ), wild yam (Dioscorea
villosa), borage ( Borago officinalis), licorice ( Glycyrrhiza
glabra), chamomile ( Chamaemelum nobile), milk thistle
(Silybum marianum), and nettles ( Urtica dioica). Tonics
of skullcap ( Scutellaria lateriafolia), and oats (Arena
sativa), may also be recommended to ease anxiety.
A 2002 preliminary study found that St. John’s wort
could be an effective treatment for generalized anxiety.
Patients taking 900 mg a day and higher doses responded
well in early trials. However, further research was need-
ed, particularly at doses higher than 900 mg per day. The
Ayurvedic herb gotu kola, long used by practitioners of
India’s holistic medical system to enhance memory and
relieve varicose veins, may also help patients with anxi-
ety by working against the startle response.
Allopathic treatment
Because anxiety often has more than one cause and
is experienced in highly individual ways, its treatment
often requires more than one type of therapy. In some
cases, several types of treatment may need to be tried be-
fore the best combination is discovered. It usually takes
about six to eight weeks to evaluate the effectiveness of a
treatment regimen.
Medications
Medications are often prescribed to relieve the phys-
ical and psychological symptoms of anxiety. Most med-
ications work by counteracting the biochemical and
muscular changes involved in the fight-or-flight reaction.
Some work directly on the brain chemicals that are
thought to underlie the anxiety.
ANXIOLYTICS. Anxiolytics are sometimes called
tranquilizers. Most anxiolytic drugs are either benzodi-
azepines or barbiturates. However, barbiturates, once
commonly used, are now rarely used in clinical practice.
Benzodiazepines work by relaxing the skeletal muscles
and calming the limbic system. They include such drugs
as chlordiazepoxide (Librium) and diazepam (Valium).
Both barbiturates and benzodiazepines are potentially
habit-forming and may cause withdrawal symptoms, but
benzodiazepines are far less likely than barbiturates to
cause physical dependency.
Two other types of anxiolytic medications include
meprobamate (Equanil), which is now rarely used, and
buspirone (BuSpar), a new type of anxiolytic that ap-
pears to work by increasing the efficiency of the body’s
own emotion-regulating brain chemicals. Unlike barbitu-
rates and benzodiazepines, buspirone does not cause de-
106
pendence problems, does not interact with alcohol, and
does not affect the patient’s ability to drive or operate
machinery. However, buspirone is not effective against
certain types of anxiety, such as panic disorder.
ANTIDEPRESSANTS AND BETA-BLOCKERS. The treat-
ment of choice for obsessive-compulsive disorder,
panic type anxiety, and other anxiety disorders is a group
of antidepressants known as selective serotonin reuptake
inhibitors (SSRIs), such as Prozac and Paxil. When anxi-
ety occurs in tandem with depressive symptoms, tricyclic
antidepressants such as imipramine (Tofranil) or
monoamine oxidase inhibitors (MAO inhibitors) such as
phenelzine (Nardil) are sometimes prescribed.
Beta-blockers are medications that work by block-
ing the body's reaction to the stress hormones that are re-
leased during the fight-or-flight reaction. They include
drugs like propranolol (Inderal) or atenolol (Tenormin).
Beta-blockers are sometimes given to patients with post-
traumatic anxiety symptoms or social phobic anxiety.
Psychotherapy
Most patients with anxiety will be given some form
of psychotherapy along with medication. Many patients
benefit from insight-oriented therapies, which are de-
signed to help them uncover unconscious conflicts and
defense mechanisms in order to understand how their
symptoms developed.
Cognitive-behavioral therapy (CBT) also works well
with anxious patients. In CBT, the patient is taught to
identify thoughts and situations that stimulate his or her
anxiety, and to view them more realistically. In the be-
havioral part of the program, the patient is exposed to the
anxiety-provoking object, situation, or internal stimulus
(like a rapid heart beat) in gradual stages until he or she
is desensitized to it.
Expected results
Unfortunately, a 2002 report stated that about half of
the patients with an anxiety disorder who see their pri-
mary care physician go untreated. The prognosis for re-
solving anxiety depends on the specific disorder and a
wide variety of factors, including the patient’s age, gen-
eral health, living situation, belief system, social support
network, and responses to different medications and
forms of therapy.
Resources
BOOKS
“Anxiety Disorders.” In Diagnostic and Statistical Manual of
Mental Disorders. 4th ed. Washington, DC: The American
Psychiatric Association, 1994.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Anxiolytic — A type of medication that helps to re-
lieve anxiety.
Aromatherapy — The therapeutic use of plant-de-
rived, aromatic essential oils to promote physical
and psychological well-being.
Autonomic nervous system (ANS) — The part of
the nervous system that supplies nerve endings in
the blood vessels, heart, intestines, glands, and
smooth muscles; it also governs their involuntary
functioning. The autonomic nervous system is re-
sponsible for the biochemical changes involved in
experiences of anxiety.
Endocrine gland — A ductless gland, such as the
pituitary, thyroid, or adrenal gland, that secretes
its products directly into the blood or lymph.
Hyperarousal — A state or condition of muscular
and emotional tension produced by hormones re-
leased during the fight-or-flight reaction.
Hypothalamus — A portion of the brain that regu-
lates the autonomic nervous system, the release of
hormones from the pituitary gland, sleep cycles,
and body temperature.
Limbic system — A group of structures in the brain
that includes the hypothalamus, amygdala, and
hippocampus. The limbic system plays an impor-
tant part in regulation of human moods and emo-
tions.
Phobia — In psychoanalytic theory, a psychologi-
cal defense against anxiety in which the patient
displaces anxious feelings onto an external object,
activity, or situation.
Bloomfield, Harold H. Healing Anxiety with Herbs. New York:
HarperCollins, 1998.
Corbman, Gene R. "Anxiety Disorders." In Current Diagnosis
9, edited by Rex B. Conn, et al. Philadelphia: W. B. Saun-
ders, 1997.
PERIODICALS
Gaby, Alan R. “Consider St. John's Wort as Alternative to
Kava. (Literature Review & Commentary).” Townsend
Letter for Doctors and Patients (May 2002):34.
Mandile, Maria Noel. “Gotu Kola: This Ayurvedic Herb May
Reduce Your Anxiety Without the Side Effects of Drugs.”
Natural Health (May-June 2002):34.
Zoler. Michael L. “Anxiety Disorder Often Goes Untreated in
Primary Care. (504 Patients in 15 Practices Studied).”
Family Practice News (April 1, 2002): 14 -21.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
ORGANIZATION
The American Botanical Council. P.O. Box 144345, Austin,
Texas 78714-4345. (512) 926-4900. Fax: (512) 926-2345.
http://www.herbalgram.org.
Paula Ford-Martin
Teresa G. Odle
Apis
Description
Not all products used in alternative healing come
from plants. Apis mellifica is the venom of the common
honeybee or a tincture made from the whole bee. Various
species of honeybees found throughout the world are
used for this remedy in homeopathic medicine. The rem-
edy made from them is usually called apis. Other folk
medicine traditions use additional bee-related substances
in healing such as honey, beeswax, pollen, royal jelly,
and propolis.
General use
Homeopathic medicine operates on the principle
that “like heals like.” This means that a disease can be
cured by treating it with products that produce the same
symptoms as the disease. These products follow another
homeopathic law, the Law of Infinitesimals. In opposi-
tion to traditional medicine, the Law of Infinitesimals
states that the lower a dose of curative, the more effec-
tive it is. To make a homeopathic remedy, the curative is
diluted many, many times until only a tiny amount re-
mains in a huge amount of the diluting liquid.
In homeopathic terminology, the effectiveness of
remedies is “proved” by experimentation and reports by
famous homeopathic practitioners. About 1900, both bee
venom and tincture from the entire insect were proved as
a remedy by the Central New York State Homeopathic
Society.
In homeopathic medicine, apis is used as a remedy
for many symptoms similar to those of bee stings. These
include:
• inflammation with a burning sensation
• stinging pain
• itchy skin
• swollen and sensitive skin
• red, flushed, hot face
• hive-like welts on the skin
107
Homeopathic practitioners use apis when stinging or
burning inflammations appear in all parts of the body,
not just on the skin. A homeopath could use apis for sore
throats, mumps, urinary tract infections, and other con-
ditions where there is a stinging or burning sensation.
Symptoms treated by apis usually appear quite rapid-
ly. There is usually some swelling or edema along with
the stinging sensation. Many people who need apis com-
plain of swollen eyelids, as if they had an eye infection. In
keeping with the symptom of edema, often little urine is
produced although there may be a strong urge to urinate.
Despite this, the patient has little thirst or desire to drink.
Often the patient who will be given apis appears
flushed or has a rough rash. The rash may appear, then
disappear. The skin will be sensitive to the touch and al-
ternatively hot and dry, then sweaty. Patients may also
feel nauseated, suffer from heartburn, or have tightness
throughout their chest or abdomen that feels like they
will burst if they cough or strain.
Certain mental and emotional symptoms also appear
in the patient that needs apis. Sadness, weeping, and de-
pression can occur. Apis is often used after a person ex-
periences a strong emotional reaction such as jealousy,
fear, rage, or anger.
In homeopathic medicine, the fact that certain
symptoms get better or worse under different conditions
is used as a diagnostic tool to indicate what remedy will
be most effective. Symptoms that benefit from treatment
with apis get worse by applying warmth or drinking
warm liquids. They also get worse from touch or pres-
sure, or when the person is in a closed, heated room. The
symptoms are often worse on the right side, after sleep-
ing, and in the late afternoon. Symptoms improve with
the application of cold and exposure to open air.
Homeopathy also ascribes certain personality types
to certain remedies. The apis personality is said to be fid-
gety, restless, and unpredictable. People with the apis per-
sonality may have wildly inappropriate reactions to emo-
tional situations. They want company, but reject affection,
and sometimes insist that they don’t need medical atten-
tion when they are clearly unwell. People who need apis
often have bouts of unprovoked jealousy and unprovoked
tears. They may fear ill health and death greatly.
Preparations
There are two homeopathic dilution scales, the deci-
mal (x) scale with a dilution of 1:10 and the centesimal
(c) scale with a dilution factor of 1:100. Once the mix-
ture is diluted, shaken, strained, then rediluted many
times to reach the desired degree of potency, the final
mixture is added to lactose (a type of sugar) tablets or
108
KEY TERMS
Edema — Puffiness caused by water retention.
Propolis — A sticky resin made by honeybees to
seal the holes in their hives.
Royal jelly — Special substance secreted by bees to
feed the young queen bees.
Tincture — An extract prepared by soaking the
remedy in alcohol.
pellets. These are then stored away from light. Homeo-
pathic apis venom is available commercially in tablets in
many different strengths. Dosage depends on the symp-
toms being treated. Homeopathic tincture of whole hon-
eybee is also available in a variety of strengths.
Homeopathic and orthodox medical practitioners
agree that by the time the initial remedy solution is dilut-
ed to strengths used in homeopathic healing, it is likely
that very few molecules of the original remedy remain.
Homeopaths, however, believe that these remedies con-
tinue to work through an effect called “potentization”
that has not yet been explained by mainstream scientists.
Precautions
No particular precautions have been noted for using
apis. However, people who are allergic or sensitive to
bee venom should be cautious. They may react adversely
to certain potencies of homeopathic apis.
Side effects
When taken in the recommended dilute form, no
side effects from apis have been reported. However, con-
centrated quantities of the bee venom can cause allergic
reactions in susceptible people.
Interactions
Studies on interactions between apis and conven-
tional pharmaceuticals are nonexistent.
Resources
BOOKS
Cummings, Stephen, and Dana Ullman. Everybody' s Guide to
Homeopathic Medicines. 3rd ed. New York: Putnam,
1997.
Hammond, Christopher. The Complete Family Guide to Home-
opathy. London: Penguin Studio, 1995.
Lockie, Andrew, and Nicola Geddes. The Complete Guide to
Homeopathy. London: Dorling Kindersley, 1995.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
ORGANIZATIONS
Foundation for Homeopathic Education and Research. 21 Kit-
tredge St., Berkeley, CA 94704. (510) 649-8930.
International Foundation for Homeopathy. RO. Box 7, Ed-
monds, WA 98020. (206) 776-4147.
National Center for Homeopathy. 801 N. Fairfax St., Suite 306,
Alexandria, VA 22314. (703) 548-7790.
OTHER
Homeopathic Internet Resources, <http://www.holisticmed.com/>
and <www/homeopathy.html>
Tish Davidson
Apitherapy
Definition
Apitherapy involves the therapeutic use of honeybee
products, including bee pollen, honey, propolis, royal
jelly, beeswax, and venom, to treat a variety of ailments.
The most well-known and well-practiced facet of apithera-
py is Bee Venom Therapy (BVT), which involves the med-
icinal use of bee stings. The venom is thought to reduce in-
flammation and boost the body’s immune system. When
most people refer to apitherapy, they are referring to BVT.
Origins
The medicinal use of bees goes back to ancient times.
Chinese texts dating back 2,000 years mention it, and Hip-
pocrates wrote about it. The Egyptians were said to treat
diseases with an ointment made from bees, and Greek
physician and writer Galen (129-c. 199), wrote about bee
treatments. In 1888, Phillip Terc, an Austrian physician,
published a paper on one of the first clinical studies in-
volving bee stings titled Report About a Peculiar Connec-
tion Between the Beestings and Rheumatism. Thereafter,
its use expanded throughout Europe and the United States.
It spread as a type of folk remedy popularized by anecdo-
tal accounts, but as the twenty-first century approached,
the medical community began investigating the therapy,
studying its use on a pharmacological level. Though clini-
cal studies had begun by 2000, most people using the ther-
apy were either doing it themselves or with the help of lay
practitioners. Physicians were beginning to use the thera-
py but mostly with an injectable form of the venom.
Benefits
The American Apitherapy Society says it has anec-
dotal evidence showing bee venom is effective in the
treatment of:
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• immune system problems, such as arthritis and multi-
ple sclerosis (MS)
• cardiovascular disease, such as hypertension, arrhyth-
mias, atherosclerosis, and varicose veins
• endocrine disorders, such as premenstrual syndrome,
menstrual cramps, irregular periods, and decreased
blood glucose levels
• infections, like herpes simplex 1 and 2, warts, mastitis,
and laryngitis
• psychological disturbances, such as depression or
mood swings
• rheumatologic disturbances, such as rheumatoid
arthritis, osteoarthritis, juvenile rheumatoid arthri-
tis, bursitis, and “tennis elbow”
• skin conditions, such as eczema, psoriasis, corns,
warts, and topical ulcers
Apitherapy is thought of as a last-resort treatment but
may be beneficial to those who cannot be helped by tradi-
tional therapies and medicines. MS patients have reported
increased stability, along with less fatigue and muscle
spasm, after trying the therapy. Patients with rheumatoid
arthritis and osteoarthritis have said pain and swelling have
decreased following the stings. It has also been said to shrink
the size of rheumatoid nodules. For those who have not
achieved relief with other treatments, apitherapy may help.
Description
Honey bee venom contains more than 40 active sub-
stances, many of which have physiological effects. The
most abundant compound is an anti-inflammatory agent
called melittin. This substance causes the body to pro-
duce cortisol, which is an agent of the body’s own heal-
ing process. As an anti-inflammatory, melittin is 100
times more potent than hydrocortisol. It is noted in Paul
L. Cerrato’s RN article that experiments have shown that
melittin can slow the body’s inflammatory response.
That is why the venom may be helpful in treating inflam-
matory conditions such as rheumatoid arthritis.
Other compounds that may have pharmacological ef-
fects include apamin, which works to enhance nerve trans-
mission; adolapin, which is an anti-inflammatory and an
analgesic; and other neurotransmitters like norepinephrine
and dopamine and seratonin, which figure in depression.
The most prevalent use of BVT is for immune sys-
tem and inflammatory disorders. One of the most promis-
ing uses may be relieving the symptoms of treatment-re-
sistant MS. More than 1,300 people with MS have sent
testimonials to the American Apitherapy Society in sup-
port of the treatment saying the therapy helped relieve fa-
tigue and muscle spasm, as well as to restore stability.
109
Apitherapy
Apitherapy
Most people receiving the therapy do it themselves
or with the help of a lay practitioner. The cost of learning
the therapy and the cost for the bees is generally not cov-
ered by insurance. The therapy may be covered, howev-
er, if prescribed and administered by a physician who
uses an injectable form.
To receive treatment, a bee is taken from a jar or hive
with a pair of tweezers and held on the body part to be
stung. The stinger should be left in for 10 to 15 minutes.
The number of stings delivered in a session and the fre-
quency of the sessions varies, depending on the patient’s
tolerance and the nature of the problem. To treat ten-
donitis, a patient might need only two to five therapy ses-
sions involving only two to three stings per session. Treat-
ing a more chronic problem like arthritis can take several
stings per session two to three times per week for up to
three months. Treating MS is a prolonged effort. Those
who have used it say the therapy must happen two to three
times per week for six months in order to start working.
On average, doctors who use the therapy delivered
injections one to two times per week. The number of in-
jections varied widely, from one to 30 per session, de-
pending on the ailment being treated.
Physicians who use the therapy do not use live bees.
Instead, they obtain venom in an injectable form and in-
ject it under the skin.
Obviously, the more stings or injections to be adminis-
tered, the more time the therapy is going to take per session.
Preparations
Before the therapy is begun, a doctor will inject the
patient with a weak form of the venom to test for allergic
reaction. The doctor will have a syringe of epinephrine
nearby in case a reaction does occur. If the patient is al-
lergic to the venom, the therapy cannot be administered.
Lay practitioners and beekeepers who deliver live
stings test patients with an initial sting to the knee or
forearm and observe the patient to see if they are aller-
gic. The test sting should only be administered if the
practitioner has a bee-sting kit containing epinephrine
nearby. If a person is allergic, a reaction will generally
occur in 15 to 20 minutes. Up to 2% of the population
may be allergic to insect venom.
Ice may be used to numb the area where the stings
will occur. It can also be used afterward to soothe the pain.
Precautions
Venom therapy should not be used by those with se-
vere allergies, tuberculosis, syphilis, gonorrhea, and
transient insulin-dependent diabetes.
110
KEY TERMS
Cardiovascular — Refers to the heart and blood
vessels as a unified system.
Multiple sclerosis — A chronic, debilitating disease
that affects the central nervous system causing a
loss of muscular coordination, speech defects,
and the like.
Propolis — A brownish, waxy substance that bees
collect from the buds of certain trees and use to
glue their hives together.
Tendonitis — Refers to an inflammation of the ten-
dons, the fibrous connective tissue that attaches
muscle to bone.
Side effects
Pain, itching, and swelling are common at the injec-
tion or sting site. Patients should also be cautioned that
severe anaphylactic allergic reactions can lead to respira-
tory problems, cardiac collapse, and death. Some may
develop nodular masses or ulcers at sting sites.
It seems, however, that major complications are rare. In
September 1999, it was reported in Patient Care magazine
that Christopher M. H. Kim, director of the Monmouth Pain
Institute in Red Bank, New Jersey, says he has given more
than 34,000 injections to 174 patients over the past 15 years
and has yet to see any major complications. The venom
Kim injects is equivalent to one to ten bee stings. The most
common side effect reported by his patients is itching, re-
ported by 80% of his patients after the first session. After 12
sessions, however, only 40% still experienced itching. Of
his patients, 29.7% reported swelling; 6.4% reported
headache; and 5.6% reported flushing.
Research & general acceptance
Due to a growing body of anecdotal evidence to sup-
port the use of BVT, formal clinical studies were
launched as 2000 approached. The National Multiple
Sclerosis Society has begun funding a study on apithera-
py at Georgetown University Medical Center in Washing-
ton, D.C. The results were expected by the end of 2000.
While the study is ongoing, Joseph A. Bellanti, who
is overseeing the study, has already changed his view of
the therapy. “In the beginning I thought it was rather
strange, but after some investigation, I saw that there are
definite immunologic changes after bee venom therapy,
and the use of venom began to seem less farfetched,” he
told Patient Care.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Over the years, researchers have experimented with
the therapy on animals and have found that bee venom
can keep arthritis at bay in rodents. A study was de-
scribed in RN in which researchers induced a condition
similar to rheumatoid arthritis in rats and found that
daily injections of bee venom suppressed the disease.
Harvard Medical School professor John Mills, who
works with arthritis patients, told Country Journal that he
has seen patients achieve short-term relief through the
sting therapy, though he does not condone its use. He be-
lieves the same response could be achieved through drug
therapy without the allergic risk the venom poses to some.
While animal studies, preliminary results of clinical
trials, and anecdotal evidence suggest BVT may have
therapeutic effects, until clinical trials on humans are
completed, there is no way to know if the treatment
works. The placebo effect may also be responsible for
some degree of benefit patients achieve.
Training & certification
Some physicians practice BVT, but the majority of
those seeking treatment rely on lay practitioners, bee keep-
ers, themselves, or a partner, who is taught to use the bees.
Those seeking treatment can contact the American
Apitherapy Society to find a practitioner near them.
Resources
PERIODICALS
Cerrato, Paul L. “A Therapeutic Bee Sting?” RN 61, 8 (August
1998): 57-58.
D'Epiro, Nancy Walsh. “Bee Venom for Multiple Sclerosis.”
Patient Care 33, 14 (September 15, 1999): 27-31.
Granstrom. Chris. “Stinging Away the Pain.” Country Journal
23, 5 (September/October 1996): 22-25.
Somerfield, Stanley D. “Bee Venom and Arthritis: Magic,
Myth or Medicine?” New Zealand Medical Journal 99,
800 (April 1986): 281-283.
ORGANIZATIONS
American Apitherapy Society. 5390 Grande Road. Hillsboro, OH
45133. (937) 364-1108. <http://www.apitherapy.org/aas.>
OTHER
“Bee Venom Therapy.” Spectrum Medical Arts. <http://www2.
shore.net/-spectrum/apitherapy.html >
Lisa Frick
Appendicitis
Definition
Appendicitis is an inflammation of the appendix,
which is the worm-shaped pouch attached to the cecum,
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
the beginning of the large intestine. The appendix has no
known function in the body, but it can become diseased.
Appendicitis is a medical emergency, and if it is left un-
treated, the appendix may rupture and cause a potentially
fatal infection.
Description
Appendicitis is the one of the most common abdomi-
nal emergencies found in the United States. More males
than females develop appendicitis. It is rare in the elderly
and in children under the age of two. The hallmark symp-
tom of appendicitis is increasingly severe abdominal
pain. Since many different conditions can cause abdomi-
nal pain, an accurate diagnosis of appendicitis can be dif-
ficult. Other conditions can have symptoms similar to ap-
pendicitis, especially in women. These include pelvic in-
flammatory disease, ruptured ovarian follicles, ruptured
ovarian cysts, tubal pregnancies, and endometriosis.
Various forms of stomach upset and bowel inflammation
may also mimic appendicitis.
A timely diagnosis of appendicitis is important, be-
cause a delay can result in perforation, or rupture, of the
appendix. When this happens, the infected contents of
the appendix spill into the abdomen, potentially causing
a serious infection of the abdomen called peritonitis.
Very rarely, the inflammation and symptoms of appen-
dicitis may disappear but recur again later. If appendici-
tis is suspected, the following activities should be avoid,
as they may cause the appendix to rupture:
• consuming food or drink
• taking pain medication, laxatives, or antacids
• the use of a heating pad on the affected area
Causes & symptoms
The causes of appendicitis are not totally under-
stood, but are believed to occur as a result of blockage of
the appendix. This blockage may be due to fecal matter,
a foreign body in the large intestine, cancerous tumors, a
parasite infestation, or swelling from an infection.
The distinguishing symptom of appendicitis is the
migration of pain to the lower right corner of the ab-
domen. The abdomen often becomes rigid and tender to
the touch. The patient may bend the knees in reaction to
the pain. Increased rigidity and tenderness indicate an in-
creased likelihood of perforation and peritonitis. Loss of
appetite is very common, accompanied by a low-grade
fever, and occasionally there is constipation or diar-
rhea, as well as nausea. Unfortunately, these signs and
symptoms may vary widely. Atypical symptoms are par-
ticularly present in pregnant women, the elderly, and
young children.
Ill
Appendicitis
Appendicitis
An extracted appendix. (Photograph by Lester V. Bergman,
Corbis Images. Reproduced by permission.)
If bacteria multiply unchecked within the appendix, it
will become swollen and filled with pus, and may eventual-
ly rupture. This produces an inflammation of the lining of
the abdominal wall, or peritonitis, which is a medical emer-
gency. Signs of rupture include the presence of symptoms
for more than 24 hours, a high fever, a distended abdomen,
a high white blood cell count, and an increased heart rate.
Diagnosis
A careful examination is the best way to diagnose
appendicitis. It is often difficult even for experienced
physicians to distinguish the symptoms of appendicitis
from those of other abdominal disorders. The physician
will ask questions regarding the nature and history of the
pain, as well doing an abdominal exam to feel for in-
flammation, tenderness, and rigidity. Bowel sounds will
be decreased or absent. A blood test will be given, be-
cause an increased white cell count may help confirm a
diagnosis of appendicitis. Urinalysis may help to rule out
a urinary tract infection that can mimic appendicitis. In
cases with a questionable diagnosis, other tests, such as a
computed tomography scan (CT) or ultrasound may be
performed to help with diagnosis without resorting to
surgery. Abdominal x rays, however, are not of much
value except when the appendix has ruptured.
112
Patients whose symptoms and physical examination
are compatible with a diagnosis of appendicitis are usu-
ally hospitalized and a surgical exploration of the ab-
domen, called a laparotomy, is done immediately to con-
firm the diagnosis. A normal appendix is discovered in
about 10-20% of patients who undergo laparotomy. Be-
cause of the potential for a life-threatening ruptured ap-
pendix, persons suspected of having appendicitis are
often taken to surgery before the diagnosis is certain. If
the symptoms are not clear, surgery may be postponed
until they progress enough to confirm a diagnosis. Some-
times the surgeon will remove a normal appendix as a
safeguard against appendicitis in the future.
Treatment
Appendicitis must be treated by a surgeon in a hos-
pital setting. However, acupressure can be helpful for
recuperation. One dose of homeopathic phosphorus 30c
can be taken before surgery to help reduce nausea, light-
headedness, and disorientation due to anesthesia. Phos-
phorus 6c can be also taken two to three times in the
hours following surgery. Other appropriate remedies
may include Aconite napellus 30c, Arnica montana 30c,
Gelsemium 6c, and Staphysagria 30c.
Allopathic treatment
The treatment for sudden, severe appendicitis is
surgery to remove the appendix, called an appendecto-
my. An appendectomy may be done by opening the ab-
domen in the standard operating technique, or through
laparoscopy, in which a small incision is made through
the navel. Recovery may be faster with a laparoscopy
than with an ordinary appendectomy. An appendectomy
should be performed within 48 hours of the first appear-
ance of symptoms, to avoid a rupture of the appendix
and peritonitis. Antibiotics are given before surgery in
case peritonitis has already taken hold. If peritonitis is
discovered, the abdomen must also be irrigated and
drained of pus, and then treated with multiple antibiotics
for 7-14 days.
Expected results
Appendicitis is usually treated successfully by ap-
pendectomy. Unless there are complications, the patient
should recover without further problems. The mortality
rate in cases without complications is less than 0.1%.
When an appendix has ruptured, or a severe infection has
developed, the likelihood is higher for complications,
with slower recovery, or death from disease. There are
higher rates of perforation and mortality among children
and the elderly.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Laparotomy — Surgical incision into the loin, be-
tween the ribs and the pelvis, which offers sur-
geons a view inside the abdominal cavity.
Pus — A fluid formed in infected tissue, consisting
of while blood cells and cellular debris.
Prevention
Appendicitis is probably not preventable, although
there is some indication that a diet high in leafy green
vegetables may help prevent appendicitis.
Resources
BOOKS
The Editors of Time-Life Books. The Medical Advisor-: The
Complete Guide to Alternative and Conventional Treat-
ments. Virginia: Time-Life, Inc., 1996.
Lininger, D.C., Skye, editor-in-chief, et al. The Natural Phar-
macy. California: Prirna Health, 1998.
Yamada, Tadataka, ed. et al. Textbook of Gastroenterology.
Philadelphia: J.B. Lippincott, 1995.
PERIODICALS
Van Der Meer, Antonia. “Do You Know the Warning Signs of
Appendicitis?” Parents Magazine (April 1997).
Wagner J.M., et al. "Does This Patient Have Appendicitis?”
JAMA: The Journal of the American Medical Association
276 (1996).
Patience Paradox
Applied kinesiology
Definition
Applied kinesiology (AK) is the study of muscles
and the relationship of muscle strength to health. It in-
corporates a system of manual muscle testing and thera-
py. AK is based on the theory that an organ dysfunction
is accompanied by a specific muscle weakness. Diseases
are diagnosed through muscle-testing procedures and
then treated. AK is not the same as kinesiology, or bio-
mechanics, which is the scientific study of movement.
Origins
AK is based on principles of functional neurology,
anatomy, physiology, biomechanics, and biochemistry as
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
well as principles from Chinese medicine, acupuncture,
and massage. It was developed from traditional kinesiol-
ogy in 1964 by George G. Goodheart, a chiropractor
from Detroit, Michigan. He observed that each large
muscle relates to a body organ. A weakness in a muscle
may mean that there is a problem in the associated
organ. Goodheart found that by treating the muscle and
making it strong again, he was able to improve the func-
tion of the organ as well. For example, if a particular nu-
tritional supplement was given to a patient, and the mus-
cle tested strong, it was the correct supplement for the
patient. If the muscle remained weak, it was not. Other
methods of treatment can be evaluated in a similar man-
ner. Goodheart also found that painful nodules (small
bumps) may be associated with a weak muscle. By
deeply massaging the muscle, he was able to improve its
strength. Goodheart ’s findings in 1964 led to the origin
and insertion treatment, the first method developed in
AK. Other diagnostic and therapeutic procedures were
developed for various reflexes described by other chiro-
practors and doctors. Goodheart incorporated acupunc-
ture meridian therapy into AK after reading the writings
of Felix Mann, M.D.
Goodheart considered AK to be a therapeutic tool
that incorporates feedback from the body. He said that
“applied kinesiology is based on the fact that the body
language never lies.” He felt that the body’s muscles
were indicators of disharmony. Once muscle weakness
has been ascertained, the problem may be solved in a va-
riety of ways. If a practitioner approaches the problem
correctly, he believed, making the proper and adequate
diagnosis and treatment, the outcome is satisfactory both
to the doctor and to the patient.
Benefits
AK is not designed for crisis medicine. For example,
an AK practitioner cannot cure cancer, arthritis, diabetes,
heart disease, or infections. This therapy is designed to
be a part of a holistic approach to preventive medicine.
The goals of AK are to (1) restore normal nerve function,
(2) achieve normal endocrine, immune, digestive, and
other internal organ functions, (3) intervene early in de-
generative processes to prevent or delay pathological con-
ditions, and to (4) restore postural balance, correct gait
(walking) impairment, and improve range of motion.
Description
According to AK, each muscle in the body relates to
a specific meridian or energy pathway (acupuncture
lines) in the body. These meridians also relate to organs
or glands, allowing the muscles to provide information
about organ or gland function and energy. The five areas
113
Applied kinesiology
Applied kinesiology
GEORGE GOODHEART 1918-
Dr. George Goodheart was born in Detroit, Michi-
gan, in 1918 and became a second-generation doctor
of chiropractic. He graduated from the National College
of Chiropractic in 1939 and is recognized as the
founder and developer of applied kinesiology. After he
joined the U.S. Air Force as an aviation cadet in World
War II, he received a promotion to major at the age of
22. He was the youngest ever to attain that rank. He
served in active duty from 1941-1946 and continued as
a member of the Air Force Reserve until the mid-1 950s.
Goodheart held numerous positions of distinction
during his career, including director of the National
Chiropractic Mutual Insurance Company and director
for the International College of Applied Kinesiology-
U.S.A. He also lectured and taught throughout the Unit-
ed States, Japan, Europe, and Australia; and he was the
official doctor of chiropractic for the Lake Placed Win-
ter Olympic Games in 1980. He contributes to a variety
of trade publications on a regular basis.
In 1998 Goodheart received a Lifetime Achieve-
ment Award from the International College of Kinesiolo-
gy. Earlier, in 1987 he was honored with the Leonardo
da Vinci Award from the Institute for the Achievement of
Human Potential, and he was cited for his research by
Logan and Palmer Colleges of Chiropractic. He repre-
sented the State of Michigan as a delegate to the Ameri-
can Chiropractic Association and was a fellow at the In-
ternational College of Chiropractic. He resides with his
wife, JoAnn in Grosse Pointe Woods, Michigan, where
he enjoys skiing and tennis.
Gloria Cooksey
of diagnosis and therapy for the applied kinesiologist are
(1) the nervous system, (2) the lymphatic system, (3) the
vascular (blood vessel) system, (4) the cerebrospinal sys-
tem, and (5) the meridian system.
The first part of AK is muscle testing, which is used
to help diagnose what part of the body is functioning ab-
normally. Muscle testing involves putting the body into a
position that requires a certain muscle to remain contract-
ed, and then applying pressure against the muscle. The
testing does not measure strength but is meant to reveal
stresses and imbalances in the body through the tension
in the muscle. The test evaluates the ability of a control-
ling system (like the nervous system) to adapt the muscle
to meet the changing pressure of the examiner’s test. AK
practitioners also examine structural factors such as pos-
ture, gait, and range of motion. Some chiropractors use
AK to help them evaluate the success of spinal adjust-
114
ment. A leg muscle is tested for strength or weakness to
determine whether the adjustments made are appropriate.
According to AK, common internal causes of mus-
cle weakness include;
• dysfunction of nerve supply (nerve interference be-
tween spine and muscles)
• impairment of lymphatic drainage
• reduction of blood supply
• abnormal pressure in cerebral fluid affecting nerve-to-
muscle relationships
• blockage of an acupuncture meridian
• imbalance of chemicals
• dysfunction of organs or glands
• excesses or deficiencies in nutrition
Physiological reactions to chemicals, including
those associated with nutrition and allergies, may also
be evaluated using AK. The AK protocol for testing
chemical compounds is to place the substance on the pa-
tient’s tongue so that he tastes the material, and the nor-
mal chemical reactions of ingestion begin. In some
cases, the substances are inhaled through the nose. The
AK practitioner then tests the associated muscle-organ
pattern to determine where or if there is a strength or
weakness. The patient does not need to swallow the sub-
stance for a change in strength or weakness to be identi-
fied. David S. Walther, a diplomate of the International
College of Applied Kinesiology, has indicated that “it is
possible that the central nervous system, recognizing the
compound being ingested, relays information to the or-
gans and glands preparing for use of the compound. If
the compound is recognized as beneficial, the energy
pattern is immediately enhanced, influencing not only
the organ or gland, but also the associated muscle.”
AK has been used as a diagnostic health tool for a
variety of conditions.
Bone health
• neck/low back pain and sciatica
• whiplash
• frozen shoulder
Joint health
• carpal tunnel syndrome
• arthritis (including rheumatoid arthritis)
• sports injuries
Muscle health
• tennis elbow
• heel spurs
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
wound healing
intermittent claudication (pain on walking)
restless legs
cramps
Vascular system health
aching varicose veins
palpitations
high blood pressure
Nervous system health
migraine and other headaches
trigeminal neuralgia and other face pains
Bell’s palsy
anxiety
depression
fears
addictions (like smoking)
claustrophobia
Meniere’s disorder
neuralgia (severe, throbbing pain)
travel sickness
fatigue
phantom limb pain
paralysis of leg or arm after a stroke
Respiratory system health
hay fever
rhinitis (inflammed nasal passages)
asthma
bronchitis
emphysema (lung disease)
Urinary system health
cystitis (bladder inflammation), especially in the elderly
early prostate enlargement
non-specific urethritis (inflammation of tube from the
bladder)
bedwetting
Reproductive organ health
menstrual pains
irregular or excessive menstrual activity
pelvic pains and endometriosis
menopausal flushes
painful, nodular breasts
• preparation for childbirth
• vaginal pain
• post herpetic (shingles) pain
• impotence and infertility
Skin health
• pain after operations
• painful, prominent scars
• wrinkles or bagginess of face
• acne
• psoriasis and eczema (skin diseases)
• boils
• excessive perspiration
• hemorrhoids
• canker sores
• itching
Immune system health
• recurring tonsillitis (inflammed tonsils)
• persisting weakness after a severe illness
Sensory organ health
• tinnitus (ringing ears)
• tired eyes
• retinitis pigmentosa and pterygium retinitis (diseases of
the retina)
Digestive system health
• constipation
• colitis or other bowel inflammations
• ulcers
• diarrhea
• obesity
The second part of AK involves the treatment phase.
Goodheart and other practitioners of AK have adapted
many treatment methods for the problems that are diag-
nosed with muscle testing. Examples of treatment meth-
ods include special diets, dietary supplements, chiro-
practic manipulation, osteopathic cranial techniques,
acupuncture/meridian therapies, acupressure, deep mus-
cle massage, and nervous system coordination proce-
dures. For example, an AK practitioner might treat asth-
ma by looking for weaknesses in specific lower back and
leg muscles that share a connection with the adrenal
glands. The practitioner will strengthen these muscles
and help the adrenal gland produce bronchodilators,
chemicals that relax or open air passages in the lungs.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
115
Applied kinesiology
Applied kinesiology
The practice of kinesiology requires that it be used
in conjunction with other standard diagnostic methods
by professionals trained in clinical diagnosis. Most prac-
titioners of AK are chiropractors, but naturopaths, med-
ical doctors, dentists, osteopaths, nutritionists, physical
therapists, massage therapists, podiatrists, psychiatrists,
and nurse practitioners are also involved. In 1991, 37.2%
of 4,835 full-time chiropractors in the United States who
responded to a survey by the National Board of Chiro-
practic Examiners (NBCE) said they used AK in their
practice. Subsequent NBCE surveys indicated that 31%
of chiropractors in Canada, 60% in Australia, and 72% in
New Zealand use AK.
Most practitioners of AK utilize a holistic approach
and evaluate a person from a triad-based health perspec-
tive. Generally, chiropractors approach health and heal-
ing from a structural basis, medical doctors generally
from a chemical basis, and psychiatrists and psycholo-
gists from a mental or emotional basis. Applied kinesiol-
ogists attempt to work with all three areas of health, and
in some cases, include a spiritual dimension.
The use of AK is often included in insurance cover-
age if the policy covers chiropractor benefits. The cost of
the AK examination is similar to the costs of other chiro-
practic practices.
Preparations
Since AK is a non-invasive diagnostic tool, there are
no preparations required.
Precautions
AK should only by used by trained professionals
with the necessary expertise to perform specific and ac-
curate tests. The AK examination should be combined
with a standard physical diagnosis, which often includes
laboratory tests, x rays, health and dietary history, and
other special tests. An AK examination should enhance a
standard diagnosis, not replace it. The total diagnostic
work-up should be used to determine the final diagnosis.
The use of manual muscle testing to evaluate nutri-
tion is particularly a problem if it is done by a lay nutri-
tion sales person as a tool to sell his/her product. The per-
son should have the educational background to evaluate
nutritional needs as well as have a high level of knowl-
edge in the use of proper muscle testing techniques.
Side effects
If AK is performed by a trained practitioner with the
appropriate educational background, side effects from
the muscle-testing procedures should be minimal.
116
Research & general acceptance
AK is a tool that is used by many health care profes-
sionals, and especially by chiropractors. A literature re-
view published in 1999 by researchers from the School
of Medicine at the University of North Carolina at
Chapel Hill and the Foundation for Allied Conservative
Therapies Research in Chapel Hill stated that, although
AK appears to be a promising methodology, there is a
lack of research results relevant to clinical practice and
outcomes of AK care. They found this lack of results
surprising, since cost, satisfaction, utilization, and
changes in symptoms are the important results of clinical
practice. In addition, they determined that some studies
that were supposed to be an evaluation of AK procedures
did not actually use clinical practices and principles of
AK. However, from studies adhering to AK principles
and employing standardized training by well-trained
practitioners, they did state there was some evidence that
AK is an objectively verifiable phenomenon. They sug-
gested that “future studies of AK should focus on out-
comes of care, including symptoms, function, costs, and
safety. Only well-designed studies that account for the
individual nature of AK diagnosis and treatment and pre-
serve the proper clinical context of AK treatment will be
informative. Understanding the individual components
of the process of AK treatment remains important. Stud-
ies addressing validation of isolated AK procedures need
to meet the methodological challenges of studying ap-
propriate subjects that reflects the current recognized
practice and understanding of AK. Further evaluation of
the basic physiologic phenomena involved and correla-
tion of AK manual muscle test results will also advance
understanding of this diagnostic and therapeutic system.”
Training & certification
In 1976, a group of doctors who were practicing AK
founded the International College of Applied Kinesiology
(ICAK). The purpose of the ICAK is to promote teaching
and research of AK. The college does not have physical
buildings. Instead, it is an organization to bring together
those in the health field with common interests and goals
and to provide education in the use of AK. The organiza-
tion has chapters representing Belgium, Luxembourg,
and the Netherlands (BeNeLux), Germany, France, Italy,
Germany, Scandanavia, United Kingdom, Canada, Aus-
tralia and Asia (Australasia), and the United States.
AK is performed by a healthcare professional who
has basic education in his or her field of practice. To be-
come an applied kinesiologist, the healthcare profession-
al must study the principles in a basic course, which in-
cludes 100 hours of classroom study taught by a diplo-
mate of the ICAK. At the end of this course, students
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
take a basic proficiency test. To obtain certification by
the board of ICAK, the professional must complete 300
hours of continuing classes, pass a diplomate test (a
comprehensive written and practical test), and present
two research papers to the general membership of ICAK.
Resources
BOOKS
Holdway, Anne. Kinesiology: Muscle Testing and Energy Bal-
ancing for Health and Well-Being. Rockport, MA: Ele-
ment, 1997.
Valentine, Tom, Carol Valentine, and D.P. Hetrick. Applied Ki-
nesiology. Rochester, VT: Healing Arts Press, 1989.
ORGANIZATIONS
International College of Applied Kinesiology. 6405 Metcalf Ave„
Suite 503, Shawnee Mission, KS 66202. 913-384-5336.
<http://www.icakusa.com and http://www.icak.com>
Judith Sims
Apricot seed
Description
Apricot seed is the small kernel enclosed within the
wood-like pit at the center of the apricot fruit. The apri-
cot tree carries the botanical name Primus armeniaca. It
is a drupe, meaning stone-fruit, and a close relative of
the peach. Both are very similar in appearance and quali-
ties. The apricot is also sometimes called apricock or Ar-
meniaca vulgaris. Like the plum, both peaches and apri-
cots are distantly related to the rose and are classified as
members of the Rosacaeae family.
Apricots grow on small to medium size trees, which
are hardy in most temperate areas. White, multi-petaled
blossoms with a slight reddish tinge nearer to the base of
the flower emerge onto the bare branches in early spring,
before the tree's heart-shaped leaves appear. By late July
or early August, the apricot fruit ripens. There are more
than 20 varieties of apricot known to botanists.
The name Primus armeniaca is actually a misnomer
based upon the long-held belief that apricots initially came
from Armenia. It is now known that in reality they originat-
ed in the Far East, most likely in the Himalayas and North-
ern China. It is speculated that the apricot had already mi-
grated to the Middle East before the Old Testament and that
the apples described in the Garden of Eden in Genesis were
actually apricots. During the reign of King Henry VIII in
the 1500s, apricots were brought to England from Italy.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Though smaller than the peach, apricots have the
same russet-tinted, golden, velvet appearing exterior and
deeper golden-orange flesh inside. The innermost layers
form the large, woody compressed stone, or pit, that con-
tains at its very center, the kernel, or seed. When pressed,
nearly half of this kernel gives forth an oil very chemi-
cally similar to the oil found in sweet almond and peach
kernels. This oil contains olein, glyceride of linoleic
acid, and a transparent, crystalline chemical compound,
amygdalin, or laetrile. This compound is also known as
vitamin B 17 . The oil is chemically indistinguishable from
oil of bitter almond. Although the oil from apricot seeds
usually breaks down into a toxic substance capable of
causing death within the human body, there are also vari-
eties of apricot seed that are reported to be edible.
General use
Because the oil from the apricot seed is far less ex-
pensive than oil of almond, confectioners use it in place of
bitter almond oil for flavoring sweets and as a culinary
seasoning. A liqueur manufactured in France is made
from apricot seed and is called Eau de Noyaux. Apricot oil
is also used extensively in the manufacture of cosmetics,
often being fraudulently added to almond oil. It has skin
softening properties and is often used in making soaps,
hand creams, cold cream, and perfume preparations.
Chinese Medicine practitioners use apricot seed as a
treatment in respiratory diseases, including bronchitis
and emphysema. It is believed to act as an cough sup-
pressant and expectorant and, because of the oil, also
used as a laxative.
There has been considerable controversy regarding
apricot seed, and specifically amygdalin, one of its com-
ponents. Since the 1920, in many countries around the
globe it has been recognized as a possible cancer preven-
tative and malignant cell growth inhibitor. In San Francis-
co, biochemist Ernst Krebs’s article The Nitrilosides ( Vit-
amin B 17 )-Their Nature , Occurrence and Metabolic Sig-
nificance (Antineoplastic Vitamin B I7 ) theorized that
amygdalin, with diet and vitamins, could inhibit cancer-
ous growths. In the years since, it has been used in many
countries as a cancer treatment, thought to be especially
beneficial in the treatment of smoking-related tumors
such as lung cancer. Several studies done in the United
States throughout the 1970s and early 1980s demonstrat-
ed that amygdalin did not kill cancer cells. Review of pa-
tients’ records where there had been reported cures or re-
markable size reduction in tumors did not provide credi-
ble evidence of amygdalin ability to treat cancer effec-
tively. There has been significant documentation that
amygdalin breaks down into cyanide, a potent poison, in
117
Apricot seed
Arginine
KEY TERMS
Expectorant — An agent that facilitates the removal
of the secretions of the bronchopulmonary mu-
cous membrane.
Unapproved drug — The FDA is responsible for en-
suring that biological products are safe and effec-
tive and in compliance with the law and FDA reg-
ulations. Biological products are licensed under
the provisions of Section 351 of the Public Health
Service Act (42USCKPHS Act).
the human body, and when taken in sufficiently high
doses, can actually bring on death due to its toxicity.
Preparations
Apricot seed is not sold in American health food
stores due to its classification as an unapproved drug by
the U.S. Food and Drug Administration. However, it is
available in other countries, including Mexico, and in
Chinese pharmacies and Asian markets. It is sold both as
the whole kernel or seed, or in decoctions including
cough syrups. Chinese practitioners usually combine
apricot seed with other herbs, including white mulberry
leaf or ophiopogon, a tuber grown in Asia. A paste made
of apricot seed and sugar has been shown, in some Chi-
nese medical trials, to relieve chronic bronchitis.
Precautions
As noted previously, the amygdalin in apricot seed
breaks down within the body into a form of the deadly
poison cyanide, or prussic acid. There has been consider-
able debate concerning its level of toxicity to human be-
ings. Following an Oklahoma judicial decision legalizing
the importation of amygdalin in 1986, clinical trials were
begun by the FDA and National Cancer Institute in 1987.
Amygdalin was used, along with the diet, enzymes, and
vitamins suggested by pro-amygdalin factions. The re-
port from this study concludes: “No substantive benefit
was observed in terms of cure, improvement, or stabi-
lization of the cancer.’’ They further reported that “the
hazards of amygdalin therapy were evidenced in several
patients by symptoms of cyanide toxicity or by blood
cyanide levels approaching lethal range. Amygdalin is a
toxic drug that is not effective as a cancer treatment.” It
has been reported that ten apricot seeds can kill a child.
Side effects
Chinese practitioners caution using apricot seed if the
person being treated suffers from diarrhea. Headache
118
and nausea have been reported following ingestion of
small amounts. The most serious side effect of apricot
seed is potential cyanide poisoning. When large doses of
cyanide are ingested, death is almost instantaneous. Toxic-
ity from smaller doses is manifested by vomiting, diar-
rhea, mental confusion, vertigo, headache, extreme dysp-
nea, and violent respirations, slow pulse, weakness, glassy
or protruding eyes, dilated pupils, and a characteristic
(peach blossoms, bitter almond) odor to the breath.
Interactions
Practitioners of Chinese medicine advise that apri-
cot seed should not be given in combination with the
herbs astragalus, skullcap, or kudzu root.
Resources
BOOKS
Carper, Jean. The Food Pharmacy. Bantam Books, 1988.
Grieve, M. and C. F. Leyel. A Modern Herbal: The Medical,
Culinary, Cosmetic and Economic Properties, Cultivation
and Folklore of Herbs, Grasses, Fungi, Shrubs and Trees
With All of Their Modern Scientific Uses. Barnes & Noble
Publishing, 1992.
Holvey, David N., MD. Merck Manual. Sharp & Dohme Re-
search Laboratories, 1972.
Taber, Clarence Wilbur. Taber's Cyclopedic Medical Dictio-
nary. F.A. Davis Co.
PERIODICALS
Krebs, Ernst T., Jr. “The Nitrilosides (Vitamin B-17)-Their Na-
ture, Occurence and Metabolic Significance Antineoplas-
tic Vitamin B- 17).” Journal of Applied Nutrition 1970.
ORGANIZATIONS
U.S. Food and Drug Administration. HFI-40, Rockville, MD
2085.1-888-463-6332. webmail@oc.fda.gov. http://www.
fda.gov/bbs/topics/ANSWERS/ANS00309.htm.
Joan Schonbeck
Arbor vitae see Thuja
Arginine
Description
Arginine is one of the amino acids produced in the
human body by the digestion, or hydrolysis of proteins.
Arginine can also be produced synthetically. Because it
is produced in the body, it is referred to as “nonessen-
tial,” meaning that no food or supplements are necessary
for humans to ingest. Arginine compounds can be used
in treating people with liver dysfunction due to its role in
promoting liver regeneration.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
General use
In March 2000 in Newsweek magazine, Stephen
Williams noted the newly discovered role arginine might
play in treating people with chronic heart failure (CHF).
The study, as reported in the Journal of the American Col-
lege of Cardiology involved 40 patients who suffered from
CHF. Rainer Hambrecht and colleagues from the Univer-
sity of Leipzig in Germany did the research by dividing
the group into four sections. One group took 8 g of argi-
nine daily for four weeks. A second took no supplement,
but did daily forearm exercises. The third did both the ex-
ercises, and took the supplement daily. The fourth group
was a control group and did nothing except taking their
usual medication, as did the others. Because of the known
fact that arginine is naturally converted into nitric oxide by
the human body, the result of that chemical relaxing blood
vessels was also known when the experiment began. The
group that took the arginine alone showed an improve-
ment in their blood-vessel dilation by four times, as did
the group doing exercises alone. The third who did both,
showed an increase six times better than the original
blood-dilation factor. Promise in the future use of arginine
in treating heart patients with this condition was indicated
as researchers continued to perform further tests. Accord-
ing to an article by Liz Brown written in Better Nutrition
in June 2000, also discussing the Leipzig study, “Numer-
ous other studies have shown that arginine has a vadodila-
tory effect on people with high cholesterol levels, those
with high blood pressure and others with compromised
circulation associated with heart disease.”
Other research in the use of arginine has indicated
that arginine is crucial to the wound-healing process,
particularly in the elderly for whom blood circulation is
poor. Arginine is necessary for growth periods but not
for body maintenance.
Benefits of the use of arginine as a supplement include:
• improves immune response to bacteria, viruses, and
tumor cells.
• promotes wound healing by repairing tissues
• plays a crucial role in the regeneration of liver
• responsible for release of growth hormones
• promotes muscle growth
• improves cardiovascular functioning
Arginine is used as a supplement in the treatment of
heart patients with arterial heart disease; as an intra-
venous supplement to patients with liver dysfunction; as
a supplement for easing exercise-related pains due to the
heart muscle not getting enough blood to circulate to the
muscles in the calves. Supplements that combine argi-
nine with other amino acids, such as ornithine and
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
lysine, are purported to assist in muscle-building exercis-
es by minimizing body fat and maximizing muscle tone.
Results vary among those who have taken these supple-
ments. Arginine is also present in “multi” amino acids
capsules that are taken as a dietary supplement.
New information released in 2002 showed that treat-
ment with arginine improved immune function in HIV
patients and proved safe for these patients when used on
a short-term patients. Other new research was finding
that arginine supplements worked as an effective antico-
agulant, but unlike aspirin and other anticoagulants,
could prevent clotting without increasing stroke risk.
New research also is showing arginine’s effectivenss in
fighting cancer and protecting and detoxifying the liver,
improving male fertility, and promoting healing.
Preparations
Arginine supplements as an alternative medicine
therapy are normally taken in either tablet or capsule
form. In naturopathic treatment of liver dysfunction, the
supplement would be added intravenously as a powder
diluted in liquid. Discoveries reported in 2000 indicated
that in the treatment of arterial heart disease, the inges-
tion of arginine tablets or capsules of 6-9 g a day are
helpful in dilating blood vessels to ease circulation and
prevent the buildup of cholesterol.
Precautions
Long-term effects of arginine supplements have not
yet been determined. Consultation with a physician re-
garding individual needs is always advised. Individuals
who attempt to treat their own heart ailments, or intend
to guard against any potential difficulty, should seek ad-
vice of a physician. Arginine does not show any positive
results in treatment of men with damaged valves or en-
larged heart tissue.
Arginine has been suspected in the formation of cold
sores. Some practitioners suggest that consuming foods
high in arginine, such as nuts, grains, and chocolates, can
promote cold sores. Reducing intake of foods high in
arginine and increasing intake of lysine (another amino
acid) can reduce or even eliminate the cold sore problem.
Side effects
As previously noted, the use of supplemental argi-
nine should be monitored for use with specific problems.
Overdose could result in unforeseen complications,
while regular use might or might not help ease everyday
problems, such as relaxation of muscles not due to the
specific heart ailment of arterial disease. People who
should not take arginine supplements are those predis-
119
Arginine
Arnica
posed to herpes outbreaks; cancer patients, due to possi-
ble increase in cell replication of cancerous cells; those
with low blood pressure; and individuals with certain
liver or kidney problems. Those taking blood thinners
are advised to seek medical advice before taking the sup-
plement. Pregnant women are also cautioned against tak-
ing the supplements due to the unknown affect it could
have on both mother and child.
Interactions
Long-term studies are ongoing. While no adverse re-
actions of ordinary supplements of 6-9 g a day have yet
been documented, caution is urged. Because amino acids
are not drugs, their use is not regulated by the U.S. Food
and Drug Administration (FDA). One study in April 1999
in Healthlnform: Essential Information on Alternative
Health Care reported that nutritional supplements of argi-
nine with omega-3 fatty acids for outpatients with HIV
showed no particular benefits in immunity.
Resources
PERIODICALS
“Arginine Treatment man Improve Immune Function.” AIDS
Weekly (September 23, 2002):3.
Brown, Edwin W. “Troubled by Cold Sores?” Medical Update
(March 1999).
Brown, Liz. “Arginine and Exercise." Better Nutrition ( June
2000 ).
Chowienczyk, Phil and Jim Ritter. “Arginine: NO more than a
simple amino acid?” The Lancet 27 (September 1997).
Gerard, James M. and Atchawee Luisiri. “A fatal overdose of
arginine hydrochloride.” Journal of Toxicology (Novem-
ber 1997).
Henderson, Charles W. “Suppression of Arginine Transport and
Nitric Oxide Synthesis in Activated Macrophages by Cat2
Antisense Oligonucleotides.” Cancer Weekly Plus (28 De-
cember 1998).
Klotter, Jule. “Arginine and Heart Disease.” Townsend Letter
for Doctors and Patients (August-September 2002): 22.
Marandino, Cristin. “Taking Heart.” Vegetarian Times (Novem-
ber 1999).
Pessarosa, A.; Dazzi. D.; Negro, C.; Cebigni, C.; Vescovi, P. P.
“Effects of Alcohol Consumption and Accompanying Diet
on Metabolic Response to Arginine in Chronic Alco-
holics.” Journal of Studies on Alcohol (September 1999).
“Prospective Study tests Nutritional Supplements enriched
with Arginine and Omega-3 Fatty Acids.” Healthlnform:
Essential Information on Alternative Health Care (April
1999).
Rodale Press. “Bypass This Snack." Men's Health (November
1999).
Rodale Press. "Is Being Henpecked Hereditary?" Mens Health
(January 2000).
Thomas, Clayton, L., M.D., M.P.H., ed. “Hyperkalemia.” Taber’s
Cyclopedic Medico Dictionary. Edition 13 Philadelphia: F.
A. Davis Company, 1977.
120
KEY TERMS
Hyperkalimia — Excessive amount of potassium in
the blood that serves as an indicator of the possi-
ble serious complications in bodily functions.
Webb, Denise. “Ease Exercise-Related Pains with Arginine.”
Prevention December 1999.
Williams, Stephen. “Passing the Acid Test.” Newsweek 27
March 2000.
OTHER
“Arginine.” Mosby’s Medical. Nursing & Allied Health Dictio-
nary, Edition 5 1998. Available from <http://web2.infotrac.
galegroup.com/itw.>
Jane Spehar
Teresa G. Odle
Arnica
Description
Arnica ( Arnica montana L.), known also as leopards-
bane, wolfsbane, and European arnica, is a member of the
Compositae (Asteraceae) family. This attractive herb is
native to the mountains of Siberia and central Europe,
where the leaves were smoked as a substitute for tobacco.
This practice led to a common name for the herb: moun-
tain tobacco. There are several North American species of
arnica, including A. fulgens, A. sororia, and A. cordifolia.
Arnica thrives in the northern mountains of the United
States and Canada, in high pastures and woodlands.
Arnica grows from a cylindrical, hairy rhizome with a
creeping underground stem. First year leaves are downy
and grow in a flat rosette at the base of the stem. In the sec-
ond year, arnica sends up a round, hairy stem with smaller,
sessile leaves growing in one to three opposite pairs. This
central stem may branch into three or more stems each
with a terminal composite blossom. Arnica’s aromatic,
daisy-like flowers have 10-14 bright yellow rays, each
with three notches at the end. Flower rays are irregularly
bent back. The central disk is composed of tubular florets.
Arnica blooms from June to August. The flowerheads,
when crushed and sniffed, may cause sneezing, resulting
in another of arnica’s common names: sneezewort.
History
Arnica has a history of folk medicine use in many lo-
cations, including North America, Germany, and Russian.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
The herb has been used in folk remedies since the six-
teenth century. A North American indigenous tribe, the
Cataulsa, prepared a tea from arnica roots to ease back
pains. The German writer Goethe credited arnica with
saving his life by bringing down a persistent high fever.
Arnica preparations are used extensively in Russia. Folk
use there includes external treatment of wounds, black
eye, sprains, and contusions. Arnica has been used in
Russian folk medicine to treat uterine hemorrhage, my-
ocarditis, arteriosclerosis, angina pectoris, cardiac insuf-
ficiency, and in numerous other unproven applications.
General use
Arnica flowers, fresh or dried, are used medicinally.
Many herbalists consider arnica to be a specific remedy
for bruises, sprains, and sore muscles. The herb is known
by some as “tumbler’s cure all,” reflecting this common
medicinal use. A compress soaked in an arnica infusion
may relieve the inflammation of phlebitis. A few drops of
arnica tincture added to warm water in a foot bath will re-
lieve fatigue and soothe sore feet. A hair rinse prepared
with arnica extract has been used to treat alopecia neuroti-
ca, an anxiety condition leading to hair loss. The very di-
lute homeopathic preparation ingested following a shock
or muscle/soft tissue trauma is said to be beneficial. The
homeopathic preparation is also used to relieve vertigo,
hoarseness, and seasickness. Studies have determined that
arnica has properties that act as an immunostimulant. The
extract of arnica has been shown to stimulate the action of
white blood cells in animal studies, increasing resistance
to bacterial infections, such as salmonella.
German studies have isolated sesquiterpenoid lac-
tones, including helenalin and dihydrohelenalin, in arni-
ca. These compounds were found to possess the pharma-
cologic properties responsible for arnica’s anti-inflamma-
tory and analgesic effects. Arnica contains sesquiterpene
lactones, flavonoid glycosides, alkaloid, volatile oil, tan-
nin, and isomeric alcohol, including arnidio and foradiol.
Arnica is approved for external use as an anti-in-
flammatory, analgesic, and antiseptic by the German
Commission E, an advisory panel on herbal medicines.
There are over one hundred medicinal preparations using
arnica extracts commercially available in Germany. In
the United States, arnica is widely used in topical appli-
cation for bruises, aches, sprains, and inflammations. Ar-
nica was listed in the U.S. Pharmacopeia from the early
1800s until 1960.
Preparations
Arnica is available commercially in the form of lini-
ments and massage oil for external application, and in
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
very dilute homeopathic preparations considered safe for
internal use.
Harvest fully open arnica blossoms throughout the
flowering season. Pick the flower heads on a sunny day
after the morning dew has evaporated. Spread the blos-
soms on a paper-lined tray to dry in a bright and airy room
away from direct sun. Temperature in the drying room
should be at least 70°F (21.1°C). When the blossoms are
completely dry, store in a dark glass container with an air-
tight lid. The dried herb will maintain medicinal potency
for 12-18 months. Clearly label the container with the
name of the herb and the date and place harvested.
Tincture: Combine four ounces of fresh or dried ar-
nica flowers with one pint of brandy, gin, or vodka in a
glass container. The alcohol should be enough to cover
the flowers. The ratio should be close to 50/50 alcohol to
water. Stir and cover. Place the mixture in a dark cup-
board for three to five weeks. Shake the mixture several
times each day. Strain and store in a tightly capped,
clearly labeled, dark glass bottle. Tinctures, properly pre-
pared and stored, will retain medicinal potency for two
years or more. Arnica tincture should not be ingested
without supervision of a qualified herbalist or physician.
Ointment: Simmer one ounce of dried and powdered
arnica flowers with one ounce of olive oil for several
hours on very low heat. Combine this medicinal oil with
melted beeswax to desired consistency. Pour into dark
glass jars while still warm. Seal with tightly fitting lids
when cool and label appropriately.
Infusion: Place two to three teaspoons of chopped,
fresh arnica blossoms in a warmed glass container. Bring
two cups of fresh, nonchlorinated water to the boiling
point, add it to the herbs. Cover. Simmer for about 10
minutes. Strain. The prepared tea will store for about two
days in the refrigerator. The infusion may be used to
bathe unbroken skin surfaces and to provide relief for
rheumatic pain, chillbains, bruises, and sprains. Because
of the toxicity of arnica, it is best to avoid internal use
without qualified medical supervision.
Precautions
Arnica is deadly in large quantities. Do not ingest
the herb or the essential oil. Do not use the undiluted es-
sential oil externally. The extremely dilute homeopathic
preparation of arnica is considered safe for internal use
in proper therapeutic dosages. Overdose of arnica extract
has resulted in poisoning, with toxic symptoms, such as
vomiting, diarrhea, and hemorrhage, even death. Use
externally with caution, and only in dilute preparations.
Only the homeopathic tincture can be safely ingested.
Discontinue if a skin rash results, and do not use on bro-
ken skin. Research has confirmed that alcoholic extracts
121
Arnica
Aromatherapy
of arnica have a toxic action on the heart, and can cause
an increase in blood pressure.
Side effects
Arnica contains a compound known as helenalin, an
allergen that may cause contact dermatitis in some per-
sons. If a rash develops discontinue use of the herbal
preparation. Prolonged external use of arnica extract in
high concentrations can result in blistering, skin ulcers,
and surface necroses.
Interactions
None reported.
Resources
BOOKS
Elias, Jason and Shelagh Ryan Masline. The A to Z Guide to
Healing Herbal Remedies. Lynn Sonberg Book Associ-
ates, 1996.
Hoffmann, David. The New Holistic Herbal. 2d ed. Massachu-
setts: Element, 1986.
Kowalchik, Claire and William H. Hylton. Rodale's Illustrated
Encyclopedia of Herbs. Pennsylvania: Rodale Press,
1987.
Lust, John. The Herb Book. New York: Bantam Books, 1974.
Magic And Medicine of Plants. The Reader's Digest Associa-
tion, Inc. 1986.
Meyer, Joseph E. The Herbalist. Clarence Meyer, 1973.
Palaise, Jean. Grandmother’ s Secrets. Her Green Guide to
Health From Plants. NY: G.P. Putnam's Sons, 1974.
PDRfor Herbal Medicines. New Jersey: Medical Economics
Company, 1998.
Phillips, Roger and Nicky Foy. The Random House Book of
Herbs. New York: Random House, Inc., 1990.
Thomson, M.D., William A. R. Medicines From The Earth, A
Guide to Healing Plants. San Francisco: Harper & Row,
1978.
Tyler, Varro E., Ph.D. Herbs Of Choice, The Therapeutic Use
of Phytomedicinals. New York: The Haworth Press, Inc.,
1994.
Tyler, Varro E., Ph.D. The Honest Herbal. New York: Pharma-
ceutical Products Press, 1993.
OTHER
Grieve, Mrs. M. A Modern Herbal, Arnica, <http://botanical.com/
botanical/mgmh/a/amic058.html.>
Hoffmann, David L. Herbal Materia Medica, Hyssop. <http://
www.healthy.net.>
Clare Hanrahan
122
Aromatherapy
Definition
Aromatherapy is the therapeutic use of plant-de-
rived, aromatic essential oils to promote physical and
psychological well-being. It is sometimes used in combi-
nation with massage and other therapeutic techniques as
part of a holistic treatment approach.
Origins
Aromatic plants have been employed for their heal-
ing, preservative, and pleasurable qualities throughout
recorded history in both the East and West. As early as
1500 B.c. the ancient Egyptians used waters, oils, in-
cense, resins, and ointments scented with botanicals for
their religious ceremonies.
There is evidence that the Chinese may have recog-
nized the benefits of herbal and aromatic remedies much
earlier than this. The oldest known herbal text, Shen
Nung's Pen Ts’ao (c. 2700-3000 B.c.) catalogs over 200
botanicals. Ayurveda, a practice of traditional Indian
medicine that dates back more than 2,500 years, also
used aromatic herbs for treatment.
The Romans were well known for their use of fra-
grances. They bathed with botanicals and integrated them
into their state and religious rituals. So did the Greeks,
with a growing awareness of the medicinal properties of
herbs. Greek physician and surgeon Pedanios Dioscorides,
whose renown herbal text De Materia Medica (60 a.d.)
was the standard textbook for Western medicine for 1,500
years, wrote extensively on the medicinal value of botani-
cal aromatics. The Medica contained detailed information
on some 500 plants and 4,740 separate medicinal uses for
them, including an entire section on aromatics.
Written records of herbal distillation are found as
early as the first century a.d., and around 1000 a.d., the
noted Arab physician and naturalist Avicenna described
the distillation of rose oil from rose petals, and the medi-
cinal properties of essential oils in his writings. Howev-
er, it wasn't until 1937, when French chemist Rene-Mau-
rice Gattefosse published Aromatherapie : Les Huiles es-
sentielles, hormones vege tales, that aromatherapie, or
aromatherapy, was introduced in Europe as a medical
discipline. Gattefosse, who was employed by a French
perfumeur, discovered the healing properties of lavender
oil quite by accident when he suffered a severe burn
while working and used the closest available liquid,
lavender oil, to soak it.
In the late twentieth century, French physician Jean
Valnet used botanical aromatics as a front line treatment
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
AROMATHERAPY OILS
Name
Description
Conditions treated
Bay laurel
Antiseptic, diuretic, sedative, etc.
Digestive problems, bronchitis, common cold, influenza,
and scabies and lice. CAUTION: Don't use if pregnant.
Clary sage
Relaxant, anticonvulsive,
antiinflammatory, and antiseptic
Menstrual and menopausal symptoms, burns, eczema, and
anxiety. CAUTION: Don't use if pregnant.
Eucalyptus
Antiseptic, antibacterial, astringent,
expectorant, and analgesic
Boils, breakouts, cough, common cold, influenza, and
sinusitis. CAUTION: Not to be taken orally.
Chamomile
Sedative, antiinflammatory,
antiseptic, and pain reliever
Hay fever, burns, acne, arthritis, digestive problems,
and menstrual an menopausal symptoms.
Lavender
Analgesic, antiseptic,
calming/soothing
Headache, depression, insomnia, stress, sprains, and nausea.
Peppermint
Pain reliever
Indigestion, nausea, headache, motion sickness, and
muscle pain.
Rosemary
Antiseptic, stimulant, and diuretic
Indigestion, gas, bronchitis, fluid retention, and influenza.
CAUTION: Don't use if pregnant or have epilepsy or
hypertension.
Tarragon
Diuretic, laxative, antispasmodic,
and stimulant
Menstrual and menopausal symptoms, gas, and indigestion.
CAUTION: Don't use if pregnant.
Tea tree
Antiseptic and soothing
Common cold, bronchitis, abscesses, acne, vaginitis,
and burns.
Thyme
Stimulant, antiseptic, antibacterial,
and antispasmodic
Cough, laryngitis, diarrhea, gas, and intestinal worms.
CAUTION: Don't use if pregnant or have hypertension.
for wounded soldiers in World War II. He wrote about
his use of essential oils and their healing and antiseptic
properties, in his 1964 book Aromatherapie, traitement
des maladies par les essences des plantes, which popu-
larized the use of essential oils for medical and psychi-
atric treatment throughout France. Later, French bio-
chemist Mauguerite Maury popularized the cosmetic
benefits of essential oils, and in 1977 Robert Tisserand
wrote the first English language book on the subject. The
Art of Aromatherapy, which introduced massage as an
adjunct treatment to aromatherapy and sparked its popu-
larity in the United Kingdom.
Benefits
Aromatherapy offers diverse physical and psycho-
logical benefits, depending on the essential oil or oil
combination and method of application used. Some
common medicinal properties of essential oils used in
aromatherapy include: analgesic, antimicrobial, anti-
septic, anti-inflammatory, astringent, sedative, anti-
spasmodic, expectorant, diuretic, and sedative. Essen-
tial oils are used to treat a wide range of symptoms
and conditions, including, but not limited to, gastroin-
testinal discomfort, skin conditions, menstrual pain
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
and irregularities, stress-related conditions, mood dis-
orders, circulatory problems, respiratory infections,
and wounds.
Description
In aromatherapy, essential oils are carefully selected
for their medicinal properties. As essential oils are ab-
sorbed into the bloodstream through application to the
skin or inhalation, their active components trigger cer-
tain pharmalogical effects (e.g., pain relief).
In addition to physical benefits, aromatherapy has
strong psychological benefits. The volatility of an oil, or
the speed at which it evaporates in open air, is thought to
be linked to its specific psychological effect. As a rule of
thumb, oils that evaporate quickly are considered emo-
tionally uplifting, while slowly-evaporating oils are
thought to have a calming effect.
Essential oils commonly used in aromatherapy treat-
ment include:
• Roman chamomile ( Chamaemelum nobilis). An anti-
inflammatory and analgesic. Useful in treating otitis
media (earache), skin conditions, menstrual pains, and
depression.
123
Aromatherapy
Aromatherapy
Limbic system of the brain
As a holistic therapy, aromatherapy is believed to benefit both the mind and body. Here, the aromatic substances from a
flower stimulates the olfactory bulb and neurons. The desired emotional response (such as relaxation) is activated from the
limbic system of the brain. (Illustration by Electronic Illustrators Group. The Gale Group)
• Clary sage ( Salvia sclarea). This natural astringent is
not only used to treat oily hair and skin, but is also said
to be useful in regulating the menstrual cycle, improv-
ing mood, and controlling high blood pressure. Clary
sage should not be used by pregnant women.
• Lavender ( Lavandula officinalis). A popular aromather-
apy oil that mixes well with most essential oils, laven-
der has a wide range of medicinal and cosmetic appli-
cations, including treatment of insect bites, burns, res-
piratory infections, intestinal discomfort, nausea, mi-
graine, insomnia, depression, and stress.
• Myrtle ( Myrtus communis). Myrtle is a fungicide, dis-
infectant, and antibacterial. It is often used in steam
aromatherapy treatments to alleviate the symptoms of
whooping cough, bronchitis, and other respiratory in-
fections.
124
• Neroli (bitter orange), ( Citrus aurantium). Citrus oil
extracted from bitter orange flower and peel and used
to treat sore throat, insomnia, and stress and anxiety-
related conditions.
• Sweet orange ( Citrus sinensis). An essential oil used to
treat stomach complaints and known for its reported
ability to lift the mood while relieving stress.
• Peppermint ( Mentha piperita). Relaxes and soothes the
stomach muscles and gastrointestinal tract. Peppennint’s
actions as an anti-inflammatory, antiseptic, and antimi-
crobial also make it an effective skin treatment, and use-
ful in fighting cold and flu symptoms. In addition, re-
search in 2002 found that peppermint scent helped ath-
letes run faster and perform more push-ups than control
subjects with odorless strips under their noses.
• Rosemary ( Rosmarinus officinalis). Stimulating essential
oil used to treat muscular and rheumatic complaints, as
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
well as low blood pressure, gastrointestinal problems, and
headaches. Recently. Brain scans have shown that fra-
grance of rosemary increases blood circulation in the brain.
• Tea tree (Melaleuca alternifolia). Has bactericidal,
virucidal, fungicidal, and anti-inflammatory properties
that make it a good choice for fighting infection. Rec-
ommended for treating sore throat and respiratory in-
fections, vaginal and bladder infections, wounds, and a
variety of skin conditions.
• Ylang ylang ( Cananga odorata). A sedative essential oil
sometimes used to treat hypertension and tachycardia.
Essential oils contain active agents that can have po-
tent physical effects. While some basic aromatherapy
home treatments can be self-administered, medical aro-
matherapy should always be performed under the guid-
ance of an aromatherapist, herbalist, massage therapist,
nurse, or physician.
Inhalation
The most basic method of administering aromather-
apy is direct or indirect inhalation of essential oils. Sev-
eral drops of an essential oil can be applied to a tissue or
handkerchief and gently inhaled. A small amount of es-
sential oil can also be added to a bowl of hot water and
used as a steam treatment. This technique is recommend-
ed when aromatherapy is used to treat respiratory and/or
skin conditions. Aromatherapy steam devices are also
available commercially. A warm bath containing essen-
tial oils can have the same effect as steam aromatherapy,
with the added benefit of promoting relaxation. When
used in a bath, water should be lukewarm rather than hot
to slow the evaporation of the oil.
Essential oil diffusers, vaporizers, and light bulb
rings can be used to disperse essential oils over a large
area. These devices can be particularly effective in aro-
matherapy that uses essential oils to promote a healthier
home environment. For example, eucalyptus and tea tree
oil are known for their antiseptic qualities and are fre-
quently used to disinfect sickrooms, and citronella and
geranium can be useful in repelling insects.
Direct application
Because of their potency, essential oils are diluted in a
carrier oil or lotion before being applied to the skin to pre-
vent an allergic skin reaction. The carrier oil can be a veg-
etable or olive based one, such as wheat germ or avocado.
Light oils, such as safflower, sweet almond, grapeseed,
hazelnut, apricot seed, or peach kernel, may be absorbed
more easily by the skin. Standard dilutions of essential oils
in carrier oils range from 2-10%. However, some oils can
be used at higher concentrations, and others should be di-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
luted further for safe and effective use. The type of carrier
oil used and the therapeutic use of the application may also
influence how the essential oil is mixed. Individuals should
seek guidance from a healthcare professional and/or aro-
matherapist when diluting essential oils.
Massage is a common therapeutic technique used in
conjunction with aromatherapy to both relax the body and
thoroughly administer the essential oil treatment. Essen-
tial oils can also be used in hot or cold compresses and
soaks to treat muscle aches and pains (e.g., lavender and
ginger). As a sore throat remedy, antiseptic and soothing
essential oils (e.g., tea tree and sage) can be thoroughly
mixed with water and used as a gargle or mouthwash.
Internal use
Some essential oils can be administered internally in
tincture, infusion, or suppository form to treat certain
symptoms or conditions; however, this treatment should
never be self-administered. Essential oils should only be
taken internally under the supervision of a qualified
healthcare professional.
As non-prescription botanical preparations, the es-
sential oils used in aromatherapy are typically not paid
for by health insurance. The self-administered nature of
the therapy controls costs to some degree. Aromatherapy
treatment sessions from a professional aromatherapist
are not covered by health insurance in most cases, al-
though aromatherapy performed in conjunction with
physical therapy, nursing, therapeutic massage, or other
covered medical services may be covered. Individuals
should check with their insurance provider to find out
about their specific coverage.
The adage “You get what you pay for” usually ap-
plies when purchasing essential oils, as bargain oils are
often adulterated, diluted, or synthetic. Pure essential
oils can be expensive; and the cost of an oil will vary de-
pending on its quality and availability.
Preparations
The method of extracting an essential oil varies by
plant type. Common methods include water or steam dis-
tillation and cold pressing. Quality essential oils should be
unadulterated and extracted from pure botanicals. Many
aromatherapy oils on the market are synthetic and/or dilut-
ed, contain solvents, or are extracted from botanicals
grown with pesticides or herbicides. To ensure best re-
sults, essential oils should be made from pure organic
botanicals and labeled by their full botanical name. Oils
should always be stored in dark bottles out of direct light.
Before using essential oils on the skin, individuals
should perform a skin patch test by applying a small amount
125
Aromatherapy
Aromatherapy
of the diluted oil behind the wrist and covering it with a ban-
dage or cloth for up to 12 hours. If redness or irritation oc-
curs, the oil should be diluted further and a second skin test
performed, or it should be avoided altogether. Individuals
should never apply undiluted essential oils to the skin unless
advised to do so by a trained healthcare professional.
Precautions
Individuals should only take essential oils internally
under the guidance and close supervision of a health care
professional. Some oils, such as eucalyptus, wormwood,
and sage, should never be taken internally. Many essential
oils are highly toxic and should not be used at all in aro-
matherapy. These include (but are not limited to) bitter al-
mond, pennyroyal, mustard, sassafras, rue, and mugwort.
Citrus-based essential oils, including bitter and
sweet orange, lime, lemon, grapefruit, and tangerine, are
phototoxic, and exposure to direct sunlight should be
avoided for at least four hours after their application.
Other essential oils, such as cinnamon leaf, black
pepper, juniper, lemon, white camphor, eucalyptus blue
gum, ginger, peppermint, pine needle, and thyme can be
extremely irritating to the skin if applied in high enough
concentration or without a carrier oil or lotion. Caution
should always be exercised when applying essential oils
topically. Individuals should never apply undiluted es-
sential oils to the skin unless directed to do so by a
trained healthcare professional and/or aromatherapist.
Individuals taking homeopathic remedies should
avoid black pepper, camphor, eucalyptus, and pepper-
mint essential oils. These oils may act as a remedy anti-
dote to the homeopathic treatment.
Children should only receive aromatherapy treat-
ment under the guidance of a trained aromatherapist or
healthcare professional. Some essential oils may not be
appropriate for treating children, or may require addi-
tional dilution before use on children.
Certain essential oils should not be used by pregnant
or nursing women or by people with specific illnesses or
physical conditions. Individuals suffering from any chron-
ic or acute health condition should inform their healthcare
provider before starting treatment with any essential oil.
Asthmatic individuals should not use steam inhala-
tion for aromatherapy, as it can aggravate their condition.
Essential oils are flammable, and should be kept
away from heat sources.
Side effects
Side effects vary by the type of essential oil used.
Citrus-based essential oils can cause heightened sensitiv-
ity to sunlight. Essential oils may also cause contact
126
dermatitis, an allergic reaction characterized by redness
and irritation. Anyone experiencing an allergic reaction
to an essential oil should discontinue its use and contact
their healthcare professional for further guidance. Indi-
viduals should do a small skin patch test with new essen-
tial oils before using them extensively.
Research & general acceptance
The antiseptic and bactericidal qualities of some es-
sential oils (such as tea tree and peppermint) and their
value in fighting infection has been detailed extensively
in both ancient and modern medical literature.
Recent research in mainstream medical literature
has also shown that aromatherapy has a positive psycho-
logical impact on patients. Several clinical studies in-
volving both post-operative and chronically ill subjects
showed that massage with essential oils can be helpful in
improving emotional well-being, and consequently, pro-
moting the healing process.
Today, the use of holistic aromatherapy is widely ac-
cepted in Europe, particularly in Great Britain, where it
is commonly used in conjunction with massage as both a
psychological and physiological healing tool. In the
United States, where aromatherapy is often misunder-
stood as solely a cosmetic treatment, the mainstream
medical community has been slower to accept its use.
Training & certification
Certification or licensing is currently not required to
become an aromatherapist in the United States; however,
many states require that healthcare professionals who
practice the “hands-on” therapies often used in conjunc-
tion with aromatherapy (e.g., massage) to be licensed.
There are state-licensed educational institutions that
offer certificates and/or diplomas in aromatherapy train-
ing. Individuals interested in aromatherapy treatment
from a professional aromatherapist may be able to obtain
a referral from one of these institutions, or from their
current healthcare provider.
Resources
BOOKS
Lawless, Julia. The Complete Illustrated Guide To Aromathera-
py. Rockport, MA: Element Books Ltd, 1997.
Schnaubelt, Kurt. Medical Aromatherapy: Healing With Essen-
tial Oils. Berkeley, CA: Frog Ltd, 1999.
PERIODICALS
ORGANIZATIONS
Claps, Frank.“Training Scents: You May be Able to Sniff Your
Way to Better Workouts with Tricks from the Aromathera-
pist's Bag.” Men's Fitness (May 2002):34.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Antiseptic — Inhibits the growth of microorgan-
isms.
Bactericidal — An agent that destroys bacteria
(e.g., Staphylococci aureus, Streptococci pneumo-
niae, Escherichia coli, Salmonella enteritidis).
Carrier oil — An oil used to dilute essential oils for
use in massage and other skin care applications.
Contact dermatitis — Skin irritation as a result of
contact with a foreign substance.
Essential oil — A volatile oil extracted from the
leaves, fruit, flowers, roots, or other components
of a plant and used in aromatherapy, perfumes,
and foods and beverages.
Holistic — A practice of medicine that focuses on
the whole patient, and addresses the social, emo-
tional, and spiritual needs of a patient as well as
their physical treatment.
Phototoxic — Causes a harmful skin reaction when
exposed to sunlight.
Remedy antidote — Certain foods, beverages, pre-
scription medications, aromatic compounds, and
other environmental elements that counteract the
efficacy of homeopathic remedies.
Steam distillation — A process of extracting essen-
tial oils from plant products through a heating and
evaporation process.
Volatile — Something that vaporizes or evaporates
quickly when exposed to air.
Stanten, Michele, and Selene Yeager.“Smell this for Instant En-
ergy: the Easiest Way to Boost your Workouts. (Fitness
News).” Prevention (April 2002):76.
National Association of Holistic Aromatherapy. 836 Hanley In-
dustrial Court, St. Louis, MO 63144. 888-ASK-NAHA.
<http://www.naha.org.>
Paula Ford-Martin
Teresa G. Odle
Arrowroot
Description
Growing to a height of up to 6 ft (2 m), arrowroot is
a tropical perennial with clusters of long, thin stems and
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
small, cream-colored flowers that grow in pairs. Once
revered by the ancient Mayans and other inhabitants of
Central America as an antidote for poison-tipped arrows,
the herb is mainly used today to soothe the stomach and
alleviate diarrhea. It has also been popular for centuries
in the culinary arts and is still used in many American
kitchens as a thickening agent. While arrowroot is native
to Central America and widely cultivated in the West In-
dies, it can also be found growing in many tropical re-
gions of the world, including Southeast Asia, South
Africa, Australia, and in Florida in the United States.
The Latin genus Maranta was derived from the name of
an Italian doctor, Bartommeo Maranto.
Arrowroot, which belongs to the Marantaceae plant
family, is widely considered an easily digested and nutri-
tious starch. The herb is extracted from the fleshy roots,
called rhizomes, of the arrowroot plant through an elabo-
rate process of washing, peeling, soaking, and drying in
the sun. The end product is a fine, white powder with the
same appearance and texture as cornstarch. Arrowroot is
valued by herbalists primarily for its demulcent and an-
tidiarrheal properties. Exactly how it produces its thera-
peutic effects is not known. The chemical composition of
the herb has not been thoroughly investigated.
While only Maranta arundinacea is considered true
arrowroot, the common name for the herb is often ap-
plied to a variety of starches. These include other species
of Maranta , such as Maranta ramosissima, Maranta al-
louya, Maranta nobilis, as well as Brazilian arrowroot
(Manihot utilissima or Manihot palmate), Tahitian ar-
rowroot ( Tacca oceanica), and East Indian arrowroot
( Curcuma augustifolia ). While some of these starches
may be chemically similar to true arrowroot, it is not
clear if they produce the same medicinal effects. Con-
sumers interested in trying arrowroot are advised to
choose Maranta arundinacea , which is sometimes re-
ferred to as West Indian arrowroot or simply Maranta.
As of 2000, much research is still required to deter-
mine if arrowroot can produce significant health benefits
safely and effectively. The proper dosage of the herb has
also yet to be determined.
General use
While not approved by the United States Food and
Drug Administration (FDA), arrowroot is thought to
have several beneficial effects. However, there is little
scientific evidence to support these claims. Today, the
herb is primarily used to soothe an uneasy stomach and
alleviate diarrhea or nausea and vomiting. Since it con-
tains calcium and carbohydrates as well as other nutri-
ents, arrowroot is also used as an easily digested source
of nutrition for infants, people recovering from illnesses
127
Arrowroot
Arsenicum album
(especially those with bowel problems), and those on re-
stricted diets . The herb is considered easier on the stom-
ach than other forms of starch.
Because arrowroot has not been studied extensively in
people or animals, its effectiveness is based mainly on its
reputation as a folk remedy. Despite the lack of scientific ev-
idence, some practitioners of alternative medicine consider it
useful for certain conditions. Alternative physicians praise
the stomach-soothing powers of arrowroot as well as its nu-
tritional value. Another prominent herbalist recommends ar-
rowroot for preventing athlete’s foot. Putting the dried pow-
der inside socks and shoes can help to combat the moisture
that contributes to the growth of foot fungus. However, ar-
rowroot is not known to have antifungal properties.
Arrowroot was popular in the past as an antidote for
arrow poison. It also had a reputation as a treatment for
scorpion and spider bites as well as gangrene. However,
there is no scientific evidence to support these uses. In
cases of poisoning, the local poison control center or an
emergency care center should be contacted immediately.
Aside from its medicinal uses, arrowroot is still used
in cooking. Much like cornstarch, arrowroot is used as a
thickener for sauces, soups, and confections.
Preparations
The optimum daily dosage of arrowroot has not
been established with any certainty. Consumers should
follow the package directions for proper use or consult a
doctor experienced in the use of alternative remedies.
Arrowroot powder, which is basically flavorless, is often
mixed with juice or other beverages before ingestion.
Precautions
Arrowroot is not known to be harmful when taken in
recommended dosages. However, it is important to re-
member that the long-term effects of taking the herb ( in
any amount) have not been investigated. Due to the lack
of sufficient medical research, arrowroot should be used
with caution in children, women who are pregnant or
breast-feeding, and people with liver or kidney disease.
People who experience vomiting or severe/pro-
longed diarrhea may be prone to dehydration. They
should drink plenty of water (six to eight glasses a day)
in order to maintain a proper fluid balance. A doctor
should be consulted if the vomiting or diarrhea lasts
longer than three days or is accompanied by other symp-
toms such as pain or fever.
Side effects
When taken in recommended dosages, arrowroot is
not associated with any significant side effects.
128
KEY TERMS
Calcium — A mineral necessary for strong bones
and the proper functioning of organs and muscles.
Demulcent — A gelatinous or oily substance that
has a protective or soothing influence on irritated
mucous membranes.
Gangrene — Localized tissue death caused by lack
of blood.
Rhizome — A relatively long and thick plant root
that can be distinguished from normal roots by the
presence of buds, nodes, or other characteristics.
Interactions
Arrowroot is not known to interact adversely with
any drug or dietary supplement. It has been combined
with milk, lemon and other fruit juices, sugar, and wine
without apparent harm.
To avoid constipation, consumers should not take
aiTowroot with other medications or dietary supplements
used to alleviate diarrhea.
Resources
BOOKS
Gruenwald, Joerg. PDR for Herbal Medicines. New Jersey:
Medical Economics, 1998.
PERIODICALS
Rolston D. D., P. Mathew, and V. I. Mathan. “Food-Based So-
lutions Are a Viable Alternative to Glucose-Electrolyte
Solutions for Oral Hydration in Acute Diarrhoea-Studies
in a Rat Model of Secretory Diarrhoea.” Transactions of
the Royal Society of Tropical Medicine and Hygiene 84,
no. 1 (1990): 156-159.
ORGANIZATIONS
American Botanical Council. P.O. Box 144345, Austin, TX
78714-4345.
OTHER
Botanical.com. <http://www.botanical.com>.
Greg Annussek
Arsenicum album
Description
Arsenicum album is a homeopathic remedy derived
from the metallic element arsenic. Traces of arsenic are
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
found in vegetables and animals. In its crude form, arsenic
is poisonous. Gradual accumulations may result in diges-
tive disturbances, nausea, vomiting, diarrhea, dehydra-
tion, coma, shock, convulsions, paralysis, and death.
Common names for arsenicum album include ar-
senic trioxide, white arsenic, white oxide of metallic ar-
senic, and arsenius acid. Arsenic is indestructible, even
by fire, and remains in bone ash after cremation. It has
been used to create pigmentation for wallpaper, carpet,
and paints. Arsenic has also been used to produce medi-
cines and pesticides.
Arsenic was used as a remedy for certain types of
cattle disease as far back as the eighth century. In the
seventeenth century, arsenic was applied topically to
treat malignant ulcers and skin diseases in humans.
Taken internally, it was used to treat fevers. When fre-
quent and repeated doses of arsenic resulted in poisoning
and death, arsenic was pronounced unsafe for use. How-
ever, housewives and practitioners still used arsenic and
were often successful in their treatments. Eventually ar-
senic use was reinstated. Weak compounds of arsenic
were often used to increase strength and endurance, rem-
edy anemia, and improve the skin and fur of animals. An
ointment made from arsenic was used to treat cancerous
growths and tumors.
General use
Arsenicum album is one of the most frequently used
homeopathic remedies and is one of the most well-
proven remedies. A polychrest with a wide field of ac-
tion, arsenicum album has the power to affect all parts of
the human body.
Arsenicum album is used to treat serious acute ail-
ments, chronic diseases, and acute colds, bronchitis, and
fevers. Homeopaths prescribe this remedy to treat asthma,
anxiety disorders, panic attacks, skin infections, boils,
burns with blisters, cystitis, eye inflammations, chicken-
pox, colds, coughs, indigestion, Crohn’s disease, herpes
simplex, flu, insomnia, measles, mumps, sore throats, al-
lergies and hay fever, food poisoning, and fevers. Ar-
senicum album has also been used to treat malarial and
septic infections, alcoholism, syphilis, lupus, and cancer
(when applied in the early stages of the disease).
Arsenicum album illnesses can be brought about by
the use of quinine, tobacco, or alcohol, or from the sup-
pression of skin eruptions, sweat, or mucous membrane
discharges.
Common characteristics
People requiring arsenicum album generally fit a
particular profile. They are anxious, restless, weak, pale,
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
emaciated, faint, chilled, and catch colds easily. Their
eyes are sunken and glassy; their faces is yellowish or
ashy pale, and mouth, lips, and tongue are parched and
dry. They desire liquids in small, frequent amounts. The
forehead, face, chest, knees, hands, and feet are often
cold, so patients crave warmth. They may suffer from
burning, pressing pains throughout the entire body.
These pains are aggravated by cold and reduced by heat.
Weakness is sudden and is reduced by lying down, al-
though the other symptoms are worsened by it.
Other physical characteristics of this remedy include
burning, offensive, and watery discharges; palpitations;
profuse, sour sweat; and a red-tipped tongue. There is a
tendency to bleed easily and from any place, and vomit-
ing of blood and bleeding from lungs, throat, and mu-
cous membranes are not uncommon.
The mental and emotional symptoms of the patient
profile also include anxiety, nervousness, suspicion, im-
pulsiveness, irritability, sadness, hopelessness, and de-
pression. People requiring this remedy are often difficult
patients. They are critical and argumentative, easily of-
fended, easily startled, insecure, forgetful, sensitive to
pain, and often suffer from delusions or hallucinations.
They think their ailment is more serious than it is and de-
spair of ever getting well, often fearing that they are
going to die. They desire company and are afraid of
being alone. Patients may be unable to sleep due to their
restlessness and anxiety or from physical discomforts
such as fever or cough. When they do sleep, they may
have anxious dreams or nightmares. Even though they
are extremely weak, arsenicum album patients are clean
and tidy, partially to relieve their restlessness.
The symptoms are aggravated by a change in tem-
perature, wet weather, cold food and drink, and by the
slightest exertion. They are worse after midnight, upon
waking, with alcohol use, and during menstruation.
Symptoms are improved by heat, hot beverages, the
warmth of the bed, fresh air, and lying down.
Arsenicum album is a useful remedy for mental dis-
orders with symptoms of melancholy, irritation, intense
anxiety, and restlessness. The patient may be prone to vi-
olent fits of anger or rage or have an impulse to commit
murder. It also can have a positive effect on alcoholism
and can improve diarrhea, weakness, stomach irritation,
and emaciation.
Specific indications
Arsenicum album can be used for the following con-
ditions:
• Throbbing, frontal headaches. These are accompanied
by a flushed or hot face, heat or burning inside the
head, and a feeling that the head will explode. These
129
Arsenicum album
Art therapy
headaches occur with regularity and are reduced by
cool air or cold applications.
• Herpetic or eczematous skin eruptions. These are
moist, scabby, pustular, itching, or burning.
• Hot, burning fevers. These sometimes alternate with
chills. Fevers are worse at night, particularly after mid-
night.
• Sore throat. It is accompanied by burning pain that is
worse from swallowing or cold drinks and is reduced
with hot drinks.
• Hacking coughs. These are frequently dry at night and
are relieved by hot drinks. They are worsened by the
cold, by fresh air, when lying down, at night (particu-
larly after midnight), and during a fever.
• Chronic nasal congestion. This is often accompanied
by bleeding, constant sneezing, chills, fatigue, restless-
ness, anxiety at night, troublesome dreams, and crusts
in the back of the nose.
Preparations
The homeopathic remedy is prepared by separating
arsenic from iron, cobalt, and nickel when the minerals
are baked at high temperatures. The powder is then
ground and diluted with milk sugar.
Arsenicum album is available at health food and
drug stores in various potencies in the form of tinctures,
tablets, and pellets.
Precautions
If symptoms do not improve after the recommended
time period, a homeopath or healthcare practitioner
should be consulted.
Consumers are advised not to exceed the recom-
mended dose.
Side effects
There are no side effects currently reported.
Interactions
When taking any homeopathic remedy, consumers
should not use peppermint products, coffee, or alcohol.
These products may cause the remedy to be ineffective.
Resources
BOOKS
Cummings, Stephen, M.D., and Ullman, Dana, M.P.H. Every-
body’s Guide to Homeopathic Medicines. New York: Jere-
my P. Tarcher/Putnam, 1997.
130
KEY TERMS
Polychrest — A homeopathic remedy that is used
to treat many ailments.
Pustular — Resembling a blister and usually con-
taining pus.
Kent, James Tyler. Lectures on Materia Medica. Delhi. India:
B. Jain Publishers, 1996.
Jennifer Wurges
Arthritis see Osteoarthritis; Rheumatoid
arthritis
Art therapy
Definition
Art therapy, sometimes called creative arts therapy
or expressive arts therapy, encourages people to express
and understand emotions through artistic expression and
through the creative process.
Origins
Humans have expressed themselves with symbols
throughout history. Masks, ritual pottery, costumes, other
objects used in rituals, cave drawings, Egyptian hiero-
glyphics, and Celtic art and symbols are all visual
records of self-expression and communication through
art. Art has also been associated spiritual power, and
such artistic forms as the Hindu and Buddhist mandala
and Native American sand painting are considered pow-
erful healing tools.
In the late nineteenth century, French psychiatrists
Ambrose Tardieu and Paul-Max Simon both published
studies on the similar characteristics of and symbolism
in the artwork of the mentally ill. Tardieu and Simon
viewed art therapy as an effective diagnostic tool to iden-
tify specific types of mental illness or traumatic events.
Later, psychologists would use this diagnostic aspect to
develop psychological drawing tests (the Draw-A-Man
test, the Draw-A-Person Questionnaire [DAP.Q]) and
projective personality tests involving visual symbol
recognition (e.g., the Rorschach Inkblot Test, the The-
matic Apperception Test [TAT], and the Holtzman
Inkblot Test [HIT]).
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
The growing popularity of milieu therapies at psy-
chiatric institutions in the twentieth century was an im-
portant factor in the development of art therapy in the
United States. Milieu therapies (or environmental ther-
apy) focus on putting the patient in a controlled thera-
peutic social setting that provides the patient with oppor-
tunities to gain self-confidence and interact with peers in
a positive way. Activities that encourage self-discovery
and empowerment such as art, music, dance, and writing
are important components of this approach.
Educator and therapist Margaret Naumburg was a
follower of both Freud and Jung, and incorporated art
into psychotherapy as a means for her patients to visual-
ize and recognize the unconscious. She founded the
Walden School in 1915, where she used students’ art-
works in psychological counseling. She published exten-
sively on the subject and taught seminars on the tech-
nique at New York University in the 1950s. Today, she is
considered the founder of art therapy in the United States.
In the 1930s, Karl, William, and Charles Menninger
introduced an art therapy program at their Kansas-based
psychiatric hospital, the Menninger Clinic. The Men-
ninger Clinic employed a number of artists in residence
in the following years, and the facility was also consid-
ered a leader in the art therapy movement through the
1950s and 60s. Other noted art therapy pioneers who
emerged in the 50s and 60s include Edith Kramer, Hanna
Yaxa Kwiatkowska (National Institute of Mental
Health), and Janie Rhyne.
Benefits
Art therapy provides the client-artist with critical in-
sight into emotions, thoughts, and feelings. Key benefits
of the art therapy process include:
• Self-discovery. At its most successful, art therapy trig-
gers an emotional catharsis.
• Personal fulfillment. The creation of a tangible reward
can build confidence and nurture feelings of self-worth.
Personal fulfillment comes from both the creative and
the analytical components of the artistic process.
• Empowerment. Art therapy can help people visually
express emotions and fears that they cannot express
through conventional means, and can give them some
sense of control over these feelings.
• Relaxation and stress relief. Chronic stress can be
harmful to both mind and body. Stress can weaken and
damage the immune system, can cause insomnia and
depression, and can trigger circulatory problems (like
high blood pressure and irregular heartbeats). When
used alone or in combination with other relaxation
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Art therapist with students. (Peter Berndt. Custom Medical
Stock Photo, Inc. Reproduced by permission.)
techniques such as guided imagery, art therapy can ef-
fectively relieve stress.
• Symptom relief and physical rehabilitation. Art therapy
can also help patients cope with pain. This therapy can
promote physiological healing when patients identify and
work through anger, resentment, and other emotional
stressors. It is often prescribed to accompany pain control
therapy for chronically and terminally ill patients.
Description
Art therapy, sometimes called expressive art or art
psychology, encourages self-discovery and emotional
growth. It is a two part process, involving both the cre-
ation of art and the discovery of its meaning. Rooted in
Freud and Jung’s theories of the subconscious and un-
conscious, art therapy is based on the assumption that vi-
sual symbols and images are the most accessible and nat-
ural form of communication to the human experience.
Patients are encouraged to visualize, and then create, the
thoughts and emotions that they cannot talk about. The
resulting artwork is then reviewed and its meaning inter-
preted by the patient.
The “analysis” of the artwork produced in art thera-
py typically allows patients to gain some level of insight
131
Art therapy
Art therapy
into their feelings and lets them to work through these is-
sues in a constructive manner. Art therapy is typically
practiced in conjunction with individual, group, or fami-
ly psychotherapy (talk therapy). While a therapist may
provide critical guidance for these activities, a key fea-
ture of effective art therapy is that the patient/artist, not
the therapist, directs the interpretation of the artwork.
Art therapy can be a particularly useful treatment
tool for children, who frequently have limited language
skills. By drawing or using other visual means to express
troublesome feelings, younger patients can begin to ad-
dress these issues, even if they cannot identify or label
these emotions with words. Art therapy is also valuable
for adolescents and adults who are unable or unwilling to
talk about thoughts and feelings.
Beyond its use in mental health treatment, art thera-
py is also used with traditional medicine to treat organic
diseases and conditions. The connection between mental
and physical health is well documented, and art therapy
can promote healing by relieving stress and allowing the
patient to develop coping skills.
Art therapy has traditionally centered on visual
mediums, like paintings, sculptures, and drawings. Some
mental healthcare providers have now broadened the def-
inition to include music, film, dance, writing, and other
types of artistic expression.
Art therapy is often one part of a psychiatric inpatient
or outpatient treatment program, and it can take place in
individual or group therapy sessions. Group art therapy
sessions often take place in hospital, clinic, shelter, and
community program settings. These group therapy ses-
sions can have the added benefits of positive social inter-
action, empathy, and support from peers. The client-artist
can learn that others have similar concerns and issues.
Preparations
Before starting art therapy, the therapist may have an
introductory session with the client-artist to discuss art
therapy techniques and give the client the opportunity to
ask questions about the process. The client-artist’s comfort
with the artistic process is critical to successful art therapy.
The therapist ensures that appropriate materials and
space are available for the client-artist, as well as an ade-
quate amount of time for the session. If the individual
artist is exploring art as therapy without the guidance of a
trained therapist, adequate materials, space, and time are
still important factors in a successful creative experience.
The supplies used in art therapy are limited only by the
artist’s (and/or therapist’s) imagination. Some of the materi-
als often used include paper, canvas, poster board, assorted
paints, inks, markers, pencils, charcoals, chalks, fabrics,
132
string, adhesives, clay, wood, glazes, wire, bendable metals,
and natural items (like shells, leaves, etc.). Providing artists
with a variety of materials in assorted colors and textures
can enhance their interest in the process and may result in a
richer, more diverse exploration of their emotions in the re-
sulting artwork. Such appropriate tools as scissors, brushes,
erasers, easels, supply trays, glue guns, smocks or aprons,
and cleaning materials are also essential.
An appropriate workspace should be available for the
creation of art. Ideally, this should be a bright, quiet, com-
fortable place, with large tables, counters, or other suitable
surfaces. The space can be as simple as a kitchen or office
table, or as fancy as a specialized artist’s studio.
The artist should have adequate time to become
comfortable with and explore the creative process. This
is especially true for people who do not consider them-
selves “artists” and may be uncomfortable with the con-
cept. If performed in a therapy group or one-on-one ses-
sion, the art therapist should be available to answer gen-
eral questions about materials and/or the creative
process. However, the therapist should be careful not to
influence the creation or interpretation of the work.
Precautions
Art materials and techniques should match the age
and ability of the client. People with impairments, such
as traumatic brain injury or an organic neurological con-
dition, may have difficulties with the self-discovery por-
tion of the art therapy process depending on their level of
functioning. However, they may still benefit from art
therapy through the sensory stimulation it provides and
the pleasure they get from artistic creation.
While art is accessible to all (with or without a ther-
apist to guide the process), it may be difficult to tap the
full potential of the interpretive part of art therapy with-
out a therapist to guide the process. When art therapy is
chosen as a therapeutic tool to cope with a physical con-
dition, it should be treated as a supplemental therapy and
not as a substitute for conventional medical treatments.
Research & general acceptance
A wide body of literature supports the use of art
therapy in a mental health capacity. And as the mind-
body connection between psychological well-being and
physical health is further documented by studies in the
field, art therapy gains greater acceptance by mainstream
medicine as a therapeutic technique for organic illness.
Training & certification
Both undergraduate and graduate art therapy pro-
grams are offered at many accredited universities across
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Catharsis — Therapeutic discharge of emotional
tension by recalling past events.
Mandala — A design, usually circular, that appears
in religion and art. In Buddhism and Hinduism,
the mandala has religious ritual purposes and
serves as a yantra (a geometric emblem or instru-
ment of contemplation).
Organic illness — A physically, biologically based
illness.
the United States. Typical art therapy programs combine
courses in art and psychology. The majority of these pro-
grams meets or exceeds standards set by the American
Art Therapy Association (AATA).
The Art Therapy Credentials Board (ATCB), a volun-
tary organization, grants the designation ATR (Art Thera-
pist Registered) to professionals who have completed an
approved master’s level program of study in art therapy
(as described by the AATA) and have accumulated at least
1,000 hours of additional supervised clinical experience.
Board certification is also available through the ATCB for
art therapists who have met the ATR requirements and
have passed a certification exam (ATR-BC). Art therapists
with the ATR-BC designation must complete continuing
education credits to maintain their certification.
Registration and/or certification is a recognition of
professional expertise, not a legal qualification or re-
quirement to practice. Professional licensing require-
ments for art therapists vary by state. However, if the
therapy is intended as a companion treatment to psycho-
logical counseling or other mental health treatment, state
licensing requirements typically apply. Where licensing
is a prerequisite to practice, a combination of education
and clinical experience, a written test, and continuing ed-
ucation are required to maintain the license.
Resources
BOOKS
Fausek, Diane. A Practical Guide to Art Therapy. Binghamton.
New York: Haworth Press, 1997.
Ganim, Barbara. Art and Healing: Using expressive art to heal
your body, mind, and spirit. New York: Three Rivers
Press, 1999.
Malchiodi, Cathy A. The Art Therapy Sourcebook. Los Ange-
les: Lowell House, 1998.
McNiff, Shaun. Art as Medicine: Creating a Therapy of the
Imagination. Boston: Shambhala, 1992.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
ORGANIZATIONS
American Art Therapy Association. 1202 Allanson Rd.,
Mundelein, IL 60060-3808. 888-290-0878 or 847-949-
6064. Fax: 847-566-4580. E-mail: arttherapy@ntr.net
w w w.arttherapy . org .
Paula Ford-Martin
Ascorbic acid see Vitamin C
Ashwaganda
Description
Ashwaganda, also spelled ashwagandha, is a member
of the pepper family known as Withania somnifera. The
small evergreen grows in the frost-free drier parts of west-
ern India, northern Africa, the Mediterranean, and the
Middle East. Ashwaganda grows to a height of 2-3 ft
(about 1 m) and has oval leaves, showy yellow flowers,
and red, raisin-sized fruits. All parts of the plant, including
the root, are used medicinally. Ashwaganda is also called
winter cherry, withania, asgandh, and Indian ginseng.
General use
Ashwaganda is a major herb in the Ayurvedic sys-
tem of health and healing. Ayurvedic medicine is a sys-
tem of individualized healing derived from Hinduism
that has been practiced in India for more than 2,000
years. It is a complex system that recognizes different
human temperaments and body types. Each of these
types has different qualities that affect a person’s health
and natural balance.
In Ayurvedic medicine, disease can result from any
of seven major categories of factors: heredity, congenital,
internal, external trauma, seasonal, habits, or supernatur-
al factors. Disease can also be caused by misuse of the
five senses: sight, touch, taste, hearing, and smell. Diag-
noses are made through questioning, observation, exami-
nation, and interpretation. Health is restored by evaluat-
ing the exact cause of the imbalance causing the disease
or condition and then prescribing herbs, exercises, diet
changes and/or meditation to help restore the natural
balance of body, mind, and spirit. Prescriptions are high-
ly individualized, so that the same symptoms may re-
quire different remedies in different people.
Ashwaganda is used to treat a great many different
conditions in Ayurvedic medicine. Every part of the plant
is used: leaves, fruit, flowers, and root. In addition, the
133
Ashwaganda
Ashwaganda
Ashwaganda plant. (© PlantaPhile, Germany. Reproduced by
permission.)
young shoots and seeds are used as food and to thicken
plant milks in the making of vegan cheeses. The fruit can
be used as a substitute for soap, and the leaves are some-
times used as an insect repellent. Although ashwaganda
can be taken alone, it is more often combined with other
herbs in tonics to enhance its rejuvenating effects.
Indian ginseng
Ashwaganda is sometimes called the Indian ginseng
because its actions and uses are in many ways similar to
those of Chinese ginseng, although its cost is much
lower. In Hindi, the name of ashwaganda means “horse
smell.” This name refers less to the herb’s odor than to a
horse’s strength and health. Ashwaganda is supposed to
impart that same horse-like strength to the people who
use it.
Ashwaganda is an adaptogen. Adaptogens are sub-
stances that non-specifically enhance and regulate the
body’s ability to withstand stress and increase its general
performance in ways that help the whole body resist dis-
ease. Ashwaganda is celebrated as an adaptogen that will
do all of the following:
• boost strength
• increase stamina and relieve fatigue
• enhance sexual energy and rejuvenate the body
• strengthen the immune system
• speed recovery from chronic illness
• strengthen sickly children
• soothe and calm without producing drowsiness
• clarify the mind and improve memory
• slow the aging process
The powdered root of ashwaganda is normally used
for whole body tonics that improve general health and well
being. For most of these uses, ashwaganda is prepared as
part of a rasayana , or rejuvenating formula that contains
many different herbs. The use of ashwaganda in multi-herb
formulas makes it difficult for modern laboratory scientists
to assess its specific effects as an adaptogen.
Disease-specific uses
In addition to the whole body effects of ashwagan-
da, the plant is used for many other specific conditions.
Different parts are used for different conditions. Ashwa-
ganda is one of the most frequently used remedies in
India. It is taken internally for:
• anemia
• arthritis
• asthma
134
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• bronchitis
• cancer
• chronic fatigue syndrome
• colds
• coughs
• depression
• diarrhea
• fluid retention
• hemorrhoids
• hypertension
• hypoglycemia
• leprosy
• nausea
• rheumatism
• sexually transmitted diseases
• stomach ulcers
• systemic lupus erythematosus
• tuberculosis
• tumors
Ashwaganda can also be made into a poultice for
external use, as it is thought to have antibacterial and an-
tifungal properties. It is used to prevent infection in skin
wounds and to treat skin diseases, including psoriasis,
ringworm, and scabies.
Laboratory studies
University and medical researchers have been study-
ing ashwaganda since at least the early 1960s. Chemical
analysis shows that ashwaganda contains compounds
thought to have anti-tumor, anti-inflammatory, and anti-
fungal properties. Other compounds have been isolated
that are associated with ashwaganda’s sedative and anti-
stress effects.
The most rigorous laboratory tests have been done
in test tubes and on rats, mice, and other small laboratory
animals. There is no proof that ashwaganda affects hu-
mans in the same way that it affects rodents. In animal
studies, however, ashwaganda has been shown to have
consistent anti-inflammatory, anti-fungal, anti-stress, and
sedative effects. In one well-known study, extracts of
ashwaganda root were shown to significantly increase
the swimming endurance of rats in a test that is consid-
ered a classic stress test.
Experimenters have had mixed results in demon-
strating anti-tumor and anti-cancer properties of ashwa-
ganda. Many have found that extracts of ashwaganda
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
root slow the growth of tumor cells in test-tube and
small-animal experiments, but these results have not yet
been reproduced in human subjects. Some researchers
report that ashwaganda makes tumors more sensitive to
chemotherapy and radiation therapy without increasing
side effects caused by these therapies.
Although there is little doubt that ashwaganda con-
tains biologically active compounds that produce some
of the healing effects in humans that have been found in
test-tube and small-animal studies, few controlled stud-
ies using people have been done. One drawback to arriv-
ing at conclusive evidence in humans is that most people
take ashwaganda as part of a multi-herb tonic, making it
difficult for researchers to attribute specific actions to
any one particular component of the formula. Scientific
interest in ashwaganda is high, and laboratory studies
continue to be performed.
Preparations
Ashwaganda is available in many forms, including
powders, decoctions, essential oil, tinctures, and teas
made from the root, root bark, and the leaves. Commer-
cially ashwaganda is available as capsules. The usual cap-
sule dosage is 300 mg of powdered root, taken once or
twice a day. Tincture dosage is often 2-4 ml (0.5-1 tsp)
daily. Ashwaganda tea can be made by boiling the roots
for about 15 minutes. Three cups a day is recommended.
The fruit is often chewed to assist in convalescence from
prolonged illness. These are simply representative doses
and uses, since Ayurvedic medicine is highly individual-
ized. The dose recommended depends on both the body
type of the person and the nature of his or her illness.
Precautions
Ashwaganda is not recommended for use by pregnant
women. Thousands of years of use have shown that this
plant is quite safe. On the other hand, laboratory tests indi-
cate that rats given high levels of ashwaganda root extract
develop kidney lesions. This effect has not been seen in
humans, but using the herb in moderation may be prudent.
Ashwaganda has a sedative effect on the central ner-
vous system. It will enhance the effect of any other cen-
tral nervous system sedatives (e.g., barbiturates or alco-
hol) that are taken at the same time. People operating
heavy equipment or working in situations that require a
high level of alertness should keep this in mind when
using ashwaganda.
Side effects
No undesirable side effects have been reported with
ashwaganda.
135
Ashwaganda
Asthma
KEY TERMS
Adaptogen — A substance that acts in nonspecific
ways to improve the body's level of functioning
and its adaptations to stress.
Decoction — A liquid extract of a herb, made by
simmering or boiling the herb in water, then
straining out the plant parts.
Poultice — A soft moist mass of cloth, usually con-
taining herbs, applied warm or hot to relieve pain
or speed healing in a part of the body.
Psoriasis — A skin disease characterized by dry,
scaling, whitish patches.
Scabies — A contagious skin disease caused by a
mite and characterized by small, raised, red, very
itchy pinprick bumps on the skin.
Tincture — An alcohol-based extract of a herb pre-
pared by soaking plant parts in alcohol or a mix-
ture of alcohol and water.
Tonic — A medicine given to strengthen and invig-
orate the body. Ashwaganda is frequently used as
a tonic.
Vegan — Food products made without any animal
products such as meat, milk, or eggs. A vegan diet
is a nutrition regimen that excludes all animal
products.
Interactions
There are few, studies of how ashwaganda interacts
with traditional Western medicines. It has been used for
many years in combination with other Ayurvedic herbs
without incident. Ayurvedic practitioners believe that
when ashwaganda is combined with other herbs in reju-
venation formulas, it enhances the effects of these other
herbs.
Resources
BOOKS
Chevallier, Andrew. Encyclopedia of Medicinal Plants. Lon-
don: Dorling Kindersley, 1996.
Peirce, Andrea. The American Pharmaceutical Association
Practical Guide to Natural Medicines. New York: William
Morrow and Company, 1999.
ORGANIZATIONS
American School of Ayurvedic Sciences. 2115 112th Avenue
NE. Bellevue, WA 98004. (425) 453-8002.
The Ayurvedic Institute. P. O. Box 23445. Albuquerque, NM
87112. (505) 291-9698.
136
OTHER
“Withania somnifera aphrodisiaca Plants for the Future:
<http:// www.metalab.unc.edu.>
Tish Davidson
Asthma
Definition
Asthma is a chronic inflammatory disease of the air-
ways in the lungs. This inflammation periodically causes
the airways to narrow, producing wheezing and breath-
lessness sometimes to the point where the patient gasps
for air. This obstruction of the air flow either stops spon-
taneously or responds to a wide range of treatments.
Continuing inflammation makes asthmatics hyper-re-
sponsive to such stimuli as cold air, exercise, dust, pollu-
tants in the air, and even stress or anxiety.
Description
Between 16 and 17 million Americans have asthma
and the number has been rising since 1980. As many as 9
million U.S. children under age 18 may have asthma.
Blacks, Hispanics, American Indians, and Alaskan na-
tives had higher rates of asthma-control problems than
whites or Asians in the United States.
The changes that take place in the lungs of asthmat-
ics make their airways (the bronchi and the smaller bron-
chioles) hyper-reactive to many different types of stimuli
that do not affect healthy lungs. In an asthma attack, the
muscle tissue in the walls of the bronchi go into spasm,
and the cells that line the airways swell and secrete
mucus into the air spaces. Both these actions cause the
bronchi to narrow, a change that is called bronchocon-
striction. As a result, an asthmatic person has to make a
much greater effort to breathe.
Cells in the bronchial walls, called mast cells, release
certain substances that cause the bronchial muscle to con-
tract and stimulate mucus formation. These substances,
which include histamine and a group of chemicals called
leukotrienes, also bring white blood cells into the area.
Many patients with asthma are prone to react to substances
such as pollen, dust, or animal dander; these are called al-
lergens. Many people with asthma do not realize that aller-
gens are triggering their attacks. On the other hand, asthma
also affects many patients who are not allergic in this way.
Asthma usually begins in childhood or adolescence,
but it also may first appear in adult life. While the symp-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
toms may be similar, certain important aspects of asthma
are different in children and adults. When asthma begins
in childhood, it often does so in a child who is likely, for
genetic reasons, to become sensitized to common aller-
gens in the environment. Such a child is known as an
atopic person. In 2004, scientists in Helsinki, Finland,
identified two new genes that cause atopic asthma. The
discovery might lead to earlier prediction of asthma in
children and adults. When these children are exposed to
dust, animal proteins, fungi, or other potential allergens,
they produce a type of antibody that is intended to engulf
and destroy the foreign materials. This has the effect of
making the airway cells sensitive to particular materials.
Further exposure can lead rapidly to an asthmatic re-
sponse. This condition of atopy is present in at least one
third and as many as one half of the general population.
When an infant or young child wheezes during viral in-
fections, the presence of allergy (in the child or a close
relative) is a clue that asthma may well continue
throughout childhood.
Allergenic materials may also play a role when
adults become asthmatic. Asthma can start at any age
and in a wide variety of situations. Many adults who are
not allergic have such conditions as sinusitis or nasal
polyps, or they may be sensitive to aspirin and related
drugs. Another major source of adult asthma is exposure
at work to animal products, certain forms of plastic,
wood dust, metals, and environmental pollution.
Causes & symptoms
In most cases, asthma is caused by inhaling an aller-
gen that sets off the chain of biochemical and tissue
changes leading to airway inflammation, bronchocon-
striction, and wheezing. Because avoiding (or at least
minimizing) exposure is the most effective way of treat-
ing asthma, it is vital to identify which allergen or irri-
tant is causing symptoms in a particular patient. Once
asthma is present, symptoms can be set off or made
worse if the patient also has rhinitis (inflammation of
the lining of the nose) or sinusitis. When, for some rea-
son, stomach acid passes back up the esophagus in a re-
action called acid reflux, this condition also can make
asthma worse. In addition, a viral infection of the respi-
ratory tract can inflame an asthmatic reaction. Aspirin
and drugs called beta-blockers, often used to treat high
blood pressure, also can worsen the symptoms of asth-
ma. But the most important inhaled allergens giving rise
to attacks of asthma are:
• animal dander
• dust mites
• fungi (molds) that grow indoors
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
INHALED ALLERGENS
MOST OFTEN TRIGGERING ASTHMA ATTACKS
Air pollutants
Animal dander
Cockroach allergens
Dust mites
Indoor fungi (molds)
Occupational allergens such as chemicals, fumes,
particles of industrial materials
Pollen
• cockroach allergens
• pollen
• occupational exposure to chemicals, fumes, or particles
of industrial materials
• tobacco smoke
• air pollutants
In addition, there are three important factors that
regularly produce attacks in certain asthmatic patients,
and they may sometimes be the sole cause of symptoms.
They are:
• inhaling cold air (cold-induced asthma)
• exercise-induced asthma (in certain children, asthma
attacks are caused simply by exercising)
• stress or a high level of anxiety
Wheezing often is obvious, but mild asthmatic at-
tacks may be confirmed when the physician listens to the
patient’s chest with a stethoscope. Besides wheezing and
being short of breath, the patient may cough or report a
feeling of tightness in the chest. Children may have itch-
ing on their back or neck at the start of an attack. Wheez-
ing often is loudest when the patient exhales. Some asth-
matics are free of symptoms most of the time but may
occasionally be short of breath for a brief time. Others
spend much of their days (and nights) coughing and
wheezing until properly treated. Crying or even laughing
may bring on an attack. Severe episodes often are seen
when the patient gets a viral respiratory tract infection or
is exposed to a heavy load of an allergen or irritant.
Asthmatic attacks may last only a few minutes or can go
on for hours or even days. Being short of breath may
cause a patient to become very anxious, sit upright, lean
forward, and use the muscles of the neck and chest wall
to help breathe. The patient may be able to say only a
few words at a time before stopping to take a breath.
Confusion and a bluish tint to the skin are clues that the
137
Asthma
Asthma
Source: “Occupational Asthma.” Occupational Safety and
Health Administration, U.S. Department of Labor.
http://www.osha.gov/oshinfo/priorities/asthma.html (Stan-
ley Publishing. Reproduced by permission.)
oxygen supply is much too low and that emergency treat-
ment is needed. In a severe attack, some of the air sacs in
the lung may rupture so that air collects within the chest,
which makes it even harder to breathe. The good news is
that almost always, even patients with the most severe at-
tacks will recover completely.
Diagnosis
Apart from listening to the patient’s chest, the exam-
iner should look for maximum chest expansion while
taking in air. Hunched shoulders and contracting neck
muscles are other signs of narrowed airways. Nasal
polyps or increased amounts of nasal secretions are often
noted in asthmatic patients. Skin changes, like dermati-
tis or eczema, are a clue that the patient has allergic
problems. Inquiring about a family history of asthma or
allergies can be a valuable indicator of asthma. A test
called spirometry measures how rapidly air is exhaled
and how much is retained in the lungs. Repeating the test
after the patient inhales a drug that widens the air pas-
sages (a bronchodilator) will show whether the narrow-
ing of the airway is reversible, which is a very typical
finding in asthma. Often patients use a related instru-
ment, called a peak flow meter, to keep track of asthma
severity when at home.
Frequently, it is difficult to determine what is trig-
gering asthma attacks. Allergy skin testing may be
used, although an allergic skin response does not al-
ways mean that the allergen being tested is causing the
asthma. Also, the body’s immune system produces an
antibody to fight off the allergen, and the amount of an-
tibody can be measured by a blood test. The blood test
138
will show how sensitive the patient is to a particular al-
lergen. If the diagnosis is still in doubt, the patient can
inhale a suspect allergen while using a spirometer to
detect airway narrowing. Spirometry also can be re-
peated after a bout of exercise if exercise-induced asth-
ma is a possibility. A chest x-ray will help rule out
other disorders.
Treatment
There are many alternative treatments available for
asthma that have shown promising results. One strong
argument for these treatments is that they try to avoid
the drugs that allopathic treatment (combating disease
with remedies to produce effects different from those
produced by the disease) relies upon, which can be toxic
and addictive. Mainstream journals have reported on the
toxicity of asthma pharmaceuticals. A 1995 New
Zealand study showed that before 1940, death from
asthma was very low, but that the death rate promptly
increased with the introduction of bronchodilators. The
New England Journal of Medicine in 1992 reported that
albuterol and other asthma drugs cause the lungs to de-
teriorate when used regularly. A 1989 study in the An-
nals of Internal Medicine showed that respiratory thera-
pists, who are exposed to bronchodilator sprays, devel-
op asthma five times more often than other healthcare
professionals, which could imply that the drugs them-
selves may induce asthma. Theophylline, another popu-
lar drug, has been reported to cause personality changes
in users. Steroids can also have negative effects on
many systems in the body, particularly the hormonal
system. Thus, natural and non-toxic methods for treat-
ing asthma are the preferred first choice of alternative
practitioners, while drugs are used to manage extreme
cases and emergencies.
Alternative medicine tends to view asthma as the
body’s protective reaction to environmental agents and
pollutants. As such, the treatment goal is often to restore
balance to and strengthen the entire body and provide spe-
cific support to the lungs, immune and hormonal systems.
Asthma sufferers can help by keeping a diary of asthma
attacks in order to determine environmental and emotional
factors that may be contributing to their condition.
Alternative treatments have minimal side effects, are
generally inexpensive, and are convenient forms of self-
treatment. They also can be used alongside allopathic
treatments to improve their effectiveness and lessen their
negative side effects.
Dietary and nutritional therapies
Some alternative practitioners recommend cutting
down on or eliminating dairy products from the diet, as
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
In normal bronchioles the airway
is open and unobstructed.
During an attack, the bronchioles of an
asthma sufferer are constricted by bands
of muscle around them. They may be
further obstructed by increased mucus
production and tissue inflammation.
A comparison of normal bronchioles and those of an asthma sufferer. (Illustration by Hans & Cassidy. The Gale Group.)
these increase mucus secretion in the lungs and are
sources of food allergies. Other recommendations in-
clude avoiding processed foods, refined starches and
sugars, and foods with artificial additives and sulfites.
Diets should be high in fresh fruits, vegetables, and
whole grains, and low in salt. Asthma sufferers should
experiment with their diets to determine if food allergies
are playing a role in their asthma. Some studies have
shown that a sustained vegan (zero animal foods) diet
can be effective for asthma, as it does not contain the an-
imal products that frequently cause food allergies and
contain chemical additives. A vegan diet also eliminates
a fatty acid called arachidonic acid, which is found in an-
imal products and is believed to contribute to allergic re-
actions. A 1985 Swedish study showed that 92% of pa-
tients with asthma improved significantly after one year
on a vegan diet. On the other hand, some people feel
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
weaker on a vegan diet. In addition, many people are al-
lergic to vegetables rather than to meat.
Plenty of water should also be drunk by asthma suf-
ferers, as water helps to keep the passages of the lungs
moist. Onions and garlic contain quercetin, a flavonoid
(a chemical compound/biological response modifier)
that inhibits the release of histamine, and should be a
part of an asthmatic’s diet. Quercetin also is available as
a supplement, and should be taken with the digestive en-
zyme bromelain to increase its absorption.
As nutritional therapy, vitamins A, C and E have
been touted as important. Also, the B complex vitamins,
particularly B 6 and B 12 , may be helpful for asthma, as
well as magnesium, selenium, and an omega-3 fatty
acid supplement such as flaxseed oil. A good multivita-
min supplement also is recommended. In 2004, a study
139
Asthma
Asthma
of supplements at Cornell University showed that high
levels of beta-carotene and vitamin C along with seleni-
um lowered risk of asthma. However, the same study
found that vitamin E had no effect.
Herbal remedies
Chinese medicine has traditionally used ma huang,
or ephedra, for asthma attacks. It contains ephedrine,
which is a bronchodilator used in many drugs. However,
the U.S. Food and Drug Administration (FDA) issued a
ban on the sale of ephedra that took effect in April 2004
because it was shown to raise blood pressure and stress
the circulatory system, resulting in heart attacks and
strokes for some users. Ginkgo has been shown to reduce
the frequency of asthma attacks, and licorice is used in
Chinese medicine as a natural decongestant and expecto-
rant. There are many formulas used in traditional Chi-
nese medicine to prevent or ease asthma attacks, de-
pending on the specific Chinese diagnosis given by the
practitioner. For example, ma huang is used to treat so-
called “wind-cold” respiratory ailments.
Other herbs used for asthma include lobelia, also
called Indian tobacco; nettle, which contains a natural
antihistamine; thyme; elecampane mullein: feverfew;
passionflower: saw palmetto: and Asian ginseng. Coffee
and tea have been shown to reduce the severity of asthma
attacks because caffeine works as a bronchodilator. Tea
also contains minute amounts of theophylline, a major
drug used for asthma. Ayurvedic (traditional East Indian)
medicine recommends the herb Tylophora asthmatica.
Mind/body approaches
Mind/body medicine has demonstrated that psy-
chological factors play a complex role in asthma. Emo-
tional stress can trigger asthma attacks. Mind/body tech-
niques strive to reduce stress and help asthma sufferers
manage the psychological component of their condition.
A 1992 study by Dr. Erik Peper at the Institute for Holis-
tic Healing Studies in San Francisco used biofeedback,
a treatment method that uses monitors to reveal physio-
logical information to patients, to teach relaxation and
deep breathing methods to 21 asthma patients. Eighty
percent of them subsequently reported fewer attacks and
emergency room visits. A 1993 study by Kaiser Perma-
nente in Northern California worked with 323 adults
with moderate to severe asthma. Half the patients got
standard care while the other half participated in support
groups. The support group patients had cut their asthma-
related doctor visits in half after two years. Some other
mind/body techniques used for asthma include relax-
ation methods, meditation, hypnotherapy,, mental
imaging, psychotherapy, and visualization.
140
Yoga and breathing methods
Studies have shown that yoga significantly helps
asthma sufferers, with exercises specifically designed to
expand the lungs, promote deep breathing, and reduce
stress. Pranayama is the yogic science of breathing,
which includes hundreds of deep breathing techniques.
These breathing exercises should be done daily as part of
any treatment program for asthma, as they are a very ef-
fective and inexpensive measure.
Controlled exercise
Many people believe that those with asthma should
not exercise. This is particularly true among parents of
children with asthma. In a 2004 study, researchers re-
ported that 20% of children with asthma do not get
enough exercise. Many parents believe it is dangerous
for their children with asthma to exercise, but physical
activity benefits all children, including those with asth-
ma. Parents should work with the child’s healthcare
provider and any coach or organized sport leader to care-
fully monitor his or her activities.
Acupuncture
Acupuncture can be an effective treatment for asth-
ma. It is used in traditional Chinese medicine along with
dietary changes. Acupressure can also be used as a self-
treatment for asthma attacks and prevention. The Lung 1
points, used to stimulate breathing, can be easily found
on the chest. These are sensitive, often knotted spots on
the muscles that run horizontally about an inch below the
collarbone, and about two inches from the center of the
chest. The points can be pressed in a circular manner
with the thumbs, while the head is allowed to hang for-
ward and the patient takes slow, deep breaths. Reflexolo-
gy also uses particular acupressure points on the hands
and feet that are believed to stimulate the lungs.
Other treatments
Aromatherapists recommend eucalyptus, lavender,
rosemary, and chamomile as fragrances that promote
free breathing. In Japan, a common treatment for asthma
is administering cold baths. This form of hydrotherapy
has been demonstrated to open constricted air passages.
Massage therapies such as Rolfing can help asthma suf-
ferers as well, as they strive to open and increase circula-
tion in the chest area. Homeopathy uses the remedies
Arsenicum album, Kali carbonicum, Natrum sul-
phuricum, and Aconite.
Allopathic treatment
Allopaths recommend that asthma patients should
be periodically examined and have their lung functions
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
measured by spirometry. The goals are to prevent trou-
blesome symptoms, to maintain lung function as close to
normal as possible, and to allow patients to pursue their
normal activities, including those requiring exertion. The
best drug therapy is that which controls asthmatic symp-
toms while causing few or no side effects.
Drugs
The chief methylxanthine drug is theophylline. It
may exert some anti-inflammatory effect and is especial-
ly helpful in controlling nighttime symptoms of asthma.
When, for some reason, a patient cannot use an inhaler
to maintain long-term control, sustained-release theo-
phylline is a good alternative. The blood levels of the
drug must be measured periodically, as too high a dose
can cause an abnormal heart rhythm or convulsions.
Beta-receptor agonists (drugs that trigger cell re-
sponse) are bronchodilators. They are the drugs of
choice for relieving sudden attacks of asthma and for
preventing attacks from being triggered by exercise.
Some agonists, such as albuterol, act mainly in lung cells
and have little effect on the heart and other organs. These
drugs generally start acting within minutes, but their ef-
fects last only four to six hours. They may be taken by
mouth, inhaled, or injected. In 2004, a new lower con-
centration of albuterol was approved by the FDA for
children ages two to 12.
Steroids are drugs that resemble natural body hor-
mones. They block inflammation and are effective in re-
lieving symptoms of asthma. When steroids are taken by
inhalation for a long period, asthma attacks become less
frequent as the airways become less sensitive to aller-
gens. Steroids are the strongest medicine for asthma, and
can control even severe cases over the long term and
maintain good lung function. However, steroids can
cause numerous side effects, including bleeding from the
stomach, loss of calcium from bones, cataracts in the
eye, and a diabetes-like state. Patients using steroids for
lengthy periods may also have problems with wound
healing, may gain weight, and may suffer mental prob-
lems. In children, growth may be slowed. Besides being
inhaled, steroids may be taken by mouth or injected, to
rapidly control severe asthma.
Leukotriene modifiers are among a newer type of
drug that can be used in place of steroids, for older chil-
dren or adults who have a mild degree of persistent asth-
ma. They work by counteracting leukotrienes, which are
substances released by white blood cells in the lung that
cause the air passages to constrict and promote mucus
secretion. Other drugs include cromolyn and ne-
docromil, which are anti-inflammatory drugs that often
are used as initial treatments to prevent long-term asth-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
matic attacks in children. Montelukast sodium (Singu-
lair) is a drug taken daily that is used to help prevent
asthma attacks rather than to treat an acute attack. In
2004, the FDA approved an oral granule formula of Sin-
gulair for young children.
If a patient's asthma is caused by an allergen that
cannot be avoided and it has been difficult to control
symptoms by drugs, immunotherapy may be worth try-
ing. In a typical course of immunotherapy, increasing
amounts of the allergen are injected over a period of
three to five years, so that the body can build up an effec-
tive immune response. There is a risk that this treatment
may itself cause the airways to become narrowed and
bring on an asthmatic attack. Not all experts are enthusi-
astic about immunotherapy, although some studies have
shown that it reduces asthmatic symptoms caused by ex-
posure to dust mites, ragweed pollen, and cats.
Managing asthmatic attacks
A severe asthma attack should be treated as quickly
as possible. It is most important for a patient suffering an
acute attack to be given extra oxygen. Rarely, it may be
necessary to use a mechanical ventilator to help the pa-
tient breathe. A beta-receptor agonist is inhaled repeated-
ly or continuously. If the patient does not respond
promptly and completely, a steroid is given. A course of
steroid therapy, given after the attack is over, will make a
recurrence less likely.
Long-term allopathic treatment for asthma is based
on inhaling a beta-receptor agonist using a special in-
haler that meters the dose. Patients must be instructed in
proper use of an inhaler to be sure that it will deliver the
right amount of drug. Once asthma has been controlled
for several weeks or months, it is worth trying to cut
down on drug treatment, but this tapering must be done
gradually. The last drug added should be the first to be
reduced. Patients should be seen every one to six
months, depending on the frequency of attacks. Starting
treatment at home, rather than in a hospital, makes for
minimal delay and helps the patient to gain a sense of
control over the disease. All patients should be taught
how to monitor their symptoms so that they will know
when an attack is starting. Those with moderate or se-
vere asthma should know how to use a flow meter. They
also should have a written plan to follow if symptoms
suddenly become worse, including how to adjust their
medication and when to seek medical help. If more in-
tense treatment is necessary, it should be continued for
several days. When deciding whether a patient should be
hospitalized, the physician must take into account the pa-
tient's past history of acute attacks, severity of symp-
toms, current medication, and the availability of good
support at home.
141
Asthma
Asthma
Expected results
Most patients with asthma respond well when the
best treatment or combination of treatments is found and
they are able to lead relatively normal lives. Patients who
take responsibility for their condition and experiment
with various treatments have good chances of keeping
symptoms minimal. Having urgent measures to control
asthma attacks and ongoing treatment to prevent attacks
are important as well. More than one half of affected
children stop having attacks by the time they reach 21
years of age. Many others have less frequent and less se-
vere attacks as they grow older. A small minority of pa-
tients will have progressively more trouble breathing.
Because they run a risk of going into respiratory failure,
they must receive intensive treatment.
Prevention
Prevention is extremely important in the treatment of
asthma, which includes eliminating all possible allergens
from the environment and diet. Homes and work areas
should be as dust and pollutant-free as possible. Areas
can be tested for allergens and high-quality air filters can
be installed to clean the air. If the patient is sensitive to a
family pet, removing the animal or at least keeping it out
of the bedroom (with the bedroom door closed) is ad-
vised. Keeping the pet away from carpets and upholstered
furniture, and removing all feathers also helps. To reduce
exposure to dust mites, it is recommended to remove
wall-to-wall carpeting, keep the humidity low, and use
special pillows and mattress covers. Cutting down on
stuffed toys, and washing them each week in hot water, is
advised for children with asthma. If cockroach allergen is
causing asthma attacks, controlling the roaches (using
traps or boric acid rather than chemicals) can help.
It is important to not to leave food or garbage exposed.
Keeping indoor air clean by vacuuming carpets once or
twice a week (with the asthmatic person absent), and
avoiding use of humidifiers is advised. Those with asthma
should avoid exposure to tobacco smoke and should not
exercise outside when air pollution levels are high. When
asthma is related to exposure at work, taking all precau-
tions, including wearing a mask and, if necessary, arrang-
ing to work in a safer area, is recommended. For chronic
sufferers who live in heavily polluted areas, moving to less
polluted regions may even be a viable alternative.
Resources
BOOKS
Bock, Steven J. Natural Relief for Your Child’ s Asthma. New
York: HarperPerennial, 1999.
Cutler, Ellen W. Winning the War against Asthma and Aller-
gies. New York: Delmar, 1998.
142
KEY TERMS
Allergen — A foreign substance that causes the air-
ways to narrow and produces symptoms of asth-
ma when inhaled.
Atopy — A state that makes persons more likely to
develop allergic reactions of any type, including
the inflammation and airway narrowing typical of
asthma.
Bronchodilator — A type of medication that acts to
open up bronchial tubes that have constricted in
an asthmatic attack.
Hypersensitivity — A condition in which very
small amounts of allergen can cause the airways
to constrict and bring on an asthmatic attack.
Leukotrienes — Substances that are produced by
white blood cells in response to antigens and con-
tribute to inflammatory and asthmatic reactions.
Pranayama — Breathing techniques taught in yoga.
Quercetin — A flavonoid (chemical compound/bi-
ological response modifier) found in onions and
garlic that may be a useful dietary supplement for
asthma patients.
Vegan diet — A vegetarian diet that excludes meat
and dairy products.
PERIODICALS
Allergy and Asthma Magazine. 702 Marshall St., Suite 61 1.
Redwood City, CA 94063. (605) 780-0546.
“Allergy Season Can Mean Trouble." Respiratory Therapeutics
Week (April 19, 2004):9.
“Asthma Antioxidants.” Better Nutrition (May 2004):26-27.
“Children with Asthma Inactive Due to Parental Health Beliefs,
Disease Severity.” Obesity, Fitness & Wellness Week (May
1, 2004):8.
“Identification of New Asthma Genes Demonstrates Model for
Improved Patient Care.” Drug Week (April 30, 2004):27.
McNamara, Daniel. “Singulair.” Family Practice News (Febru-
ary 1,2004): 108-109.
“Nine Million U.S. Children Diagnosed With Asthma, New
Report Finds." Medical Letter on the CDC & FDA (April
25, 2004): 11.
“Patent Granted for Pediatric Asthma Medication.” Health &
Medicine Week (April 12, 2004):552.
Ressel, Genevieve. “FDA Issues Regulation Prohibiting Sale of
Dietary Supplements Containing Ephedra.” American
Family Physician (March 15, 2004): 1343.
“U.S. Asthma Rates on the Rise." Medical Letter on the CDC
<6 FDA (March 28, 2004): 1 1.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
ORGANIZATIONS
Asthma and Allergy Foundation of America. 1125 15th St.
NW, Suite 502. Washington, DC 20005. 800-7 ASTHMA.
<http://www.aafa.org>.
Center for Complementary and Alternative Medicine Research
in Asthma, Allergy, and Immunology. University of Cali-
fornia at Davis. 3150B Meyer Hall. Davis, CA 95616.
(916) 752-6575. <http://www-camra.ucdavis.edu>.
Douglas Dupler
Teresa G. Odle
Astigmatism
Definition
Astigmatism is a problem of visual distortion caused
by a misshapen cornea. The cornea acts as a focusing
lens for the eye. If the cornea does not have the proper
shape, the eye is unable to properly focus an image.
Most people have a certain degree of astigmatism. Cor-
rective measures are necessary only in cases where the
distortion is severe.
Description
Light rays entering a normal eye come to a point of
focus on the retina through a transparent, dome-shaped
layer called the cornea. In astigmatism there is unequal
curvature of the cornea, and the light rays come to focus at
more than one point on the retina. This causes the person
to see a blurred or doubled image. Astigmatism is usually
present at birth and may increase during childhood as the
eye tissue develops. Usually the degree of astigmatism re-
mains fairly constant throughout adulthood.
Causes & symptoms
It is unknown why some people develop a mis-
shapen cornea. It is possible that astigmatism is an inher-
ited trait. Factors such as stress, continual reading in dim
lighting, or excessive close-up work may also contribute
to the development of astigmatism. It is sometimes
caused by pressure from chalazion, a condition that
causes the eyelid to swell; from scars on the cornea; or
from keratoconus, a condition that involves swelling of
the cornea. The main symptom of astigmatism is blurred
or distorted vision. There may also be a history of
headaches, eye strain, fatigue, and double vision.
Diagnosis
The standard eye examination with a refraction
test, given by an optometrist or opthalmologist, is
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Horizontal line out of focus
Astigmatism corrected by lens
Astigmatism can be treated by the use of cylindrical lenses.
The lenses are shaped to counteract the shape of the sec-
tions of the cornea that are causing the difficulty. (Illustra-
tion by Electronic Illustrators Group.)
used to determine the presence of astigmatism. An in-
strument called a keratometer is used to measure the
cornea and calculate the shape of the required correc-
tive lens.
Treatment
The Bates method or other type of visual training
may be helpful in improving vision and reducing symp-
toms. The homeopathic remedies Ruta graveolens (from
common rue) and Apis mellifica (from the honey bee)
can be used to relieve eyestrain, one of the main symp-
toms and possible contributors to astigmatism.
Acupuncture treatment or Traditional Chinese
Medicine may help, as the liver system is connected to
eye functions. Certain treatments can strengthen and
correct the skewing of the Liver qi. ( Qi is the flow of
energy in the body. It is sometimes associated with cer-
tain organs.)
143
Astigmatism
Aston-Patterning
KEY TERMS
Chalazion — A condition in which clogging of the
Meibomiam gland causes a cyst inside the eyelid.
Keratoconus — A progressive condition in which
the cornea takes on a cone shape, causing major
changes in the eye's refractive power.
Refraction — The turning or bending of light waves
as the light passes from one medium or layer to
another. In the eye it means the ability of the eye
to bend light so that an image is focused onto the
retina.
Refractive surgery — Eye surgery to correct a de-
fect in the eye's ability to focus accurately on an
image.
Retina — The substance of the eye, made of nerve
tissue. It receives and transmits images to the
brain.
Allopathic treatment
Astigmatism can be most simply treated with either
eyeglasses or contact lenses. The lenses are made so as
to counteract the shape of the sections of cornea that are
causing difficulty. Contact lenses that are used to correct
astigmatism are called toric lenses. Hard contact lenses
may be better for correcting astigmatism than soft con-
tact lenses. In the case of keratoconus, a corneal trans-
plant is performed if the astigmatism cannot be corrected
with hard contact lenses.
Refractive surgery can be performed to correct the
curvature of the cornea. In radial keratotomy (RK) for
astigmatism, cuts are made into the cornea with a dia-
mond blade instrument. In photorefractive keratectomy
(PRK), a laser is used to improve the shape of the cornea
by removing micro-thin slices. Laser assisted in situ ker-
atomileusis (LASIK) is the most recently developed type
of refractive surgery. A flap of the cornea is cut with a
laser and then the corneal tissue underneath is shaved to
improve the shape.
Doctors continue to improve LASIK techniques. In
2002, a cross-cylinder method was developed in refrac-
tive surgery to help treat mixed astigmatism, one of the
most difficult types to treat. Refractive surgery requires
a high level of expertise. Anyone considering it should
make sure that the surgeon has a lot of experience in
the procedure. There should also be an in-depth discus-
sion of the possible side effects and risks of the proce-
dure. For instance, patients with flatter corneas seem to
come out of surgery with more light distortion than
144
those with curved corneas. Pupil size also may affect
surgery outcome.
Expected results
Effects of astigmatism can generally be greatly im-
proved with eyeglasses or contact lenses. Refractive
surgery may diminish the need for lenses or make them
unecessary altogether. The major risks of surgery include
chronic visual problems, injury to the eye tissue, infec-
tion, and over- or under-correction, which would still
leave some astigmatism. Complications may require the
use of medication or further surgery.
Resources
BOOKS
Lininger, Skye, ed. The Natural Pharmacy. Rocklin, Calif.:
Prima Health, 1998.
Newell, Frank W. Ophthalmology, Principles and Concepts.
8th ed. St. Louis: Mosby, 1996.
PERIODICALS
“Clues to LASIK Vision Problems (Risk of ‘Starbursts’).” Pre-
vention (June 2002): 161.
Meszaros, Liz. “Cross-Cylinder Technique Offers Many Bene-
fits. Little Trauma: Method to Correct Mixed Astigmatism
Minimizes Tissue Removal, not Ideal for High-Correction
Cases.” Ophthalmology Times (May 15, 2002): 41.
OTHER
“Refractive Surgery.” The Merck Manual Online. (December
2000).<http://www.merck.com/pubs/mmanual/section8/cha
pterl02/102c.htm/>.
Patience Paradox
Teresa G. Odle
Aston-Patterning
Definition
Aston-Patterning is an integrated system of move-
ment education, bodywork, ergonomic adjustments, and
fitness training that recognizes the relationship between
the body and mind for well being. It helps people who
seek a remedy from acute or chronic pain by teaching
them to improve postural and movement patterns.
Origins
Aston-Patterning is a process originated by Judith
Aston in 1977. After graduating from college with an
advanced degree in dance, Aston began working with
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
athletes, dancers, and actors in movement education pro-
grams in California. In 1968 she suffered injuries from
two automobile accidents. In seeking relief from pain,
she met Dr. Ida Rolf, the innovator of Rolfing. When
Aston recovered from her injuries, Rolf asked her to de-
velop a movement education program that would com-
plement the gains achieved with rolfing. She worked
with Rolf in creating this program from 1971 to 1977.
By 1977 Aston and Rolf’s interests and views of
bodywork had diverged. Aston left Rolf and established
her own techniques, which she called Aston-Patterning.
She has also developed a special program for older peo-
ple called the Aston-Patterning Fitness Program for Se-
niors. Today Aston-Patterning is a registered trademark
of the Aston Paradigm Corporation of which Judith
Aston is the director.
Benefits
Aston-Patterning assists people in finding more effi-
cient and less stressful ways of performing the simple
movements of everyday life to dissipate tension in the
body. This is done through massage, alteration of the en-
vironment, and fitness training.
Description
Seeking to solve movement problems, Aston-Pat-
terning helps make the most of their own unique body
types rather than trying to force them to conform to an
ideal. Unlike Rolfing, it doesn’t strive for linear symme-
try. Rather it works with asymmetry in the human body
to develop patterns of alignment and movement that feel
right to the individual. Aston also introduced the idea of
working in a three-dimensional spinal pattern.
Aston-Patterning sessions have four general compo-
nents. They are:
• A personal history that helps the practitioner assess the
client’s needs.
• Pre-testing, in which the practitioner and the client explore
patterns of movement and potential for improvement.
• Movement education and bodywork, including mas-
sage, myofacial release, and arthrokinetics, to help re-
lease tension and make new movement patterns easier.
• Post-testing, when pre-testing movements are repeated,
allowing the client to feel the changes that have taken
place and integrate them into daily life.
Aston-Patterning requires more participation from
the client than many bodywork techniques. The massage
aspect of Aston-Patterning is designed around a three-di-
mensional, non-compressive touch that releases patterns
of tension in the body. It is gentler than Rolfing. Myoki-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
JUDITH ASTON ?-
Judith Aston was born in Long Beach, California.
She graduated from University of California at Los An-
geles with a B.A. and a M.F.A. in dance. Her interest in
movement arose from working as a dancer. In 1963
Aston established her first movement education pro-
gram for dancers, actors, and athletes at Long Beach
City College.
Five years later, while recovering from injuries sus-
tained during two consecutive automobile accidents,
Aston met Ida Rolf, the developer of rolfing. Aston
began working for Rolf, teaching a movement educa-
tion program called Rolf-Aston Structural Patterning that
emphasized using the body with minimum effort and
maximum precision.
In time, Rolf and Aston's views on movement di-
verged, and the partnership was dissolved in 1977.
Aston formed her own company called the Aston Para-
digm Corporation in Lake Tahoe, California. This com-
pany provides training and certification for Aston practi-
tioners. She also began exploring how environmental
conditions affect body movement, foreshadowing the
ergonomic movement in the workplace that developed
in the 1990s. Over time, Aston has expanded her move-
ment work to include a fitness program for older adults.
Today, Judith Aston serves as director of Aston Paradigm
Corporation.
Tish Davidson
netics uses touch to release tension in the face and neck.
Arthrokinetics addresses tension at bones and joints.
This massage is accompanied by education about the es-
tablishment of new movement patterns.
In addition to Aston-Patterning sessions, clients are
also helped to examine their environment for factors, such
as seating or sleeping arrangements, that may limit their
body function and introduce tension. Finally, they may
choose to participate in the Aston fitness training program
that includes loosening techniques based on self-massage,
toning, stretching, and cardiovascular fitness.
Preparations
Since clients typically work with an Aston-Pattern-
ing practitioner for extended periods of time, it is impor-
tant that they feel comfortable with their specific practi-
tioner. Certified Aston practitioners recommend that
prospective clients make a get-acquainted visit before
enrolling in a course of treatment.
145
Aston-Patterning
Aston-Patterning
Precautions
Aston-Patterning can be quite demanding. People
with any of the following diseases or disorders should
consult a physician before undertaking a course of
Aston-Patterning :
• Heart conditions.
• Diabetes. Because diabetes affects blood circulation,
diabetics taking Aston-Patterning should ask the practi-
tioner to avoid massage of the legs and feet.
• Carpal tunnel syndrome. Aston-Patterning may worsen
the pain associated with this disorder.
• Respiratory disorders, including asthma and emphysema.
• Osteoporosis. The deep tissue massage in Aston-Pat-
terning may cause hairline fractures in brittle bones.
• Bleeding disorders and other disorders requiring treat-
ment with anticoagulant or corticosteroid medications.
Drugs in these categories can make the tissues fragile.
• Disorders requiring medications that affect the sense of
balance.
• Post-traumatic stress syndromes. People suffering from
acute stress disorder, post-traumatic stress disorder,
or other emotional disorders related to abuse should
consult a psychotherapist as well as a physician before
undertaking any form of bodywork. The physical con-
tact involved in Aston-Patterning may cause flashbacks
or bring up emotional and psychological issues.
The Aston-Patterning program can, however, be mod-
ified to meet the needs of older adults, those in poor
health, or persons with special rehabilitation requirements.
Side effects
Most clients of Aston-Patterning report a diminution
of tension, improved ease of movement, and an enhanced
feeling of well-being. Some clients, however, do report
side effects, the most common being pain and exhaustion.
To minimize side effects, clients should give the practi-
tioner as much feedback as possible during sessions.
Research & general acceptance
Aston-Patterning is an outgrowth of Rolfing that has
been shown to be of benefit in a limited number of con-
trolled studies. Little controlled research has been done on
either the benefits or limitations of Aston-Patterning; as of
early 2003, no reports have been published in any peer-re-
viewed medical, alternative medical, or bodywork journals.
Its claims have been neither proven nor disproved, al-
though anecdotally many clients report relief from pain
and tension as well as improved body movement. Aston-
146
KEY TERMS
Bodywork — Any healing technique involving
hands-on massage or manipulation of the body.
Ergonomics — A branch of applied science that co-
ordinates the physical design and arrangement of
furniture, machines, and other features of a living
or working environment with the needs and re-
quirements of the individuals in that environment.
Rolfing — Developed by Dr. Ida Rolf (1896-1979),
rolfing is a systematic approach to relieving stress
patterns and dysfunctions in the body's structure
through the manipulation of the highly pliant myofa-
cial (connective) tissue. It assists the body in reorga-
nizing its major segments into vertical alignment.
Patterning is a member of the International Alliance of
Healthcare Educators (IAHE), and Judith Aston is a fre-
quent speaker at IAHE conferences. In addition, Aston’s
postural assessment workbook is used by practitioners in
other fields of bodywork and physical therapy.
Training & certification
The Aston Training Center in Incline Village, Nevada,
offers courses and certification and promotes a code of
ethics among its practitioners. Certification must renewed
annually. As of early 2003 there are certified Aston-Pat-
terning practitioners in fifteen states, with the largest con-
centrations in California, Colorado, and Washington.
Resources
BOOKS
Aston, Judith. Aston Postural Assessment Handbook: Skills for
Observing and Evaluating Body Patterns. San Diego, CA:
Academic Press, Inc., 1998.
Pelletier, Kenneth R., MD. The Best Alternative Medicine, Part
I: Sound Mind, Sound Body. New York: Simon & Schus-
ter, 2002.
ORGANIZATIONS
Aston Training Center. P. O. Box 3568, Incline Village, NV
89450. (775) 831-8228. <http://www.aston-patteming.com>.
International Alliance of Healthcare Educators (IAHE). 11211 Pros-
perity Farms Road, D-325, Palm Beach Gardens, FL 34410.
(561) 622-4334 or (800) 311-9204. <http://www.iahe.com>.
OTHER
Rast, Mechthild. Book Review: Aston Postural Assessment Work-
book. Neuro-Developmental Treatment Association Network
January-February 2000. <http://www.ndta.org/edu>.
Tish Davidson
Rebecca J. Frey, PhD
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Astragalus
Description
Astragalus, also called milk vetch root, is the root of
the Astragalus membranaceus plant, which is a member
of the pea family. This perennial grows to a height of 2-A
ft. (5-10 cm). It has white or yellow flowers and leaves
with 10-18 pairs of leaflets. The large yellow taproots of
four- to seven-year-old plants are used for medicinal pur-
poses. Although there are many varieties in the Astra-
galus family. Astragalus membranaceus is the sole medi-
cinal type. The plant is found only in the grasslands and
mountains of central and western Asia, principally in
China, Taiwan, and Korea. Astragalus is a good source of
selenium, an antioxidant and immune system stimulant.
General use
Astragalus is called Huang Qi in traditional Chi-
nese medicine (TCM) and is considered to be an im-
portant tonic herb. It is used to strengthen what is
called the wei qi, or the defensive energy of the body
against disease. TCM identifies astragalus as being
helpful in conditions involving the Spleen, the Lungs,
and the Triple Burner. It is a warming tonic, and it im-
proves the functioning of the qi (the flow of energy in
the body), the Spleen, the Blood, and the fluids of the
body. Astragalus is recommended for Spleen deficien-
cy symptoms, such as diarrhea, fatigue, sweating,
and lack of appetite. It is used as a tonic for the Lungs
and is good for shortness of breath, asthma, and
chronic lung problems. Astragalus is prescribed for
arthritis, diarrhea, and nervous symptoms. It is often
given to people who are in a state of generally poor or
weakened health.
Astragalus is classified as an adaptogen, an herb that
increases the body’s endurance and resistance to a wide
array of physical, chemical, and biological stressors.
Adaptogens help normalize the functioning of various
body systems by affecting the action of hormones. Adap-
togens are usually beneficial in treating chronic condi-
tions. They have been found to enhance the immune re-
sponse, reduce inflammation, stabilize blood sugar, and
support the hormone systems, particularly the adrenal
and pituitary glands. Adaptogens should be used for an
extended period of time — at least six weeks.
Astragalus helps the body function at its best
level. It helps the body deal with stress and enhances
overall immune function. It has been shown to stimu-
late production and activation of the white blood cells,
which fight infection. It is highly recommended for
preventing and alleviating colds and flu. Astragalus
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
can be used to cure chronic weaknesses of the lungs.
Because it improves blood circulation and heart func-
tion, astragalus is useful in treating heart disease. It
has also been found to prevent or reduce blood clot-
ting. Astragalus can be taken as a tonic for the kidneys.
It has a diuretic (urine-producing) effect and so it
flushes out the urinary system. It is thus very effective
in treating kidney infections, proteinuria (too much
protein in the urine), chronic prostate problems, and
chronic urinary tract problems.
Astragalus is helpful to those taking chemotherapy
and radiation treatments. It reduces toxic side effects and
enhances therapeutic effects. Cancer patients who take
astragalus during or after cancer treatments tend to re-
cover more quickly from the ill effects of the treatment,
and they generally have better survival rates. This ap-
pears to be connected with the strengthening of the im-
mune system. Astragalus also stimulates the adrenal
glands, whose functions are suppressed in cancer. The
herb improves poor appetite, diarrhea, weakness, wast-
ing, and night sweats. This makes it helpful for cancer
patients as well as AIDS sufferers and those with other
debilitating diseases.
Astragalus is recommended as a tonic for the el-
derly. It protects cells from the aging process and
may diminish other negative effects of aging. For ex-
ample, it strengthens digestion, stimulates the ap-
petite, and helps improve mental functioning. Astra-
galus shows promise in the treatment of Alzheimer’s
disease. By itself or in combinations, it may be useful
in treating viral infections, hypoglycemia, diabetes
mellitus, chronic ulcers, insomnia,
hyperthyroidism, chronic fatigue syndrome, open
wounds, liver problems, sexual dysfunction, fertility
problems, and autoimmune diseases.
Preparations
Astragalus is available as a capsule, a tablet, a tinc-
ture, as a part of an herbal combination, as a prepared
tea, and as a sweet dried root that can be eaten or made
into tea. Traditionally, several slices of the root are often
added to soups and stews. A strong tea can be made by
boiling three ounces of astragalus root in three cups of
water and letting the mixture steep for at least five min-
utes. Two or three cups of the unheated tea can be taken
over the course of a day. In tincture form, 30-60 drops of
astragalus can be taken four times per day. Candied roots
can be purchased ready-made or prepared in the home.
Preparation involves combining four parts of the dried
root with one part honey in water, then simmering until
the herb is dried and brownish. In TCM, astragalus oint-
ments are used to heal wounds, particularly those that
are slow to heal.
147
Astragalus
Atherosclerosis
Resources
KEY TERMS
Adrenal glands — Glands atop the kidneys that
produce hormones.
Blood— In TCM, it is the fluid that transports phys-
ical and emotional nourishment.
Heat condition — A disease whose symptoms in-
clude fever, rashes, redness, dehydration, and in-
flammation.
Lungs — In TCM, the parts of the body associated
with breathing, such as the lungs and the skin. It
also regulates the movement of water and qi
through the body channels.
Qi — In the TCM system, the underlying force that
controls the body's movement, resistance to dis-
ease, use of nourishment, tissue integrity, and tem-
perature. It circulates through channels, or path-
ways, called meridians.
Spleen — In TCM, the system of organs that in-
cludes the pancreas, large muscles, the lips, the
eyelids, the lymph system, and the spleen. It also
includes the functions that extract nourishment
and convert it into qi and Blood.
Triple Burner — The pathways and relationships
between the Spleen, the Lungs and the Kidney.
Precautions
Since astragalus is a warming herb, its use should be
avoided in heat conditions, such as fevers or agitated
states. Astragalus membranaceus is the only species of
its family to have a medicinal use; other species may be
toxic. Therefore, local Western varieties should not be
used. Use only the root portion of the plant; other parts
of the plant may be poisonous.
Side effects
Sometimes individuals experience a slight stomach
upset or allergic reaction to astragalus. However, it is
generally a very safe herb, even at high doses.
Interactions
Astragalus increases the effectiveness of other herbs
when used in combinations. It is often used with Siberian
ginseng, Eleutherococcus senticosus; Echinacea spp.;
dong quai, Angelica sinensis; and Lingusticum wallichi.
Astragalus may interfere with the actions of diuretics, phe-
nobarbital, beta-blockers, and anticoagulants (substances
that prevent blood clotting). Users of these medications
should consult a healthcare provider before using the herb.
148
BOOKS
Graedon, Joe, and Teresa Graedon. The People's Pharmacy
Guide to Home and Herbal Remedies. New York: St. Mar-
tin’s Press, 1999.
Green, James. The Male Herbal: Health Care for Men and
Boys. Freedom, Calif.: Crossing Press, 1991.
Hart, Carol, and Magnolia Goh. Traditional Chinese Medicine:
The A-Z Guide to Natural Healing from the Orient. New
York: Dell. 1997.
OTHER
“Astragalus.” Go-Symmetry, <http://www.go-symmetry.com/
astragalus.htm.>
“Astragalus.” The Herbalist, <http://www.theherbalist.com/
astragal.htm.>
“Astragalus." HerbsHerbals.com. <http://www.herbsherbals.
com/astragalus.html.>
“Astragalus." Pro Health International, <http://www.planet.eon.
net/~wiggles/astra 1 galus.htm.>
Patience Paradox
Atherosclerosis
Definition
Atherosclerosis is the build up of plaque on the inside
of blood vessels. Atherosclerosis is often called arterioscle-
rosis, which is a general term for hardening of the arteries.
Description
Atherosclerosis, a progressive condition responsible
for most heart disease, is a type of hardening of the ar-
teries. It can be caused by normal aging processes, by
high blood pressure, and by some diseases, such as dia-
betes. Atherosclerosis can begin in the late teens, but it
usually takes decades for the signs and symptoms of the
disease to be apparent. Some people experience rapidly
progressing atherosclerosis in their 30s or later.
An artery is made up of several layers: an inner lin-
ing called the endothelium, an elastic membrane that al-
lows the artery to expand and contract, a layer of smooth
muscle, and a layer of connective tissue. Atherosclerosis
affects the inner lining of an artery. It is characterized by
plaque deposits that block the flow of blood. Plaque is
made of fatty substances, cholesterol, waste products
from the cells, calcium, iron, and fibrin, a material that
helps clot blood.
As plaque builds up in and around the cells of the
artery walls, they accumulate calcium. The innermost
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
layer thickens, the artery’s diameter is reduced, and
blood flow and oxygen delivery are decreased. Plaque
can rupture or crack open, causing the sudden formation
of a blood clot, called a thrombosis. As a result of throm-
bosis and/or the buildup of plaque, atherosclerosis can
cause a heart attack if it completely blocks the blood
flow in the coronary arteries. It can cause a stroke if it
completely blocks the carotid arteries of the brain. Ath-
erosclerosis can also occur in the arteries of the neck,
kidneys, thighs, and arms, and may lead to kidney fail-
ure, gangrene, and even death.
Causes & symptoms
It is thought that atherosclerosis is caused by the
body’s response to damage to the artery wall from cho-
lesterol, high blood pressure, and cigarette smoking. A
person who has all three of these risk factors is eight
times more likely to develop atherosclerosis than is a
person who has none. Physical inactivity, damage by ox-
idants, diabetes, and obesity are also risk factors for ath-
erosclerosis. High levels of the amino acid homocysteine
and abnormal levels of fats called lipoproteins also raise
the risk. Other risk factors include:
• High triglycerides. Most fat in food and in the body
takes the form of triglycerides. Blood triglyceride levels
above 400 mg/dL have been linked to atherosclerosis.
• Physical inactivity. Lack of exercise increases the risk
of atherosclerosis.
• Diabetes mellitus. The risk of developing atherosclero-
sis is seriously increased for diabetics and can be low-
ered by keeping diabetes under control. Many diabetics
die from heart attacks caused by atherosclerosis.
• Obesity. Excess weight increases the strain on the heart
and increases the risk of developing atherosclerosis,
even if no other risk factors are present.
• Heredity. People whose parents have coronary artery
disease, atherosclerosis, or stroke at an early age are at
increased risk.
• Sex. Before age 60, men are more likely to have heart
attacks than women.
• Age. Risk is higher in men who are 45 years of age and
older and women who are 55 years of age and older.
The symptoms of atherosclerosis differ depending
upon the location. They may involve:
• In the coronary (heart) arteries: chest pain, heart at-
tack, and sudden death.
• In the carotid arteries of the brain: sudden dizziness,
weakness, loss of speech, and blindness.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• In the femoral arteries of the legs: cramping and fa-
tigue in the calves of the legs when walking.
• In the renal arteries of the kidneys: high blood pressure
resistant to treatment.
Diagnosis
Physicians may be able to make a diagnosis of ath-
erosclerosis during a physical exam by means of a listen-
ing to the activity of the arteries and the heart with a
stethoscope and probing them with the hands. More de-
finitive tests are usually called for, however. These in-
clude an electrocardiogram, which shows the heart’s ac-
tivity; exercise electrocardiography, more familiarly
known as a stress test, conducted while the patient exer-
cises on a treadmill or a stationary bike; echocardiogra-
phy, a type of ultrasound using sound waves to create an
image of the heart’s chambers and valves; and ultra-
sonography to assess arteries of the neck and thighs.
Radionuclide angiography and thallium scanning
use radioactive material injected into the bloodstream.
These tests enable physicians to see the blood flow
through the coronary arteries and the heart chambers and
to record pictures of the heart. Coronary angiography is
the most accurate diagnostic method for artheroscerosis,
and it is also the only invasive procedure. A cardiologist
inserts a catheter equipped with a viewing device into a
blood vessel in the leg or arm and guides it into the heart.
A contrast dye makes the heart visible to x rays. Motion
pictures are taken of the dye flowing though the arteries,
and plaques and blockages are well defined.
Treatment
The most common treatments focus on dietary and
lifestyle changes to reduce cholesterol and other prob-
lems that contribute to atherosclerosis. Dietary modifica-
tions usually incorporate eating foods that are low in sat-
urated fats, cholesterol, sugar, and animal proteins. Foods
high in fiber, such as fresh fruits and vegetables, and
whole grains, are encouraged. By consuming fruits and
vegetables, the person also consumes helpful dietary an-
tioxidants, such as carotenoids found in vegetable pig-
ments, and bioflavenoids in fruit pigments. Liberal use of
onions and garlic is recommended, as well as eating fish,
especially cold-water fish, such as salmon. Smoking, al-
cohol, and coffee are to be avoided; and exercise is
strongly recommended. There are several well-known
programs, such as those created by Nathan and Robert
Pritikin and Dean Ornish, which are very helpful in set-
ting up and maintaining dietary and lifestyle programs.
Herbal remedies for atherosclerosis include garlic
( Allium sativum), ginger (Zingiber officinale), haw-
149
Atherosclerosis
Atherosclerosis
thorn (Crataegus oxycantha), (Ginkgo biloba), and
Siberian ginseng root (Eleutherococcus senticosus).
Gugulipids, or myrrh (Commiphora molmol ) is highly
regarded for its ability to lower cholesterol and triglyc-
eride levels. Other herbs with this ability include alfalfa
(Medicago sativum), turmeric (Curcuma longa), (Panax
ginseng ), and fenugreek (Trigonella foenum-graecum).
Atherosclerosis is a complex condition. Therefore, a
knowledgeable practitioner of herbal healing should be
consulted for recommendations on the right combination
of herbs and dosages.
Chelation therapy involves injecting a drug called
EDTA and drug taken orally called DMSA, together
with nutrients into the bloodstream. It is thought to work
by either binding to the calcium in plaque and transport-
ing it for excretion, or by acting as an antioxidant, or by
both methods. It has shown some success, but it remains
a controversial method.
Several disciplines can offer helpful long-term
treatment strategies for those with atherosclerosis. A
knowledgeable practitioner should be consulted.
Ayurvedic medicine practitioners combine diet, herbal
remedies, relaxation, and exercises. A homeopath will
prescribe a treatment regimen based on a complete as-
sessment. A traditional Chinese medicine practitioner
may prescribe a combination of herbs such as siler
(Ledebouriellla divaricata), Platycodon grandiflorum.
Polygonum multiflorum, and Bupleurum chinense.
Acupuncture and massage may be recommended, par-
ticularly for the accompanying circulatory problems. A
homeopath will prescribe remedies based on an in-depth
interview and evaluation.
Stress is known to worsen blood pressure and ather-
osclerosis, and hasten the progression of the disease.
Therapeutic relaxation techniques are, therefore, helpful
adjuncts to treatment. Recommended approaches include
yoga, meditation, guided imagery, biofeedback, and
counseling. In fact, a 2002 study showed that transcen-
dental meditation, when combined with diet, exercise
and antioxidant food supplements, contributed to nearly
a 33% reduced long-term risk for heart attack and stroke
in some patients.
Allopathic treatment
Allopathic treatment includes medications, balloon
angioplasty, and coronary artery bypass surgery. Most of
the drugs prescribed for atherosclerosis seek to improve
conditions that contribute to the disease, such as high
cholesterol, blood clots, or high blood pressure.
Angioplasty and bypass surgery are invasive proce-
dures that improve blood flow in the coronary arteries.
Coronary angioplasty is performed by a cardiologist. It
150
KEY TERMS
Cardiac catheterization — A treatment using a nar-
row tube to clear out a blocked blood vessel.
Cholesterol — A fat-like substance that is made by
the human body and eaten in animal products.
Cholesterol is used to form cell membranes and
process hormones and vitamin D. High choles-
terol levels contribute to the development of ath-
erosclerosis.
Homocysteine — An amino acid involved with
protein use in the body. High levels have been im-
plicated in the development of atherosclerosis.
Triglyceride — A fat that comes from food or is
made from other energy sources in the body. Ele-
vated triglyceride levels contribute to the develop-
ment of atherosclerosis.
is a nonsurgical procedure in which a catheter tipped
with a balloon is threaded from a blood vessel in the
thigh into the blocked artery. When the balloon is inflat-
ed, it compresses the plaque and enlarges the blood ves-
sel to open the blocked artery. In one-third of patients,
the artery narrows again within six months. The proce-
dure may have to be repeated and a wire mesh stent may
be placed in the artery to help keep it open. In bypass
surgery, a detour is created with grafted or synthetic
blood vessels. The blood can then go around the block-
age. Other procedures may be used, including catheteri-
zation and laser treatments.
Expected results
Atherosclerosis can be successfully treated, but not
cured. Studies have shown that atherosclerosis can be
delayed, stopped, and even reversed by aggressively low-
ering cholesterol and changing the diet.
Prevention
A healthy lifestyle — eating right, regular exercise,
maintaining a healthy weight, not smoking, and control-
ling hypertension — can reduce the risk of developing ath-
erosclerosis, help keep the disease from progressing, and
sometimes cause it to regress. A 2002 study presented
promising news about the impact of simple exercise on
modifying the elasticity of one’s arteries. A small group
of healthy but sedentary postmenopausal women began
walking at a moderate pace for 40 to 45 minutes a day
five times a week. By the end of 12 weeks, 48% of the
women had restored elasticity to their carotid arteries.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Resources
BOOKS
American Heart Association and American Cancer Society, ed.
Living Well, Staying Well. New York and Toronto: American
Heart Association and American Cancer Society, 1996.
The Editors of Time-Life Books. The Medical Advisor: The
Complete Guide to Alternative & Conventional Treatments.
Virginia: Time-Life Books, 1997.
Shealy, C. Norman. The Complete Family Guide to Alternative
Medicine. New York: Barnes & Noble Books, 1996.
PERIODICALS
“Research Briefs: Meditation Reduces Atherosclerosis.” GP
(May 13, 2002): 4.
"Walking Aids Older Women’s Arterial Elasticity, Helping
Heart.” Women s Health Weekly (May 23, 2002): 3.
ORGANIZATIONS
American Heart Association, National Center. 7272 Greenville
Avenue, Dallas, TX 75231M596, <http://www.amhrt.org.>
National Heart, Lung, and Blood Institute. RO. Box 30105,
Bethesda, MD 20824-0105. <http://www.nhlbi.nih.gov/
nhlbi/nhlbi.htm.>
Patience Paradox
Teresa G. Odle
Athlete's foot
Definition
Athlete’s foot is a common fungus infection in
which the skin of the feet, especially on the sole and
toes, becomes itchy and sore, cracking and peeling away.
Athlete’s foot, also known as tinea pedis, can be difficult
to clear up completely.
Athlete’s foot received its common name because
the infection is often found among athletes. This is be-
cause the fungi flourish best in the around swimming
pools, showers, and locker rooms.
Description
Athlete’s foot is very common, so common that
most people will have at least one episode with this fun-
gal infection at least once in their lives. It is found more
often in adult males. In fact, symptoms that appears to be
athlete’s foot in young children are probably caused by
some other skin condition.
Causes & symptoms
Athlete’s foot is caused by a fungal infection that espe-
cially affects the skin between the toes. The fungi that cause
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Athlete’s foot fungus on toes of patient. (Custom Medical
Stock Photo. Reproduced by permission.)
athlete’s foot include Trichophyton ruhrum, T. mentagro-
phytes, and Epidermophyton floccosum. These fungi live
exclusively on dead body tissue, such as hair, the outer layer
of skin, and the nails. The fungus grows best in moist,
damp, dark places with poor ventilation. The problem is
rare in children and those who customarily go barefoot.
Most people carry fungus on their skin. However, it
will only flourish to the point of causing athlete’s foot if
conditions are right. The fungi multiply on the skin when it
is irritated, weakened, or continuously moist. Sweaty feet,
tight shoes, synthetic socks that do not absorb moisture
well, a warm climate, and not drying the feet well after
swimming or bathing, all contribute to the overgrowth of
the fungus. Symptoms include itchy, sore skin on the toes,
with scaling, inflammation, and blisters. Blisters that
break, exposing raw patches of tissue, can cause pain and
swelling. The infected feet also may have an unpleasant
smell. As the infection spreads, itching and burning may
worsen. In severe cases, the skin cracks and seeps fluid.
Sometimes a secondary bacterial infection is also present.
If it is not treated, athlete’s foot can spread to the
soles of the feet and toenails. Stubborn toenail infections,
called tinea unguium, may appear at the same time, with
crumbling, scaling, and thickened nails, and nail loss. The
infection can spread further if patients scratch and then
touch themselves elsewhere (especially in the groin or
under the arms). It is also possible to spread the infection
to other parts of the body via contaminated bed sheets,
towels, or clothing. Athlete’s foot is more severe and more
common in people taking antibiotics, corticosteroids, birth
control pills, drugs to suppress immune function, and in
people with obesity, AIDS, and diabetes mellitus.
Diagnosis
A dermatologist can diagnose the condition by
physical examination and by examining a preparation of
151
Athlete's foot
Athlete's foot
skin scrapings under a microscope. Not all foot rashes
are athlete’s foot, which is why a physician should diag-
nose the condition before any remedies are used. In
order to properly diagnose the infection, the physician
may do a fungal culture. Using nonprescription products
on a rash that is not athlete's foot could worsen the rash,
therefore, proper diagnosis is important.
Treatment
The infected foot should be kept well ventilated. A
foot bath containing cinnamon has been shown to slow
down the growth of certain molds and fungi, and is said
to be very effective in clearing up athlete’s foot. Eight to
ten broken cinnamon sticks are boiled in four cups of
water, simmered for five minutes, and then steeped for
45 minutes. The mixture can be then placed in a basin
and used daily to soak the feet.
Herbal remedies used externally to treat athlete’s
foot include goldenseal ( Hydrastis canadensis ), tea tree
oil ( Melaleuca spp.), myrrh ( Commiphora molmol ), gar-
lic (Allium sativa), oregano oil (though its smell is quite
pungent), and calendula. The affected area should be
swabbed with an herbal mixture twice daily or the feet
should be soaked in a herbal footbath. Pau d’arco, also
called taheebo or lapacho, can be used for athlete’s foot
as well. The tea bags can be soaked in water for about 10
minutes and then placed on the affected areas, or by mak-
ing a tincture and directly rubbing the tea onto the toes.
Aromatherapy may be helpful. Several drops of the
essential oils of tea tree, peppermint (Mentha piperita), or
chamomile (Matricaria recutita ), can be added to the bath
water. Chamomile may be applied directly to the toes.
Allopathic treatment
Simple cases of athlete’s foot usually respond to an-
tifungal creams or sprays, such as tolnaftate (Aftate or
Tinactin), clotrimazole, miconazole nitrate (Micatin
products), or Whitfield’s tincture made of salicylic acid
and benzoic acid. Athlete’s foot may be resistant to topi-
cal medication and should not be ignored. If the infec-
tion is resistant, the doctor may prescribe an oral antifun-
gal drug such as ketoconozole or griseofulvin. Untreated
athlete’s foot may lead to a secondary bacterial infection
in the skin cracks.
Expected results
Athlete’s foot usually responds well to treatment, but
it is important to complete the recommmended treatment,
even if the skin appears to be free of fungus; otherwise,
the infection could return. Tinea unguium may accompany
athlete’s foot. It is typically very hard to treat effectively.
152
KEY TERMS
Corticosteroids — Synthetic hormones which con-
trol nutritional processes in the body as well as
the function of several organ systems.
Prevention
A healthy diet should be maintained. Foods with a
high sugar content should be avoided, including undilut-
ed fruit juice, honey, and maple syrup.
Good personal hygiene and a few simple precau-
tions can help prevent athlete’s foot. These include:
• The feet should be washed daily; care should be taken
to avoid contact with other parts of the body.
• The feet should be kept dry, especially between toes.
• Tight shoes and shoes made of synthetic material
should not be worn.
• The feet need to be kept well ventilated, especially in
the summer; bare feet and sandals are recommended.
• Absorbent polypropylene or white cotton socks are rec-
ommended; they should be and changed often.
• Bathing shoes should be worn in public bathing or
showering areas.
• A good quality foot powder should be used to keep the
feet dry.
• If anyone in the family has athlete’s foot, towels,
floors, and shower stalls should be washed with hot
water and disinfectant after use.
Resources
BOOKS
Donahue, Peggy Jo. Relief from Chronic Skin Problems. New
York: Dell Publishing, 1992.
Orkin, Milton, Howard Maibach, and Mark Dahl. Dermatol-
ogy. Connecticut: McGraw-Hill Professional Publishing,
1991.
Stoffman, Phyllis. The Family Guide to Preventing and Treat-
ing 100 Infectious Illnesses. New York: John Wiley and
Sons, 1995.
Thompson, June, et al. Mosby’s Clinical Nursing. St. Louis:
Mosby, 1998.
ORGANIZATIONS
American Podiatric Medical Association. 9312 Old George-
town Rd., Bethesda, MD 20814.
Patience Paradox
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Atkins diet
Definition
The Atkins diet is a high-protein, high-fat, very low-
carbohydrate regimen. It emphasizes meat, cheese, and
eggs, while discouraging foods such as bread, pasta,
fruit, and sugar. It is a form of ketogenic diet.
Origins
Robert C. Atkins, a cardiologist and internist, devel-
oped the diet in the early 1970s. It first came to public at-
tention in 1972 with the publication of Dr. Atkins' Diet
Revolution. It quickly became a bestseller but unlike
most other fad diets, has remained popular. At last count,
it had sold more than 15 million copies worldwide. Since
then, Atkins authored a number of other books on his
diet theme before his accidental death in 2003.
Benefits
The primary benefit of the diet is rapid and substan-
tial weight loss. By restricting carbohydrate intake, the
body will bum more fat stored in the body. Since there
are no limits on the amount of calories or quantities of
foods allowed on the diet, there is little hunger between
meals. According to Atkins, the diet can alleviate symp-
toms of conditions such as fatigue, irritability,
headaches, depression, and some types of joint and
muscle pain.
Description
The regimen is a low-carbohydrate, or ketogenic
diet, characterized by initial rapid weight loss, usually
due to water loss. Drastically reducing the amount of
carbohydrate intake causes liver and muscle glycogen
loss, which has a strong but temporary diuretic effect.
Long-term weight loss is said to occur because with a
low amount of carbohydrate intake, the body burns
stored fat for energy.
The four-step diet starts with a two-week induction
program designed to rebalance an individual’s metabo-
lism. Unlimited amounts of fat and protein are allowed
but carbohydrate intake is restricted to 15-20 grams per
day. Foods allowed include butter, oil, meat, poultry,
fish, eggs, cheese, and cream. The daily amount of car-
bohydrates allowed equals about three cups of salad veg-
etables, such as lettuce, cucumbers, and celery.
The second stage is for ongoing weight loss. It allows
15-40 grams of carbohydrates a day. When the individual
is about 10 pounds from their desired weight, they begin
the pre-maintenance phase. This gradually adds one to
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
three servings a week of high carbohydrate foods, such as
a piece of fruit or slice of whole-wheat bread. When the
desired weight is reached, the maintenance stage begins. It
allows 40-60 grams of carbohydrates per day.
Preparations
No advance preparation is needed to go on the diet.
However, as with most diets, it is generally considered ap-
propriate to consult with a physician and to have a physi-
cal evaluation before starting such a nutritional regimen.
The evaluation should include blood tests to determine
levels of cholesterol, triglycerides, glucose, insulin, and
uric acid. A glucose tolerance test also is recommended.
Precautions
Adherence to the Atkins diet can result in vitamin
and mineral deficiencies. In his books, Atkins recom-
mends a wide range of nutritional supplements, includ-
ing a multi-vitamin. Among his recommendations,
Atkins suggests the following daily dosages: 300-600
micrograms (meg) of chromium picolinate, 100-400
milligrams (mg) of pantetheine, 200 meg of selenium,
and 450-675 meg of biotin.
The diet is not recommended for lacto-ovo vegetari-
ans, since it cannot be done as successfully without pro-
tein derived from animal products. Also, vegans cannot
follow this diet, since a vegan diet is too high in carbohy-
drates, according to Atkins. Instead, he recommends
vegetarians with a serious weight problem give up vege-
tarianism, or at least include fish in their diet. In 2003, a
physicians group warned that high-protein diets may
cause permanent kidney loss in anyone with reduced
kidney function. They also can increase people’s risk of
colon cancer and osteoporosis.
Side effects
According to Atkins, the diet causes no adverse side
effects. Many health care professionals disagree. In a
fact sheet for the Healthcare Reality Check Web site
(http://www.hcrc.org), Ellen Coleman, a registered dieti-
cian and author, said the diet may have serious side ef-
fects for some people. She said complications associated
with the diet include ketosis, dehydration, electrolyte
loss, calcium depletion, weakness, nausea, and kidney
problems. “It is certainly riskier for overweight individu-
als with medical problems such as heart disease, hyper-
tension, kidney disease, and diabetes than it is for over-
weight people with no health problems,” she said.
People with diabetes taking insulin are at risk of be-
coming hypoglycemic if they do not eat appropriate car-
bohydrates. Also, persons who exercise regularly may
153
Atkins diet
Atkins diet
DR. ROBERT C. ATKINS 1930-2003
(APAA/ide World Photos. Reproduced by permission.)
Dr. Robert C. Atkins graduated from the University of
Michigan in 1951 and received his medical degree from
Cornell University Medical School in 1955 with a special-
ty in cardiology. As an internist and cardiologist he devel-
oped the Atkins diet in the early 1 970s. The diet is a keto-
genic diet — a high protein, high fat, and very low carbohy-
drate regimen resulting in ketosis. It emphasizes meat,
cheese, and eggs, while discouraging foods such as bread,
pasta, fruit, and sugar. It first came to public attention in
1 972 with the publication of Dr. Atkins' Diet Revolution.
The book quickly became a bestseller but unlike most
other fad diet books, this one has remained popular. At last
count, it had been reprinted 28 times and sold more than
10 million copies worldwide. Since then, Atkins has au-
thored a number of other books on his diet theme, includ-
ing Dr. Atkins' New Diet Revolution (1992), Dr. Atkins'
Quick and Easy New Diet Cookbook (1 997), and The Vita-
Nutrient Solution: Nature's Answer to Drugs (1 998).
During his life, Atkins saw about 60,000 patients in
his more than 30 years of practice. He also appeared on
numerous radio and television talk shows, had his own
syndicated radio program, Your Health Choices, and au-
thored the monthly newsletter Dr. Atkins' Health Revela-
tions. Atkins received the World Organization of Alterna-
tive Medicine's Recognition of Achievement Award and
was named the National Health Federation's Man of the
Year. He was the director of the Atkins Center for Com-
plementary Medicine which he founded in the early
1980s until his death in 2003. The center is located at
152 E. 55th St., New York, NY 10022.
Ken R. Wells
experience low energy levels and muscle fatigue from
low carbohydrate intake.
Research & general acceptance
Opinion from the general medical community re-
mains mixed on the Atkins diet, but is generally unfavor-
able. There have been no significant long-term scientific
studies on the diet. A number of leading medical and
health organizations, including the American Medical As-
sociation, American Dietetic Association (ADA), and the
American Heart Association oppose it. It is drastically
different than the dietary intakes recommended by the
U.S. Department of Agriculture and the National Insti-
tutes of Health. Much of the opposition is because the
diet lacks some vitamins and nutrients, and because it is
high in fat. In a hearing before the U.S. Congress on Feb-
ruary 24, 2000, an ADA representative called the Atkins
diet “hazardous” and said it lacked scientific credibility.
Just a month after Dr. Atkins’ death, two studies of-
fering scientific support of the diet’s claims emerged.
The research found that people lost weight without rais-
154
ing their cholesterol. However, one of the studies
showed that at the end of one year, dieters regained
much of the weight.
Training & certification
There is no formal training or certification required.
Resources
BOOKS
Atkins, Dr. Robert C. Dr. Atkins' Age-Defying Diet Revolution.
New York: St. Martin’s Press. 1999.
Atkins, Dr. Robert C. Dr. Atkins' Diet Revolution: The High
Calorie Way to Stay Thin Forever. New York: Bantam
Books. 1989.
Atkins, Dr. Robert C. Dr. Atkins’ New Diet Revolution. New
York City: Avon Books. 1992.
Atkins, Dr. Robert C. Dr. Atkins' Health Revolution: How
Complementary Medicine Can Extend Your Life. New
York: Bantam Books. 1990.
Atkins, Dr. Robert C. Dr. Atkins’ Vita-Nutrient Solution: Na-
ture’s Answer to Drugs. New York: Simon & Schuster.
1998.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Biotin — A B complex vitamin, found naturally in
yeast, liver, and egg yolks.
Carbohydrates — Neutral compounds of carbon,
hydrogen, and oxygen found in sugar, starches,
and cellulose.
Hypertension — Abnormally high arterial blood
pressure, which if left untreated can lead to heart
disease and stroke.
Ketogenic diet — A diet that supplies an abnormal-
ly high amount of fat, and small amounts of car-
bohydrates and protein.
Ketosis — An abnormal increase in ketones in the
body, usually found in people with uncontrolled
diabetes mellitus.
Pantetheine — A growth factor substance essential
in humans, and a constituent of coenzyme A.
Triglycerides — A blood fat lipid that increases the
risk for heart disease.
PERIODICALS
Alger, Alexandra. “Meat’s Neat.” Forbes (August 11, 1997):
129.
“Atkins Diet Vindicated But Long-term Success Questionable.”
Obesity, Fitness and Wellness Week (June 14, 2003): 25.
Carroll, Joanne. “The Ketogenic Diet: A Practical Guide for
Caregivers.” Journal of the American Dietetic Association
(March 1998): 316-321.
Cray, Dan, et al. “The Low-Carb Diet Craze.” Time (November
1, 1999): 72-79.
“Doctor Group Describes Dangers of Atkins Diet.” Obesity,
Fitness and Wellness Week (August 9, 2003): 33.
Gotthardt, Melissa Meyers. “The New Low-Carb Diet Craze.”
Cosmopolitan (February 2000): 148.
Hammock, Delia. “Dr. Atkins’ New Diet Revolution.” Good
Housekeeping (June 1997): 127.
Howe, Maggy. “Excess Pounds.” Country Living (November
1995): 60-61.
Merrell, Woodson. "How I Became a Low-Carb Believer.”
Time (November 1, 1999): 80.
Turner, Richard. “The Trendy Diet That Sizzles.” Newsweek
September 6, 1999): 60.
OTHER
Atkins Center for Complementary Medicine. 152 E. 55th St..
New York. NY 10022. 212-758-2110. http://www.atkins
center.com.
Ken R. Wells
Teresa G. Odle
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Atopic dermatitis see Eczema
Atractylodes
Description
Atractylodes is the dried or steam-dried rhizome
(rootstalk) of Atractylodes macrocephala or A. ovata ,
perennial north Asian herbs in the Compositae family. It
grows in mountain valleys, especially in China’s Zhe-
jiang province. It may also be cultivated. In autumn, it
presents magenta corolla blooms.
In Mandarin, atractylodes is called Bai Zhu, Bai Shu,
Yu Zhu, and Dong Zhu. The Cantonese term is Paak Sat ,
and the Japanese call it Byakujutsu. Common names in-
clude large-headed atractylodes, white atractylodes, and
white shu. Its pharmaceutical name, used to distinguish it
as a medicine, is Rhizoma Atractylodis, and it is one of
more than 500 plants recognized as official drugs in tradi-
tional Chinese medicine. Related species, A. lancea and
A. chinensis , both called black or gray atractylodes, are
also used medicinally for similar but distinct purposes.
General use
Practitioners of Chinese medicine believe that
atractylodes affects the Spleen and Stomach meridians,
or energy pathways in the body. Its medicinal properties
are considered warm, mildly bitter, and sweet.
Atractylodes is thought to dry dampness, strengthen
the Spleen or digestion, and promote diuresis, the forma-
tion and excretion of urine. It is used for diarrhea, gen-
eralized aching, mental fatigue, dizziness, lack of ap-
petite, vomiting, edema (accumulation of fluids), and
spontaneous sweating. It is also used to prevent miscar-
riage and to treat restless fetal movement. Other uses in-
clude restoring deficient digestion associated with poor
absorption, malnutrition, anorexia, metabolic acidosis,
hypogylcemia, and rheumatism. It has also been used to
treat tumors of the cervix, uterus, breast, and stomach.
According to traditional Chinese medicine, both white
and black atractylodes may be used for digestive and urinary
problems. Black atractylodes is more drying than white.
White atractylodes has the additional benefit of being a
“Spleen Qi tonic,” meaning that it rebuilds metabolic func-
tion by increasing nutrition, increasing energy, and regulat-
ing fluids. White atractylodes is also thought to have restora-
tive, normalizing effects on the digestive system and Liver.
Research on atractylodes has generally been conducted
in China and has focused on pharmacological investigation
and animal experiments. In-vitro and animal studies show it
155
Atractylodes
Attention-deficit hyperactivity disorder
KEY TERMS
Cold — In Chinese pathology, the term defines a
condition that has insufficient warmth, either ob-
jective (hypothermia) or subjective (feeling cold).
Decoction — A strong tea brewed for twenty to
thirty minutes.
Heat — In Chinese pathology, the term defines a
condition that has excessive heat, either objective
(fever, infection) or subjective (feeling hot).
Meridians — Energetic pathways inside the body
through which qi flows; also called channels.
Tincture — A solution of medicinal substance in alco-
hol, usually more or less diluted. Herb tinctures are
made by infusing the alcohol with plant material.
Qi — A Chinese medical term denoting active
physiological energy.
has significant diuretic, sedative, and hypoglycemic (lower-
ing of blood glucose) effects. Animal studies pinpoint the
essential oil as responsible for sedative effects. It also pro-
motes digestion and quells nausea and diarrhea.
Major chemical constituents include atractylone,
atractylol, butenolide B, acetoxyatractylon, hydroxya-
tractylon, and vitamin A.
Preparations
Atractylodes is not generally available in American
health food stores, but it can be found at most Chinese
pharmacies and Asian groceries. Good quality atracty-
lodes is large, firm, solid, aromatic, and has a yellowish
cross section.
The standard dose is 3-10 g as a decoction (strong tea)
or 1—4 ml of tincture. Doses of dried material are 3-12 g.
Atractylodes is commonly prescribed in conjunction
with moisture-removing drugs and digestants. Practition-
ers of Chinese medicine commonly also combine
atractylodes with other Chinese herbs. The following are
the major herbs with which it is combined and the symp-
toms for which the combinations are prescribed.
• Radix codonopsis ( Codonopsis pilosula, Dang Shen)
and rhizoma zingiberis ( Zingiber officinalis, Gan
Jiang , dried ginger root) for abdominal pain, disten-
tion, vomiting, and diarrhea.
• Fructus Immaturus Citri Aurantii ( Citrus aurantium,
Zhi Shi, unripened bitter orange) for reduced appetite
with abdominal distention and fullness due to Spleen
deficiency with qi stagnation.
156
•Gray or black atractylodes (Atractylodes japonica,
Cang Zhu ) for damp-cold painful obstruction or vagi-
nal discharge.
• Sclerotium Poriae Cocos ( Poria cocos; Fu Ling ; tucka-
hoe, poria, or Indian bread) and Ramulus Cinnamomi
Cassiae ( Cinnamomum cassia, Gui Zhi, cinnamon
twig) for congested fluids with distention of the chest
and edema due to Spleen deficiency.
• Astragalus (Astragalus memhranaceus, Huang Qi) and
Fructus Tritici ( Triticum aestivum, Fu Xiao Mai, name
wheat grain) for unrelenting spontaneous sweating.
• Ramulus Perillae (Perilla frutescens, Su Geng ) and
Pericarpium Citri Reticulatae (Citrus reticulata, Chen
Pi, aged tangerine rind) for restless fetus disorder with
qi stagnation giving rise to distention and fullness in
the chest and abdomen.
Precautions
According to tradition, atractylodes is contraindicat-
ed in the presence of deficient heat conditions.
Side effects
None noted.
Interactions
No interactions with pharmaceutical drugs have
been noted.
Resources
BOOKS
Bensky, Dan, and Andrew Gamble. Chinese Herbal Medicine:
Materia Meclica. Rev. ed. Seattle: Eastland Press, 1993.
Fan, Warner J-W. A Manual of Chinese Herbal Medicine: Prin-
ciples and Practice for Easy Reference. Boston: Shamb-
hala, 1996.
Holmes, Peter. Jade Remedies: A Chinese Herbal Reference for
the West. Boulder, Colo.: Snow Lotus Press, 1996.
Hsu, Hong-yen, et al. Oriental Materia Medica: A Concise
Guide. Long Beach, Calif.: Oriental Healing Arts Insti-
tute, 1986.
Erika Lenz
Attention-deficit
hyperactivity disorder
Definition
Attention-deficit hyperactivity disorder (ADHD) is
a developmental disorder characterized by distractibility,
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
hyperactivity, impulsive behaviors, and the inability to
remain focused on tasks or activities.
Description
ADHD, also known as hyperkinetic disorder (HKD)
outside the United States, is estimated to affect 7% of
children ages six to 11, or about 1.6 million children in
the United States. It also affects about 4% of adults. The
disorder affects boys more often than girls. Although dif-
ficult to assess in infancy and toddlerhood, signs of
ADHD may begin to appear as early as age two or three,
but the symptom picture changes as adolescence ap-
proaches. Many symptoms, particularly hyperactivity,
diminish in early adulthood. However, impulsivity and
inattention problems remain with up to 50% of ADHD
individuals throughout their adult life.
Children with ADHD have short attention spans and
are easily bored and/or frustrated with tasks. Although
they may be quite intelligent, their lack of focus fre-
quently results in poor grades and difficulties in school.
ADHD children act impulsively, taking action first and
thinking later. They are constantly moving, running,
climbing, squirming, and fidgeting, but often have trou-
ble with gross and fine motor skills. As a result, they
may be physically clumsy and awkward. Their clumsi-
ness may extend to the social arena, where they are
sometimes shunned due to their impulsive and intrusive
behavior. Some critics argue that ADHD is a condition
created and diagnosed in the Western world, particular to
the environment of highly developed countries, since it is
not diagnosed in other cultures. These critics of the
ADHD diagnosis feel that medicating a child does not
address the true underlying problem. They also note that
there may not be a problem at all because children are
naturally active and impulsive.
Causes & symptoms
The causes of ADHD are not known. However, it ap-
pears that heredity plays a major role in the development
of ADHD. Children with an ADHD parent or sibling are
more likely to develop the disorder. Before birth, ADHD
children may have been exposed to poor maternal nutri-
tion, viral infections, or maternal substance abuse. In
early childhood, exposure to lead or other toxins can
cause ADHD-like symptoms. Traumatic brain injury or
neurological disorders also may trigger ADHD symp-
toms. Although the exact cause of ADHD is not known,
an imbalance of certain neurotransmitters (the chemicals
in the brain that send messages between nerve cells) is
believed to be the mechanism behind ADHD symptoms.
A widely publicized study conducted by Ben Fein-
gold in the early 1970s suggested that allergies to certain
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
foods and food additives caused the characteristic hyper-
activity of ADHD children. Although some children may
have adverse reactions to certain foods that can affect
their behavior (for example, a rash might temporarily
cause a child to be distracted from other tasks), carefully
controlled follow-up studies have uncovered no link be-
tween food allergies and ADHD. Another popularly held
misconception about food and ADHD is that eating
sugar causes hyperactive behavior. Again, studies have
shown no link between sugar intake and ADHD. It is im-
portant to note, however, that a nutritionally balanced
diet is important for normal development in all children.
People with ADHD suffer from a variety of symp-
toms. These symptoms include such things as distrac-
tion, not paying attention, inconsistency, forgetfulness of
even simple tasks, fidgeting, verbal impulsivity, and so
on. It is interesting to note that everyone suffers from
these symptoms at times, but an individual with ADHD
will have more of these symptoms more of the time.
Some doctors indicated immature symmetric tonic
neck reflex (STNR) as a possible cause of certain symp-
toms. Other studies in 1993 and 1994 showed a link be-
tween the disorder and diet, dyes, and preservatives. In
another study in 1996, ADHD was linked to maternal
smoking during pregnancy.
Psychologists and other mental health professionals
typically use the criteria listed in the Diagnostic and Sta-
tistical Manual of Mental Disorders, Fourth Edition
(DSM-IV) as a guideline for determining the presence of
ADHD. For a diagnosis of ADHD, DSM-IV requires the
presence of at least six of the following symptoms of
inattention, or six or more symptoms of hyperactivity
and impulsivity combined.
Inattention
• fails to pay close attention to detail or makes careless
mistakes in schoolwork or other activities
• has difficulty sustaining attention in tasks or activities
• does not appear to listen when spoken to
• does not follow through on instructions and does not
finish tasks
• has difficulty organizing tasks and activities
• avoids or dislikes tasks that require sustained mental
effort (like homework)
• is easily distracted
• is forgetful in daily activities
Hyperactivity
• fidgets with hands or feet or squirms in seat
• does not remain seated when expected to
157
Attention-deficit hyperactivity disorder
Attention-deficit hyperactivity disorder
• runs or climbs excessively when inappropriate (in ado-
lescents and adults, feelings of restlessness)
• has difficulty playing quietly
• is constantly on the move
• talks excessively
Impulsivity
• blurts out answers before the question has been com-
pleted
• has difficulty waiting for his or her turn
• interrupts and/or intrudes on others
DSM-IV also requires that some symptoms develop
before age seven, and that they significantly impair func-
tioning in two or more settings (e.g., home and school) for
at least six months. Children who meet the symptom crite-
ria for inattention, but not for hyperactivity/impulsivity are
diagnosed with Attention-deficit/hyperactivity disorder,
predominantly inattentive type, commonly called ADD.
(Young girls with ADHD may not be diagnosed because
they have mainly this subtype of the disorder.)
Diagnosis
The first step in determining if a child has ADHD is
to consult with a pediatrician, a doctor who treats chil-
dren. The pediatrician can make an initial evaluation of
the child’s developmental maturity compared to other
children in his or her age group. The doctor also should
perform a comprehensive physical examination to rule
out any organic causes of ADHD symptoms, such as an
overactive thyroid or vision or hearing problems.
If no organic problem can be found, a psychologist, psy-
chiatrist, neurologist, neuropsychologist, or learning specialist
typically is consulted to perform a comprehensive ADHD as-
sessment. A complete medical, family, social, psychiatric, and
educational history is compiled from existing medical and
school records and from interviews with parents and teachers.
Interviews also may be conducted with the child, depending
on his or her age. Along with these interviews, several clinical
inventories also may be used, such as the Conners Rating
Scales (Teacher’s Questionnaire and Parent’s Questionnaire),
Child Behavior Checklist (CBCL), and the Achenbach Child
Behavior Rating Scales. These inventories provide valuable
information on the child’s behavior in different settings and
situations. In addition, the Wender Utah Rating Scale has been
adapted for use in diagnosing ADHD in adults.
It is important to note that mental disorders such as
depression and anxiety disorder can cause symptoms
similar to ADHD. A complete and comprehensive psychi-
atric assessment is critical to differentiate ADHD from
other possible mood and behavioral disorders. Bipolar
disorder, for example, may be misdiagnosed as ADHD.
158
Public schools are required by federal law to offer
free ADHD testing upon request. A pediatrician also can
provide a referral to a psychologist or pediatric specialist
for ADHD assessment. Parents should check with their
insurance plans to see if these services are covered.
Treatment
A 2003 survey showed that approximately 54% of
parents reported using complementary or alternative
medicine treatments for their children in the previous
year. Some parents reported turning to these therapies
because doctors don’t always agree on the ADHD diag-
nosis and cannot adequately explain how allopathic drug
treatments calm people and improve mental focus. Be-
havior modification therapy uses a reward system to re-
inforce good behavior as well as task completion and can
be used both in the classroom and at home. A tangible
reward such as a sticker may be given to the child every
time he completes a task or behaves in an acceptable
manner. A chart system may be used to display the stick-
ers and visually illustrate the child’s progress. When a
certain number of stickers are collected, the child may
trade them in for a bigger reward such as a trip to the zoo
or a day at the beach. The reward system stays in place
until the good behavior becomes ingrained.
A variation of this technique, cognitive-behavioral
therapy, works to decrease impulsive behavior by getting
the child to recognize the connection between thoughts
and behavior, and to change behavior by changing nega-
tive thinking patterns.
Individual psychotherapy can help ADHD children
build self-esteem, give them a place to discuss their worries
and anxieties, and help them gain insight into their behavior
and feelings. Family therapy also may be beneficial in help-
ing family members develop coping skills and work
through feelings of guilt or anger they may be experiencing.
ADHD children perform better within a familiar,
consistent, and structured routine with positive reinforce-
ments for good behavior and real consequences for bad.
Family, friends, and caretakers should be educated on
the special needs and behaviors of the ADHD child.
Communication between parents and teachers is espe-
cially critical to ensuring an ADHD child has an appro-
priate learning environment.
A number of alternative treatments exist for ADHD.
Although there is a lack of controlled studies to prove
their efficacy, proponents report that they are successful
in controlling symptoms in some ADHD patients. Some
of the more popular alternative treatments are listed.
• Electroencephalograph (EEG) biofeedback. By mea-
suring brain wave activity and teaching the ADHD pa-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
tient which type of brain wave is associated with atten-
tion, EEG biofeedback attempts to train patients to gen-
erate the desired brain wave activity.
• Dietary therapy. Based in part on the Feingold food al-
lergy diet, dietary therapy focuses on a nutritional plan
that is high in protein and complex carbohydrates and
free of white sugar and salicylate-containing foods
such as strawberries, tomatoes, and grapes.
• Herbal therapy. Herbal therapy uses a variety of natural
remedies to address the symptoms of ADHD. Ginkgo
( Gingko biloba) is used for memory and mental sharp-
ness and chamomile ( Matricaria recutita ) extract is
used for calming. The safety of herbal remedies has not
been demonstrated in controlled studies. For example,
it is known that gingko may affect blood coagulation,
but controlled studies have not yet evaluated the risk of
the effect.
• Vitamin and mineral supplements. Some vitamin and
mineral supplements that are thought to be effective by
some alternative practitioners include calcium, zinc,
magnesium, iron, inositol, trace minerals, blue-green
algae. Also recommended are the combined amino
acids GABA, glycine, taurine, L-glutamine, L-pheny-
lalanine, and L-tyrosine. In 2003, a study reported that
a combination of omega-3 and omega-6 fatty acids
supplements may help with cognitive and behavioral
symptoms of ADHD.
• Homeopathic medicine. This is probably the most effec-
tive alternative therapy for ADD and ADHD because it
treats the whole person at a core level. Constitutional
homeopathic care is most appropriate and requires con-
sulting with a well-trained homeopath who has experi-
ence working with ADD and ADHD individuals.
• Auricular acupuncture. A small study in 1997 indicat-
ed that this type of acupuncture therapy might be effec-
tive in some children.
Allopathic treatment
Psychosocial therapy, usually combined with medica-
tions, is the treatment approach of choice to alleviate
ADHD symptoms. Psychostimulants, such as dextroam-
phetamine (Dexedrine), pemoline (Cylert), and
methylphenidate (Ritalin) commonly are prescribed to
control hyperactive and impulsive behavior and increase
attention span. They work by stimulating the production of
certain neurotransmitters in the brain. Possible side effects
of stimulants include nervous tics, irregular heartbeat, loss
of appetite, and insomnia. However, the medications usu-
ally are well-tolerated and safe in most cases. But accord-
ing to Carolyn Chambers Clark, R.N., Ed.D., 25% of the
children with ADHD do not respond to stimulant drugs.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
In children who don’t respond well to stimulant
therapy, tricyclic antidepressants such as desipramine
(Norpramin, Pertofane) and amitriptyline (Elavil) are
frequently recommended. Reported side effects of these
drugs include persistent dry mouth, sedation, disorien-
tation, and irregular heartbeat (particularly with de-
sipramine). Other medications prescribed for ADHD
therapy include buproprion (Wellbutrin), an antidepres-
sant; fluoxetine (Prozac), an antidepressant; and carba-
mazepine (Tegretol, Atretol), an anticonvulsant drug.
Clonidine (Catapres), a medication for high blood pres-
sure, also has been used to control aggression and hyper-
activity in some ADHD children, although it should not
be used with Ritalin. A child's response to medication
will change with age and maturation, so ADHD symp-
toms should be monitored closely and prescriptions ad-
justed accordingly.
In mid-2003, the first new drug for treating ADHD
was about to become available. Called atomoxetine
(Strattera), it was planned to offer several advantages
over standard stimulants. First, atomoxetine is not a con-
trolled substance, so physicians can write prescriptions
for a larger number of pills and refills. Further, it doesn’t
have the potential for abuse that the stimulant drugs pose.
Expected results
Untreated, ADHD negatively affects a child’s social
and educational performance and can seriously damage
his or her sense of self-esteem. ADHD children have im-
paired relationships with their peers and may be looked
upon as social outcasts. They may be seen as slow learn-
ers or troublemakers in the classroom. Siblings and even
parents may develop resentful feelings toward the
ADHD child.
Some ADHD children also develop a conduct disor-
der problem. For those adolescents who have both ADHD
and a conduct disorder, up to 25% go on to develop anti-
social personality disorder and the criminal behavior,
substance abuse, and high rate of suicide attempts that are
symptomatic of it. Children diagnosed with ADHD also
are more likely to have a learning disorder, a mood disor-
der such as depression, or an anxiety disorder.
Approximately 70-80% of ADHD patients treated
with stimulant medication experience significant relief
from symptoms, at least in the short-term. Approximate-
ly half of ADHD children seem to “outgrow” the disor-
der in adolescence or early adulthood. The other half
will retain some or all symptoms of ADHD as adults.
With early identification and intervention, careful com-
pliance with a treatment program, and a supportive and
nurturing home and school environment, ADHD children
can flourish socially and academically.
159
Attention-deficit hyperactivity disorder
Aucklandia
KEY TERMS
Conduct disorder — A behavioral and emotional
disorder of childhood and adolescence. Children
with a conduct disorder act inappropriately, in-
fringe on the rights of others, and violate societal
norms.
Nervous tic — A repetitive, involuntary action,
such as the twitching of a muscle or repeated
blinking.
Resources
BOOKS
Alexander-Roberts, Colleen. The ADHD Parenting Handbook:
Practical Advice for Parents from Parents. Dallas: Taylor
Publishing Co., 1994.
American Psychiatric Association. Diagnostic and Statistical
Manual of Mental Disorders, 4th ed. Washington, DC:
American Psychiatric Press Inc., 1994.
Diller, Laurence H. Running on Ritalin: A Physician Reflects
on Children, Society, and Performance in a Pill. New
York: Bantam Books, 1998.
Hallowell, Edward M., and John J. Ratey. Driven to Distrac-
tion. New York: Pantheon Books, 1994.
Kennedy, Patricia, Leif Terdal, and Lydia Fusetti. The Hyper-
active Child Book. New York: St. Martin's Press, 1993.
Maxmen, Jerrold S., and Nicholas G. Ward. “Disorders Usually
First Diagnosed in Infancy, Childhood, or Adolescence.”
In Essential Psychopathology and Its Treatment, 2nd ed.
New York: W.W. Norton, 1995, 419-457.
Osman, Betty B. Learning Disabilities and ADHD: A Family
Guide to Living and Learning Together. New York: John
Wiley & Sons, 1997.
PERIODICAL
“Complementary, Alternative Medicine Being Used by Parents
for ADHD.” The Brown University Child and Adolescent
Psychopharmacology Update (August 2003): 1-3.
Gaby, Alan R. “Essential Fatty Acids for ADHD.” Townsend
Letter for Doctors and Patients (April 2003):43.
Glicken, Anita D. "Attention Deficit Disorder and the Pediatric
Patient: A Review.” Physician Assistant 2 1 . no. 4 (April
1997): 101-111.
Hallowell, Edward M. “What I've Learned from A.D.D." Psy-
chology Today 30, no. 3 (May-June 1997): 40-46.
Monaco, John E. “New Drug for ADHD." Pediatrics for Par-
ents (June 2003):7-l 1.
“New National ADHD Resource Center Opens in Maryland.”
Special Education Report (June 2003): 12.
“Parents Increasingly Seek Alternative ADHD Treatments.”
Mental Health Weekly (September 22, 2003):7.
Swanson, J.M., et al. “Attention-deficit Hyperactivity Disorder
and Hyperkinetic Disorder.” The Lancet 35 1 (February 7,
1997): 429-433.
160
ORGANIZATION
Children and Adults with Attention Deficit Disorder.
(CH.A.D.D.). 499 Northwest 70th Ave., Suite 101, Planta-
tion, FL 33317. (800) 233-4050. <http://www.chadd.org/.>
The National Attention Deficit Disorder Association. (ADDA).
9930 Johnnycake Ridge Rd., Suite 3E, Mentor, OH
44060. (800) 487-2282. <http://www.add.org/.>
The National Resource Center of ADHD. (800) 233-4050.
<http://www.help4adhd.org/.>
Kim Sharp
Teresa G. Odle
Aucklandia
Description
Aucklandia, also known as costus or Mu Xiang , is the
root of the plant Saussurea costus. Aucklandia has been
used for centuries in Chinese and Indian herbal healing.
More recently it has been used in Western aromatherapy.
Aucklandia comes from a perennial plant that grows
to about 6 ft (2 m) in height. It is native to northern India
and Pakistan. This plant is also cultivated in other parts
of India and in southwest China. The long, tapering root
is harvested and dried for healing.
In some regions of Asia, several other species of
plant are used interchangeably with Saussurea costus.
These include Saussurea lappa and Saussurea
vladimirus. Locally, aucklandia is also called kuth, kust,
kushta, qust-e-shereen, and patchak.
General use
Aucklandia is used in China and India to treat three
main categories of complaints that center around the diges-
tive system, the lungs, and infections. Aucklandia is used to
treat symptoms such as nausea, vomiting, diarrhea, colon
spasms, poor digestion, abdominal gas, and stomach pain.
In laboratory studies, aucklandia has been shown to be an
antispasmodic, accounting for its effectiveness against such
symptoms as nausea and diarrhea. It is also sometimes used
to treat gallstones and jaundice, although no scientific
studies have confirmed its effectiveness for these uses.
Aucklandia is used in many places in Asia to treat
asthma, bronchitis, and uncontrolled cough. The anti-
spasmodic component of the root extract causes the air-
ways to relax and open more widely so that breathing
becomes easier. This same property causes it to mildly
lower blood pressure by relaxing the artery walls. How-
ever, it does not lower blood pressure as effectively as
some other herbs.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
In India, aucklandia is used primarily as an antisep-
tic, an insecticide, and a fungicide. It is also said to be
effective against yeast infections. Some research sug-
gests that aucklandia may be effective against infections
such as cholera and typhoid.
A 1991 study published in the Journal of the Pak-
istani Medical Association found that oral doses of an
extract of the root of Saussurea lappa significantly re-
duced nematode infestation in children. Nematodes are
parasitic roundworms. Another 1998 study done in
Korea found that an extract of Saussurea lappa killed
tiny brine shrimp. One compound isolated in the brine
shrimp investigation is known to be moderately effective
in killing some types of human tumor cell types in labo-
ratory settings. It appears that the use of aucklandia as an
antiseptic has some basis in scientific fact.
Other uses of aucklandia that have not been investi-
gated in regulated scientific studies include using it as a
treatment for water retention and lung tumors. In addi-
tion to its medicinal uses, aucklandia is a fragrance and
fixative in perfumes, shampoo, and hair dye. It is used in
the Asian food industry to flavor alcoholic beverages,
soft drinks, and sweets.
Preparations
Aucklandia can be prepared as either a distilled ex-
tract or as an essential oil. The dried roots are chopped
fine and softened in warm water, then distilled with
steam. The resulting water-based distillate is then sub-
jected to a solvent extraction to remove the active ingre-
dients. The resulting yellow-brown fluid has a long-last-
ing woody or musty odor. In Chinese medicine, aucklan-
dia is classified as acrid and bitter.
Aucklandia is used in formulas to treat both diges-
tive and respiratory complaints. The best known of these
formulas is Mu Xiang Shun Qi Wan. It is used to relieve
pain and encourage digestion. Mu Xiang Shun Qi Wan is
also used to treat chronic hepatitis, newly developed cir-
rhosis of the liver, and abdominal pain. This formula is
commercially available as pills, with the recommended
dose of eight pills twice a day.
Several other common formulas contain aucklandia.
Ginseng and longan formula ( Gui Pi Tang ) is used to
treat gastrointestinal upsets and various kinds of physical
and emotional stress. Rhubarb and Scutellaria formula
(Li Dan Plan) is used to treat gallstones. Tang Gui and
indigo formula (Chien Chin Chih Tai Wan) is used to
treat vaginal discharge and vaginal infections, as well as
lower body pain.
The oil of aucklandia is more commonly used in
India than in China, and it is also used in Western aro-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Antispasmodic — A substance that relieves spasm
or uncontrolled contraction, usually of the smooth
or involuntary muscle of the arteries, intestines, or
the airways.
Distillate — When a substance is distilled (vapor-
ized and condensed to separate out different com-
pounds), the material that is obtained through that
process is called the distillate.
Yin aspects — Yin aspects are the opposite of yang
aspects and are represented by qualities such as
cold, stillness, darkness, and passiveness.
matherapy. It is applied externally or inhaled. The oil
also is used by the cosmetic and perfume industry, where
it blends well with other fragrances such as patchouli
and floral fragrances.
Precautions
In Chinese medicine, aucklandia should not be used
by people with deficient yin, which means people who
are dehydrated or have a lot of dryness.
Side effects
When used externally, aucklandia causes skin irrita-
tion (contact dermatitis) in some sensitive individuals.
Interactions
Aucklandia has been used safely in Asia as a medici-
nal herb and a food and cosmetic additive for centuries. It
is often used in conjunction with other herbs with no re-
ported interactions. Since aucklandia has been used al-
most exclusively in Asian medicine, there are no available
studies of its interactions with Western pharmaceuticals.
Resources
BOOKS
Lawless, Julia. The Illustrated Encyclopedia of Essential Oils.
Rockport, MA: Element, 1995.
Molony. David. Complete Guide to Chinese Herbal Medicine.
New York: Berkeley Books, 1998.
ORGANIZATIONS
American Association of Oriental Medicine (AAOM). 433
Front Street, Catasauqua, PA 18032. (610) 266-2433.
Tish Davidson
161
Aucklandia
Auditory integration training
Auditory integration training
Definition
Auditory integration training (AIT), is one specific
type of music/auditory therapy based upon the work of
French otolaryngologists Dr. Alfred Tomatis and Dr. Guy
Berard.
Origins
The premise upon which most auditory integration
programs are based is that distortion in how things are
heard contributes to commonly seen behavioral or learn-
ing disorders in children. Some of these disorders in-
clude attention deficit/hyperactive disorder (ADHD),
autism, dyslexia, and central auditory processing disor-
ders (CAPD). Training the patient to listen can stimulate
central and cortical organization.
Auditory integration is one facet of what audiolo-
gists call central auditory processing. The simplest defin-
ition of central auditory processing, or CAP, is Universi-
ty of Buffalo Professor of Audiology Jack Katz’s, which
is: “What we do with what we hear.” Central auditory in-
tegration is actually the perception of sound, including
the ability to attend to sound, to remember it, retaining it
in both the long- and short-term memory, to be able to
listen to sound selectively, and to localize it.
Guy Berard developed one of the programs com-
monly used. Berard’s auditory integration training con-
sists of twenty half-hour sessions spent listening to musi-
cal sounds via a stereophonic system. The music is ran-
dom, with filtered frequencies, and the person listens
through earphones. These sound waves vibrate and exer-
cise structures in the middle ear. This is normally done in
sessions twice a day for 10 days.
Alfred Tomatis is also the inventor of the Electronic
Ear. This device operates through a series of filters, and
reestablishes the dominance of the right ear in hearing. The
basis of Tomatis’ work is a series of principles that follow:
• The most important purpose of the ear is to adapt sound
waves into signals that charge the brain.
• Sound is conducted via both air and bone. It can be
considered something that nourishes the nervous sys-
tem, either stimulating or destimulating it.
• Just as seeing is not the same as looking, hearing is not
the same as listening. Hearing is passive. Listening is
active.
• A person's ability to listen affects all language develop-
ment for that person. This process influences every as-
pect of self-image and social development.
162
• The capacity to listen can be changed or improved
through auditory stimulation using musical and vocal
sounds at high frequencies.
• Communication begins in the womb. As early as the
beginning of the second trimester, fetuses can hear
sounds. These sounds literally cause the brain and ner-
vous system of the baby to develop.
Description
A quartet of CAP defects have been identified that
can unfavorably alter how each person processes sound.
Among these are:
• Phonetic decoding, a problem that occurs when the
brain incorrectly decodes what is being heard. Sounds
are unrecognizable, often because the person speaking
talks too fast.
• Tolerance-fading memory, a condition with little or
poor tolerance for background sounds.
•Auditory integration involves a person’s ability to put
together things heard with things seen. Characteristi-
cally there are long response delays and trouble with
phonics, or recognizing the symbols for sounds.
• The fourth problem area, often called auditory organi-
zation, overlaps the previous three. It is characterized
by disorganization in handling auditory and other infor-
mation.
Certain audiological tests are carried out to see if the
person has a CAP problem, and if so, how severe it is.
Other tests give more specific information regarding the
nature of the CAP problem. They include:
• Puretone air-conduction threshold testing, which mea-
sures peripheral hearing loss. If loss is found, then
bone-conduction testing, or evaluation of the vibration
of small bones in the inner ear, is also carried out.
• Word discrimination scores (WDS) determines a per-
son’s clarity in hearing ideal speech. This is done by
presenting 25-50 words at 40 decibels above the per-
son’s average sound threshold in each ear. Test scores
equal the percentage of words heard correctly.
• Immittance testing is made up of two parts, assessing
the status of, and the protective mechanisms of the
middle ear.
• Staggered sporadic word (SSW) testing delivers 40
compound words in an overlapping way at 50 decibels
above threshold to each ear of the person being tested.
This test provides expanded information that makes it
possible to break down CAP problems into the four
basic types.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
ALFRED TOMATIS 1920-2001
(Photograph by V. Brynner. Gamma Liaison. Reproduced by
permission.)
Internationally renowned French otolaryngologist,
psychologist, educator and inventor Alfred Tomatis early-
on perceived the importance of sound and hearing. He
took his degree as a Doctor of Medicine from the Univer-
sity of Paris and specialized in ear, nose and throat medi-
cine. The son of two opera singers, Tomatis early in his
career treated some of his parents' fellow opera singers.
From these experiences with the sound of music, he de-
veloped the principle that has come to be known as the
Tomatis Effect, i.e. that the human voice can only sing
what it hears.
Tomatis has been called the Einstein of the ear. It
was his research that made the world aware that the ears
of an infant in utero are already functioning at four and
half months of age. Just as the umbilical cord provides
nourishment to the unborn infant's body, Tomatis postu-
lated that the sound of the mother's voice is also a nutri-
ent heard by the fetus. This sound literally charges and
stimulates the growth of the brain.
Dr. Tomatis took this further, into the realm of lan-
guage. Tomatis concluded that the need to communicate
and to be understood are among our most basic needs.
He was a pioneer in perceiving that language problems
convert into social problems for people. "Language is
what characterizes man and makes him different from
other creatures," Tomatis is quoted as saying. The tech-
niques he developed to teach people how to listen effec-
tively are internationally respected tools used in the treat-
ment of autism, attention-deficit disorder, and other
learning disabilities.
His listening program, the invention of the Electronic
Ear, and his work with the therapeutic use of sound and
music for the past fifty years have made Tomatis arguably
the best known and most successful ear specialist in the
world. There are more than two hundred Tomatis Centers
worldwide, treating a vast variety of problems related to
the ability to hear.
Joan Schonbeck
• Speech in noise discrimination (SN) testing is similar to
Staggered Sporadic Word testing except that other noise
is also added and the percentage correct in quiet is com-
pared with that correct when there is added noise.
• Phonemic synthesis (PS) determines serious learning
problems. The types of errors made in sounding out
written words or associating written letters with the
sounds they represent help in determining the type and
severity of CAP problems.
Benefits
Upon completion of an auditory integration training
program, the person’s hearing should be capable of per-
ceiving all frequencies at, or near, the same level. Total
improvement from this therapy, in both hearing and be-
havior, can take up to one year.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Research & general acceptance
Auditory integration training is based upon newly
learned information about the brain. Though brain structures
and connections are predetermined, probably by heredity,
another factor called plasticity also comes into play. Learn-
ing, we now know, continues from birth to death. Plasticity
is the ability of the brain to actually change its structuring
and connections through the process of learning.
Problems with auditory processing are now viewed
as having a wide-reaching ripple effect on our society. It
is estimated that 30-40% of children starting school
have language-learning skills that can be described as
poor. CAP difficulties are a factor in several different
learning disabilities. They affect not only academic suc-
cess, but also nearly every aspect of societal difficulties.
One example to illustrate this is a 1989 University of
163
Auditory integration training
Aura therapy
Buffalo study where CAP problems were found to be
present in a surprising 97% of youth inmates in an up-
state New York corrections facility.
Training & certification
Both Tomatis and Berard have certification pro-
grams in their therapies.
Resources
BOOKS
Katz, Jack, Ph.D., Wilma Laufer Gabbay, M.S., Deborah S.
Ungerleider, M.A., and Lorin Wilde, M.S. Handbook of
Clinical Audiology. Waverly Press, Inc., 1985.
PERIODICALS
Katz, Jack, Ph.D. “Central Auditory Processing Evaluation."
(1996).
Masters, M. Gay. “Speech and Language Management of
CAPD.” (1996).
Musiek, Frank, Ph.D. "Auditory Training: An Eclectic Ap-
proach.” American Journal of Audiology (1995).
OTHER
“Auditory Integration and Alfred Tomatis.” The Spectrum Cen-
ter. <http://listeningtraining.com/ (December 2000). >
Cooper, Rachel. “What is Auditory Integration Training?”
http://www.vision3d.com/adhd/ (December 2000).
Dejean, Valerie. About the Tomatis Method, 1997 . Tomatis Au-
ditory Training Spectrum Center, Bethseda, MD.
Masters, M. Gay and Jack Stecker Katz, N.A. Central Auditory
Processing Disorders: Characteristic Difficulties.
Miniseminar, 1994.
Joan Schonbeck
Aura therapy
Definition
Aura therapy is a healing technique based on read-
ing a person’s aura, or vital energy field, and then treat-
ing diseases revealed by the aura color or colors. Aura
therapy is generally considered a subtype of biofield
therapy, which is a form of energy therapy that utilizes
energies thought to reside in or emanate from the human
body (as distinct from electromagnetic energy therapies).
There are several variations of treatment, but in general
aura therapy emphasizes manipulating the aura energy
back into a positive balance.
Origins
The exact origin of aura therapy is unknown, but
historical references to it date back about 5,000 years.
164
East Indian, Chinese, Jewish, and Christian faiths all
have references to auras as energies that vibrate through
physical matter. The energies are seen as colors and rep-
resent such states of being emotional, mental, astral, and
celestial. Halos have also been considered a kind of aura.
Historically, it was believed that the special powers of a
psychic, mystic, or clairvoyant were needed to see auras.
Today, there are many New Age centers that teach the art
of aura reading and therapy.
In the late 1890s, the scientist and inventor Nicola
Tesla (1856-1943) became the first person to photograph
an aura. Auric photography took a big leap forward in
the late 1930s when Semyon and Valentina Kirlian intro-
duced a high-voltage imaging process that became
known as Kirlian photography. Although there have
been challenges to the use of Kirlian photography, the
process was designed to photograph aura energy emitted
by life forms, including plants, animals, and humans. A
newer variation is aura imaging photography, which uses
a special camera to take instant photos of a person’s
aura. The size, shape, and color of the aura can then be
analyzed to reveal specific physical, emotional, and
mental problems.
Types of aura therapy
Since the early 1970s, several different forms of
aura therapy have emerged within the alternative medi-
cine field. Some brief descriptions follow.
Aura color therapy
Aura color therapy is more closely related to light
therapy than to such other forms of aura therapy as ther-
apeutic touch. In aura color therapy, the proportions of
the colors in a person’s aura as well as their clarity or in-
tensity are analyzed and treated. Aura color therapists
maintain that the aura of a healthy person will have an
undistorted oval shape around the body, with clear lines
of light energy and a perfect balance of the seven colors
of the rainbow. Muddy colors, bulges or swirls in the en-
ergy lines, or an absence of any of the major colors signal
energy imbalances. For example, a depressed person will
have large amounts of blue and green in the aura with no
orange or yellow. A chronically angry person will have
too much red and little or no blue.
Color therapy treatment consists of adding extra col-
ors to a dull or depleted aura or using complementary
colors to correct a color imbalance in the aura. For exam-
ple, orange, which is the complementary color of blue,
would be used to treat the aura of a depressed person.
Several different techniques may be used to add or bal-
ance the colors, the most common being the use of col-
ored lights to irradiate the client’s body, or the placement
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
of colored gemstones on the client’s body while he or she
lies on the floor or on a massage table. In another varia-
tion of aura color therapy, the client is advised to wear
clothing in colors intended to balance or correct the aura.
Therapeutic touch (TT)
Therapeutic touch, or TT, is a form of energy thera-
py that was developed in the United States in 1972 by
Dora Kunz, a psychic healer, and Dolores Krieger, a pro-
fessor of nursing at New York University. In TT, the
practitioner alters the patient’s energy field through a
transfer of energy from his or her hands to the patient.
When illness occurs, it creates a disturbance or blockage
in the aura or vital energy field. The TT practitioner uses
her/his hands to discern the blockage or disturbance. Al-
though the technique is called “therapeutic touch,” there
is generally no touching of the client’s physical body,
only his or her energetic body or biofield. TT is usually
performed on fully clothed patients who are either lying
down on a flat surface or sitting up in a chair.
A therapeutic touch session consists of five steps or
phases. The first step is a period of meditation on the
practitioner’s part, to become spiritually centered and en-
ergized for the task of healing. The second step is assess-
ment or discernment of the energy imbalances in the pa-
tient’s aura. In this step, the TT practitioner holds his or
her hands about 2-3 inches above the patient’s body and
moves them in long, sweeping strokes from the patient’s
head downward to the feet. The practitioner may feel a
sense of warmth, heaviness, tingling, or similar cues, as
they are known in TT. The cues are thought to reveal the
location of the energy disturbances or imbalances. In the
third step, known as the unruffling process, the practi-
tioner removes the energy disturbances with downward
sweeping movements. In the fourth step, the practitioner
serves as a channel for the transfer of universal energy to
the patient. The fifth step consists of smoothing the pa-
tient’s energy field and restoring a symmetrical pattern
of energy flow. After the treatment, the patient rests for
10-15 minutes.
Tellington touch (Ttouch)
Tellington touch, which is also known as Ttouch, is an
interesting instance of an alternative therapy that began in
veterinary practice and was later extended to humans.
Ttouch was developed in England by Linda Tellington-
Jones, a graduate of Feldenkrais training. The Feldenkrais
method, which is usually considered a bodywork therapy,
originated with Dr. Moshe Feldenkrais (1904-1984), a
scientist and engineer who was also a judo instmctor. The
Feldenkrais method is based on redirecting the client’s ha-
bitual patterns of body movement, but it is unusual among
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
bodywork therapies in its emphasis on new patterns of
thinking and imagination as byproducts of the body’s reed-
ucation. Tellington-Jones, who was employed as a horse
trainer, began using Feldenkrais techniques on horses in
1975. In 1983 she developed the pattern of circular touch-
ing motions known as Tellington touch.
In the 1980s, Ttouch expanded from treating behav-
ioral problems in horses to treating cats, dogs, and other
household pets. In the 1990s, Ttouch was introduced into
nursing school curricula for the treatment of humans. It
has been used to treat patients suffering from such
chronic conditions as pain syndromes, Alzheimer’s dis-
ease, arthritis, and multiple sclerosis as well as patients
recovering from traumatic injuries or stroke. Ttouch is
growing in popularity among hospice nurses as an alter-
native treatment for patients facing death.
In Ttouch, the practitioner touches the client’s skin
but does not manipulate the underlying muscles or
bones. The practitioner imagines the face of a clock on
the client’s body and places a lightly curved finger at the
6-o’clock position. He or she then pushes the skin clock-
wise around the face of the clock for one and one-quarter
circles, maintaining a constant pressure. The client’s
body is gently supported with the practitioner’s free
hand, which is placed opposite the hand making the cir-
cle. After each circular touch, the practitioner gently
slides the hand down the body and repeats the circle.
Benefits
Aura therapy is generally designed to bring imbal-
ances in the aura back into physical, mental, emotional,
and spiritual balance. The benefits can be subtle (like a
general feeling of peace and well-being) or dramatic
(like experiencing a spiritual transformation or feelings
of ecstasy). Changes may be immediate or can occur
over several days. Repeated therapy sessions can main-
tain and deepen the aura energy balance.
Persons who have received therapeutic touch or
Tellington touch from nurses frequently mention “com-
fort” or “humanizing of health care” as important benefits.
Therapeutic touch and Tellington touch appear to
benefit patients in intensive care units (ICUs), who fre-
quently develop mild psychiatric disturbances from being
isolated and from the fact that ICU equipment interferes
with normal human sensory perception. It is thought that
TT and Ttouch help to break down the patient's feelings
of isolation and disconnection from other people.
Description
Traditionally, an aura is a protective psychic and
spiritual energy field that surrounds the physical body.
165
Aura therapy
Aura therapy
Energy from an aura is usually not static. It is constantly
flowing, flashing, vibrating, expanding, and decreasing.
The colors detected usually indicate emotions, such as:
• lavender and purple for spirituality
• red/orange for sexual passion
• white for truth
• rose or pink for love
• red for anger
• yellow for intellect
Slow, deep breaths expand the aura while fast, shallow
breaths decrease it. Spaces or gaps in the aura usually signi-
fy disease. These gaps often appear near the affected area,
such as around the heart to signify heart disease. In gener-
al, auras have seven levels. Physical and ethereal auras ex-
tend up to a foot from the body, imagination and emotional
auras extend about two feet, while the mental, archetypal
(destiny), and spiritual auras extend about three feet.
There seems to be a general consensus among aura
therapists that more than one session is required for opti-
mal balancing. Many suggest three sessions within two
or three weeks. The first session focuses on the physical
aura, the next on the emotional, and the third on the spir-
itual. Once the aura levels are in balance, follow-up ses-
sions are encouraged every six months to a year. Aura
therapy is not covered by medical insurance. The cost
can range from $50 to $100 or more per session.
Preparations
No advance preparation is required. However, many
aura readers and therapists say the patient should have a
genuine desire for better health and happiness. Also,
many therapists suggest patients abstain from recreation-
al drugs, alcohol, and sex for several days before the
therapy for a better sense of clarity and focus.
Precautions
There are no known precautions associated with
aura therapy.
Side effects
No negative side effects associated with aura thera-
py have been reported, although a small minority of pa-
tients treated with TT or Ttouch report feeling uncom-
fortable with being touched by strangers.
Research & general acceptance
Aura color therapy is considered a New Age treat-
ment and is not generally accepted as valid by the con-
166
ventional medical community. Skeptics argue that there
are no scientific studies documenting the benefits of aura
therapy or the existence of a human biofield. Most re-
ports of the benefits of aura color therapy are anecdotal
and appear in New Age journals and magazines.
Although therapeutic touch has become a popular
alternative/complementary approach in some schools of
nursing in the United States and Canada, acceptance by
the mainstream medical community varies. Many hospi-
tals permit nurses and staff to perform TT on patients at
no extra charge. On the other hand, however, therapeutic
touch became national news in April 1998 when an ele-
mentary-school student carried out research for a science
project that questioned its claims. Twenty-one TT practi-
tioners with experience ranging from one to 27 years
were blindfolded and asked to identify whether the in-
vestigator’s hand was closer to their right hand or their
left. Placement of the investigator's hand was determined
by flipping a coin. The TT practitioners were able to
identify the correct hand in only 123 (44%) of 280 trials,
a figure that could result from random chance alone. De-
bate about the merits of TT filled the editorial pages of
the Journal of the American Medical Association for
nearly a year after the news reports.
Tellington touch training is offered by some schools
of veterinary medicine in the United States, and as of
2003 is also offered in continuing education programs in
schools of nursing. It appears to be gaining wider sup-
port from the mainstream medical community as a useful
technique in calming patients facing unpleasant or
painful procedures. One study found that patients await-
ing venipuncture who received Ttouch were more re-
laxed before the procedure and had significantly less dis-
comfort afterward.
Training & certification
No formal training or certification is required to
practice aura reading, aura color therapy, TT, or Ttouch.
However, a number of alternative medicine and New
Age healing schools offer formal training and certifica-
tion. Therapeutic touch and Tellington touch have their
own training and certification programs.
Resources
BOOKS
Bain, Gabriel Hudson. Auras 101 : A Basic Study of Human
Auras and the Techniques to See Them. Flagstaff, AZ:
Light Technology Publications, 1998.
Bartlett, Sarah. Auras and How to See Them. London, UK:
Collins & Brown, 2000.
Chiazzari, Suzy. The Complete Book of Color: Using Color for
Lifestyle. Health, and Well-Being, Part Six: Healing
Through the Aura. Boston, MA: Element, 1998.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Astral — Of or from the stars.
Aura — An energy field that is thought to emanate
from the human body and to be visible to people
with special psychic or spiritual powers.
Biofield therapies — A subgroup of energy thera-
pies that make use of energy fields (biofields)
thought to exist within or emanate from the
human body. Biofield therapies include such ap-
proaches as aura therapy, Reiki, therapeutic touch,
qigong, and polarity balancing.
Bodywork — Any healing technique involving
hands-on massage or manipulation of the body.
Clairvoyant — A person who has the power to see
within their mind a future event or an event or
thing out of their visual range.
Ethereal — Something that is of or from the heav-
ens, usually used in a metaphysical sense.
Tellington touch (Ttouch) — A form of energy ther-
apy that combines aspects of the Feldenkrais
method of bodywork with aura therapy.
Therapeutic touch (TT) — An American form of en-
ergy therapy based on the ancient tradition of the
laying-on of hands. TT is thought to work by re-
moving energy blockages or disturbances from the
patient's aura.
Krieger, Dolores, Ph.D., R.N. Accepting Your Power to Heal:
The Personal Practice of Therapeutic Touch. New York:
Bear & Company, 1993.
MacFarlane, Muriel. Heal Your Aura: Finding True Love by
Generating A Positive Personal Energy Field. Secaucus,
NJ: Citadel Press, 1999.
Oslie, Pamela. Life Colors: What the Colors in Your Aura Re-
veal. Novato, CA: New World Library, 2000.
Snellgrove, Brian. The Magic in Your Hands: How to See Auras
and Use Them for Diagnosis and Healing. Essex, UK: C.
W. Daniel, 1998.
Tellington-Jones, Linda, and Sybil Taylor. The Tellington
Touch: A Breakthrough Technique to Train and Care for
Your Favorite Animal. New York and London, UK: Pen-
guin Books, 1995.
PERIODICALS
Demmer, C., and J. Sauer. “Assessing Complementary Therapy
Services in a Hospice Program.” American Journal of
Hospice and Palliative Care 19 (September-October
2002): 306-314.
Hewitt, J. “Psychoaffective Disorder in Intensive Care Units: A
Review.” Journal of Clinical Nursing 11 (September
2002): 575-584.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Rosa, Linda, MSN; Emily Rosa; Larry Sarner; and Stephen
Barrett, MD. “A Close Look at Therapeutic Touch.” Jour-
nal of the American Medical Association 279 (April 1,
1998): 1005-11.
“Somesthetic Aura: The Experience of Alice in Wonderland.”
The Lancet (June 27 , 1998): 1934.
Wendler, M. Cecilia. “Tellington Touch Before Venipuncture:
An Exploratory Descriptive Study.” Holistic Nursing
Practice 16 (July 2002): 51-64.
ORGANIZATIONS
Feldenkrais Guild of North America. 3611 S.W. Hood Avenue,
Suite 100, Portland, OR 97201. (800) 775-2118 or (503) 221-
6612. Fax: (503) 221-6616. <http://www.feldenkrais.com>.
International Society for the Study of Subtle Energies and En-
ergy Medicine (ISSSEEM). 356 Goldco Circle. Golden,
CO 80401. (303) 278-2228. <http://www.vitalenergy.
com/ISSS EEM.>.
National Center for Complementary and Alternative Medicine
(NCCAM) Clearinghouse. P.O. Box 7923, Gaithersburg,
MD 20898. (888) 644-6226. TTY: (866) 464-3615. Fax:
(866) 464-3616. <http://www.nccam.nih.gov.>.
The Nurse Healers Professional Associates International (NH-
PAI), the Official Organization of Therapeutic Touch. 3760
S. Highland Drive, Salt Lake City, UT 84106. (801) 273-
3399. nhpai@therapeutic-touch.org. <http://www.therapeu-
tic-touch.org.>.
TTEAM/Ttouch in USA. P. O. Box 3793, Santa Fe, NM 87506.
(800) 854-8326. <http://www.tellingtontouch.com>.
TTEAM/Ttouch in Canada. Rochdell Road, Vernon, BC V1B
3E8. (250) 545-2336. <http://www.tellingtontouch.com>.
OTHER
Auras website. The Healing Channel. <http://www.healing
channel.org/aura.html>.
Ken R. Wells
Rebecca J. Frey, PhD
Auriculotherapy
Definition
Auriculotherapy, also called ear acupuncture, ap-
plies the principles of acupuncture to specific points on
the ear. Auriculotherapists believe that healing processes
can be promoted by working with these points on the ear,
because the ear contains many blood vessels and nerve
endings that, when stimulated, influence the organs and
bodily functions.
Origins
Acupuncture is one of the world’s oldest therapeutic
techniques, having its roots in ancient China. Some of the
167
Auriculotherapy
Auriculotherapy
oldest texts of Chinese medicine mention acupuncture
points and massage techniques specifically for the ear. For
eye problems, silver or gold earrings were sometimes pre-
scribed in ancient times to provide constant healing stimu-
lation at points on the ear, a practice that is still performed
in some areas of the world, including parts of Europe. The
ancient Egyptians and Greeks believed that working with
the ears could influence health. Hippocrates, the Greek fa-
ther of medicine, mentioned a point on the ear that could
be operated on as a birth control measure in men. In Eu-
rope in the Middle Ages, doctors prescribed surgery on a
particular spot on the ear for a condition called sciatica,
which causes nerve pain in the hips and thighs.
In modern times, auriculotherapy has been advanced
by Paul Nogier of France. Beginning his work and ex-
periments in the 1950s, Nogier laid out an intricate map
of points on the ear that correspond to the organs and
processes in the body. Nogier believed that the ear is
shaped like an upside down human fetus, and the
acupuncture points on the ear correspond to the body
parts of the fetus shape, with the earlobe representing the
head. Nogier theorized that by stimulating these points
on the ear, the corresponding organs and bodily process-
es would be stimulated by nerve impulses. Nogier also
theorized that by measuring electrical impulses on the
skin of the ear, problems could be detected in the internal
organs, and therefore auriculotherapy could be used to
diagnose illnesses. Nogier and many followers, includ-
ing ear acupuncturists in America and China, conducted
scientific experiments in auriculotherapy, and showed
some significant and surprising results in both treatment
and diagnosis of conditions. In 2002, a center in Maine
received a unique grant to study auriculotherapy for sub-
stance abuse. Although recognizing that acupuncture had
been used before for helping those with abuse, this study
sought to show that auriculotherapy ’s effects on relax-
ation response helped those abusing drugs and alcohol
better deal with the anxiety and life circumstances
thought to lead them to substance abuse.
Benefits
Auriculotherapy is a quick, inexpensive, and non-in-
vasive method of pain control. Ear acupuncture is also
used as anesthesia during medical procedures. It is used
frequently to help people overcome drug, tobacco, and
alcohol addictions, and is used to treat chronic health
conditions and diseases.
Description
After an initial exam and interview, auriculothera-
pists begin treatment by checking the patient’s ears
closely. Practitioners may palpate (feel) the ears with
168
their hands, and check for any irregularities or painful
spots. They may check for spots that are insensitive or
numb by using cold or hot needles on the ear. They may
also rely on electrical devices that measure skin resis-
tance at points on the ear.
Several techniques may be used during auriculother-
apy. Acupuncture needles are typically extremely thin.
More than one needle may be used at one time, inserted
deeply, or just pricked slightly along the contours of the
ear. On some points, needles may be twisted or slanted
to create more healing effects. Needles may be left in
from a few minutes to half an hour or more.
Auriculotherapists may use permanent press nee-
dles. These small, tack-shaped needles may be attached
to the ear with a narrow band of tape for several days or
weeks. They are used for conditions that may require
constant stimulation to acupuncture points on the ear,
such as addictions, chronic (long-lasting) infections, and
other health problems.
Auriculotherapists also practice electroacupuncture,
which utilizes electrical devices to send small electrical
currents into the ear or through the body. Electroacupunc-
ture is used for conditions such as paralysis or nerve dam-
age in the body, drug and alcohol addictions, and chronic
pain. Auriculotherapists may also employ bleeding, which
removes one or two drops of blood at certain points on the
ear. Bleeding is used for health problems such as high
blood pressure, high cholesterol, or heart disease.
Auriculotherapy is generally performed once per
week on patients for a sequence of several months, al-
though the frequency of treatment depends on the patient
and condition. Treatment may last for several months.
The initial visit to an acupuncturist is typically the most
expensive, costing from $80 to $200. Follow-up visits
are less expensive, from $50 to $100 on average. Auricu-
lotherapists may also prescribe herbal and nutritional
remedies. Insurance coverage of acupunture fees varies,
depending on individual policies.
Preparations
Before treatment, an auriculotherapist may perform
a thorough examination and interview the patient to de-
termine health conditions and any precautions or adjust-
ments that must be made. Acupuncturists often rely on
pulse diagnosis and other diagnostic techniques before
and during treatment.
For treatment, the patient should lie in a horizontal
position on a comfortable surface in a calm, stress-free
environment. After treatment, the patient should be per-
mitted to lie down until feeling capable of leaving the
practitioner’s office.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Acupuncture needles should be sterilized before use.
The ears should be disinfected before acupuncture as
well, which is usually done with a cotton ball dipped in
rubbing alcohol.
Precautions
Auriculotherapy, like all acupuncture, should not be
performed on weak or exhausted patients, nor on those
who are very hungry or have just eaten a meal or drunk
alcohol. Auriculotherapy should not be performed on
pregnant women during the first two trimesters (six
months) of pregnancy, and afterwards only on very par-
ticular points on the ear for pain control. Auriculotherapy
is not recommended for children under seven years old,
and should be performed with care on the elderly. Ear
acupuncture is to be avoided by those with anemia (low
red blood cell quantity in the blood). Patients with ner-
vous conditions should be thoroughly relaxed and pre-
pared before treatment. For people that find acupuncture
disagreeable, ear massage and acupressure may be
preferable to treatment with needles.
Side effects
Some patients may experience uncomfortable side
effects during or after acupuncture. Side effects that
may occur after treatment include fainting, dizziness,
nausea, numbness, headaches, sweating, or sharp pains
throughout the body. These reactions may be due to
anxiety or because acupuncture needles have been in-
serted too deeply or in the wrong area. Side effects can
be alleviated by removing the needles and allowing the
patient to lie down under supervision. Some side effects
that occur during treatment, such as hot flashes, in-
creased pulse, and temporarily increased symptoms, are
considered normal and usually disappear quickly.
Training & certification
The American Academy of Medical Acupuncture
(AAMA) was chartered in 1987 to support the education
and correct practice of physician-trained acupuncturists.
Its members must be either MDs or DOs who have com-
pleted proper study of acupuncture techniques.
The National Commission for Certification of
Acupuncturists (NCCA) conducts certification exams,
promotes national standards, and registers members.
Most states that license acupuncturists use the NCCA
standards as certification.
The American Association of Acupuncture and Ori-
ental Medicine (AAAOM) is the largest organization for
practitioners, with more than 1,600 members.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Anesthesia — Method of pain control during med-
ical procedures.
Chronic — Referring to illness or condition that is
long lasting.
Resources
BOOKS
Fleischman, Dr. Gary. Acupuncture : Everything You Ever
Wanted to Know. Barrytown, NY: Station Hill, 1998.
Hicks, Angela. Thorson’s Principles of Acupuncture. New
York: HarperCollins, 1997.
Requena, Yves, MD. Terrains and Pathology in Acupuncture.
Massachusetts: Paradigm, 1986.
PERIODICALS
American Journal of Acupuncture. 1840 41st Ave., Suite 102,
P.O. Box 610, Capitola, CA 95010.
Savage, Lorraine. “Grant to Study Acupuncture’s Effectiveness
on Patients Suffering from Substance Abuse." Healthcare
Review. (March 19, 2002): 16.
ORGANIZATIONS
American Academy of Medical Acupuncture. 5820 Wilshire
Blvd., Suite 500, Los Angeles, CA 90036, (213) 937-5514.
American Association of Acupuncture and Oriental Medicine.
433 Front St., Catasaugua, PA 18032, (610) 266-1433.
National Commission for Certification of Acupuncturists. 1424
16th St. NW, Suite 501, Washington, D.C. 20036, (202)
232-1404.
Douglas Dupler
Teresa G. Odle
Autism
Definition
Autism is a chronic and often severe disorder of
brain functioning that begins during childhood. It is
marked by problems with social contact, intelligence,
and language, coupled with ritualistic or compulsive be-
havior, sensory integration and processing problems, and
strange environmental responses.
Description
Autism is a lifelong disorder that interferes with the
ability to understand what is seen, heard, and touched.
This can cause profound problems in personal behavior
169
Autism
Autism
Autistic children sometimes respond to behavioral and educational treatments in schools such as this one in Salt Lake City,
Utah, that offers teachers specially trained to work with autistic children. (A/P Wide World Photos. Reproduced by permission.)
and in the ability to relate to others. A person with
autism must learn how to communicate normally and
how to relate to people, objects, and events. However,
not all patients suffer the same degree of impairment.
The severity of the condition varies between individuals,
ranging from the person with extremely unusual and ag-
gressive behavior to one with something resembling a
mild personality disorder or a learning disability.
Autism occurs in as many as one in 1 ,000 children,
and incidence is rapidly increasing. It is found three to
four times more often in boys than in girls. The condi-
tion occurs around the world in all races and all social
backgrounds. Autism usually is evident in the first three
years of life, although in some children it is difficult to
pinpoint when the problem actually takes hold. Often,
the condition may not be diagnosed until the child enters
school. A person with autism can have symptoms rang-
ing from mild to severe.
Two subgroups of autism have recently been ex-
plained by clinicians. Those with essential autism, as de-
fined by diagnostic tests, appear to have higher IQ scores
and fewer seizures than those with complex autism,
which offers a poorer outcome.
170
Causes & symptoms
Although the exact causes of autism are unknown,
many possibilities have been proposed. Most experts
believe that several independent factors contribute to
development of autism. The number and combinations
of these factors probably differ from person to person.
Research points to such precipitating conditions as fetal
alcohol syndrome, genetic connections (as with identi-
cal twins), brain stem defects, lead poisoning, a ner-
vous system defect, infections, food and inhalant aller-
gies, infant vaccination reactions, and digestive system
deficiencies.
Further studies point to major disturbances in the
body chemistry of children with autism. Disruption is
most often found in fatty acid metabolism, electrolyte
balances, problems with digestive functioning, pro-
duction of red and white blood cells, and the body’s
balance of minerals. Diseases that may trigger autistic
behavior include rubella in the pregnant mother,
tuberous sclerosis, candiasis infection, fragile X syn-
drome, encephalitis, cytomegalovirus (CMV), a se-
vere form of a herpes simplex infection, and untreated
phenylketonuria.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
There also appears to be a strong genetic basis for
autism. In October 2001, the National Institutes of
Health (NIH) reported that two regions of chromosomes
contain genes involved with autism, and that two other
chromosomes had a weaker relation to autism-related
genes. Genetically identical twins are much more likely
than fraternal twins to both have autism if one is affect-
ed. In a family with one autistic child, the chance of hav-
ing another child with autism is about one in 20, much
higher than in the normal population. Sometimes, rela-
tives of an autistic child have mild behaviors that look
very much like autism, such as repetitive behaviors and
social or communication problems. Research also has
found that some emotional disorders, such as manic de-
pression, occur more often in families of a child with
autism. At least one group of researchers has also found
a link between an abnormal gene and autism. The gene
may be just one of at least three to five genes that inter-
act in some way to cause the condition. Scientists sus-
pect that a faulty gene or genes might make a person vul-
nerable to develop autism in the presence of other fac-
tors, such as chemical imbalance, infection, or a lack of
oxygen at birth.
Autism affects the way in which the brain uses or
transmits information. Studies have found abnormalities
in several parts of the brains of those with autism that al-
most certainly occurred during fetal development. The
problem may be centered in the parts of the brain re-
sponsible for processing language and information from
the senses. Profound problems with social interactions
are the most common symptoms of autism. Infants with
the disorder will not cuddle, avoid eye contact, and in
general do not seem to like or require physical contact or
affection. Often, the child will not form attachments to
parents or the rest of the family. The child may not speak
at all, or speak very little and may show bizarre patterns
of speech, such as endlessly repeating words or phrases.
About 10% of those with autism have an exceptional
ability in particular areas, such as mathematics, memory,
art, or music.
Most autistic children appear to be mentally retard-
ed to at least some degree. Bizarre behavior patterns are
very common and may include repeated mimicking of
the actions of others, complex rituals, screaming fits,
rhythmic rocking, arm flapping, finger twiddling, and
crying without tears. Many of these children may react
to sounds by banging their head or flapping fingers.
Some less affected autistic adults who have written
books about their childhood experiences report that
sounds were often excruciatingly painful to them, forc-
ing them to withdraw from the environment or to try to
cope by withdrawing into their own invented world. A
common characteristic of individuals with autism is an
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
insistence on sameness. There may be strong reactions to
changes in food, clothing, and routines.
Diagnosis
Autism is diagnosed by obtaining a developmental
history of the child and observing and evaluating the
child’s behavior, communication skills, and social inter-
actions. Because the symptoms of autism are so varied,
the condition may go undiagnosed for some time. There
is no medical test for autism. The condition is often
missed, especially in mild cases or when additional hand-
icaps are present. Special screening tools help physicians
diagnose the condition. Medical tests are sometimes used
to rule out other possible causes of autistic symptoms.
Treatment
Early intervention proves critical in managing
autism. The American Academy of Pediatrics (AAP)
says that many parents have chosen alternative therapies
when more traditional therapies do not produce desired
results. Among therapies mentioned in the group's report
are nutritional supplements, elimination diets, immune
globulin therapy, and secretin (a hormone) therapy.
There is often a strong nutritional dysfunction in-
volved in autism. A major overhaul of the child’s diet
should be done, but very gradually. A healthy diet of
whole foods with no preservatives or additives, including
food dyes, is recommended. Autistic children may have
particular difficulty handling Nutrasweet and monosodi-
um glutamate (MSG), as these chemicals may further in-
terfere with already disrupted nerve impulses. Processed
foods such as white flour, white sugar, margarine, and
hydrogenated fats should be avoided because they inter-
fere with the stability of blood chemistry.
Many autistic children may be unable to effectively
break down the protein in grains such as wheat, barley,
and oats, called gluten, and the protein in milk called ca-
sein. Overgrowths of Candida albicans may be present
and should be tested for and treated. Testing should also
be done for food, chemical, and inhalant allergies. Di-
gestive functioning should be tested and monitored. Ex-
tensive testing should be done for blood levels of chemi-
cals in the body, as well. Allergens should be subse-
quently removed from the diet and environment; further
dietary changes should be made to correct chemical im-
balances. Possible gut and immune system dysfunction
should also be addressed.
Studies have shown that supplementation with mega-
doses of vitamin B 6 together with magnesium improves
eye contact, speech, and behavior problems. Vitamin B 6
causes fewer side effects than other medications, but
171
Autism
Autism
megadoses should only be given under the supervision of
a healthcare provider. A B-complex vitamin is probably
the best way to give B 6 , due to the interdependent func-
tioning of the B vitamins. Zinc and vitamin C supple-
mentation is also recommended. In addition, dimethyl-
glycine (DMG) has been reported to improve speech in
some children with autism in as little as a week’s time.
Other therapeutic methods that have been shown to be
helpful include special auditory integration training
(AIT) based on the Berard method or the Tomatis method.
Craniosacral therapy may also improve symptoms of
autism by relieving compressions of the skull bones and
membranes. Autism is a complex condition. A practitioner
who has already worked with cases of autism successfully
will be able to offer a comprehensive treatment plan.
Allopathic treatment
Most experts recommend a complex treatment regi-
men for autism that begins early in life and continues
through the teenage years. Behavioral therapies are used
in conjunction with medications and special diets. Be-
cause the symptoms vary so widely from one person to the
next, there is not a single approach that works best for
every person. Interventions include special training in
music, listening, vision, speech and language, and senses.
Sensory integration training may be used to normalize
sensory functions. Training to change aberrant behaviors
should be started as early in the autistic child’s life as pos-
sible, since early intervention appears to have the most in-
fluence on brain development and functioning. A child
with autism is able to learn best in a specialized, struc-
tured program that emphasizes individualized instruction.
No single medication has yet proved highly effec-
tive for the major features of autism. However, a variety
of drugs can control self-injurious, aggressive, and other
behaviors. Drugs also can control epilepsy, which af-
flicts up to 20% of people with autism. Types of recom-
mended medication may include stimulants, such as
methylphenidate (Ritalin); antidepressants, such as
fluroxamine (Luvox); opiate blockers, such as naltrexone
(Re Via); antipsychotics; and tranquilizers.
Expected results
Studies show that people with autism can improve
significantly with proper treatment. While there is no
cure, the negative behaviors of autism can be made to
improve. Earlier generations placed autistic children in
institutions; now, even severely disabled children can be
helped to eventually become more responsive to others.
Children with autism usually can learn to better under-
stand and deal with the world around them. Some can
even lead nearly mainstream lives.
172
KEY TERMS
Antidepressant — A type of medication that is used
to treat depression; it is also sometimes used to
treat autism.
Asperger syndrome — Children who have autistic
behavior but no problems with language.
Encephalitis — A rare inflammation of the brain
caused by a viral infection. It has been linked to
the development of autism.
Fragile X syndrome — A genetic condition related
to the X chromosome that affects mental, physical,
and sensory development.
Phenylketonuria (PKU) — An enzyme deficiency
present at birth that disrupts metabolism and caus-
es brain damage. This rare inherited defect may be
linked to the development of autism.
Rubella — Also known as German measles. When
a woman contracts rubella during pregnancy, her
developing infant may be damaged. One of the
problems that may result is autism.
Tuberous sclerosis — A genetic disease that causes
skin problems, seizures, and mental retardation. It
may be confused with autism.
Prevention
The mechanisms of autism are poorly understood.
There is currently no known method of prevention for
the condition. However, there is much debate as to what
part the measles, mumps, and rubella (MMR) vaccina-
tion and the diphtheria, pertussis, and tetanus (DPT)
vaccination may play in the onset of autism. A knowl-
edgeable alternative healthcare provider should be con-
sulted about the necessity of vaccination and possible al-
ternatives.
Resources
BOOKS
Barron, Sean, and Judy Barron. There’s a Boy in Here. New
York: Simon & Schuster, 1992.
Bratt, Berneen. No Time for Jello. Massachusetttes: Brookline
Books, 1989.
Cohen, Donald J., and Fred R. Volkmar. Handbook of Autism
and Pervasive Developmental Disorders. John Wiley &
Sons, 1997.
Cohen, Shirley. Targeting Autism: What We Know, Don't Know,
and Can Do to Help Young Children with Autism and Re-
lated Disorders. California: University of California
Press, 1998.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Hart, Charles. A Parent’s Guide to Autism: Answers to the Most
Common Questions. New York: Pocket Books, 1993.
PERIODICALS
Brunk D. “Three Tests Identify Two Autism Subgroups. (Two
Types Termed Essential and Complex).” Pediatric News
35, no. 12 (December 2001): 24.
“Could New Changes be on the Horizon for Managing
Autism?” The Brown University Child and Adolescent
Behavior Letter 17, no. 7 (July 2001): 1.
“Autism Genes Identified.” The Brown University Child and
Adolescent Behavior Letter 17, no. 10 (October 2001): 1.
Patience Paradox
Teresa G. Odle
Autoimmune arthritis see Ankylosing
spondylitis
Ayurvedic medicine
Definition
Ayurvedic medicine is a system of healing that origi-
nated in ancient India. In Sanskrit, ayur means life or liv-
ing, and veda means knowledge, so Ayurveda has been
defined as the “knowledge of living” or the “science of
longevity.” Ayurvedic medicine utilizes diet, detoxifica-
tion and purification techniques, herbal and mineral
remedies, yoga, breathing exercises, meditation, and
massage therapy as holistic healing methods. Ayurvedic
medicine is widely practiced in modern India and has
been steadily gaining followers in the West.
Origins
The three basic physiological principles or doshas.
Illustration by GGS Information Services, Inc. The Gale Group.
during the last two decades. Chopra is an M.D. who has
written several bestsellers based on Ayurvedic ideas. He
also helped develop the Center for Mind/Body Medicine
in La Jolla, California, a major Ayurvedic center that
trains physicians in Ayurvedic principles, produces
herbal remedies, and conducts research and documenta-
tion of its healing techniques.
Ayurvedic medicine originated in the early civiliza-
tions of India some 3,000-5,000 years ago. It is men-
tioned in the Vedas , the ancient religious and philosophi-
cal texts that are the oldest surviving literature in the
world, which makes Ayurvedic medicine the oldest sur-
viving healing system. According to the texts, Ayurveda
was conceived by enlightened wise men as a system of
living harmoniously and maintaining the body so that
mental and spiritual awareness could be possible. Med-
ical historians believe that Ayurvedic ideas were trans-
ported from ancient India to China and were instrumen-
tal in the development of Chinese medicine.
Today, Ayurvedic medicine is used by 80% of the
population in India. Aided by the efforts of Deepak
Chopra and the Maharishi, it has become an increasing-
ly accepted alternative medical treatment in America
Benefits
According to the original texts, the goal of Ayurveda
is prevention as well as promotion of the body’s own ca-
pacity for maintenance and balance. Ayurvedic treatment
is non-invasive and non-toxic, so it can be used safely as
an alternative therapy or alongside conventional therapies.
Ayurvedic physicians claim that their methods can also
help stress-related, metabolic, and chronic conditions.
Ayurveda has been used to treat acne, allergies, asthma,
anxiety, arthritis, chronic fatigue syndrome, colds, coli-
tis, constipation, depression, diabetes, flu, heart disease,
hypertension, immune problems, inflammation, insom-
nia, nervous disorders, obesity, skin problems, and ulcers.
Ayurvedic physicians seek to discover the roots of a
disease before it gets so advanced that more radical treat-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
173
Ayurvedic medicine
Ayurvedic medicine
Ayurvedic physician uses a hot iron rod and fabric soaked
in herbs to heal an arthritic hip, Bhubaneswar, India. (©
Lindsay Hebberd/Corbis. Reproduced by permission.)
ments are necessary. Thus, Ayurveda seems to be limited
in treating severely advanced conditions, traumatic in-
juries, acute pain, and conditions and injuries requiring
invasive surgery. Ayurvedic techniques have also been
used alongside chemotherapy and surgery to assist pa-
tients in recovery and healing.
Description
Key ideas
To understand Ayurvedic treatment, it is necessary
to have an idea how the Ayurvedic system views the
body. The basic life force in the body is prana, which is
also found in the elements and is similar to the Chinese
notion of chi. As Swami Vishnudevananda, a yogi and
expert, put it, “Prana is in the air, but is not the oxygen,
nor any of its chemical constituents. It is in food, water,
and in the sunlight, yet it is not vitamin, heat, or light-
174
rays. Food, water, air, etc., are only the media through
which the prana is carried.”
In Ayurveda, there are five basic elements that contain
prana: earth, water, fire, air, and ether. These elements in-
teract and are further organized in the human body as
three main categories or basic physiological principles in
the body that govern all bodily functions known as the
doshas. The three doshas are vata, pitta, and kapha. Each
person has a unique blend of the three doshas, known as
the person’s prakriti, which is why Ayurvedic treatment is
always individualized. In Ayurveda, disease is viewed as a
state of imbalance in one or more of a person’s doshas,
and an Ayurvedic physician strives to adjust and balance
them, using a variety of techniques.
The vata dosha is associated with air and ether, and
in the body promotes movement and lightness. Vata peo-
ple are generally thin and light physically, dry-skinned,
and very energetic and mentally restless. When vata is
out of balance, there are often nervous problems, hyper-
activity, sleeplessness, lower back pains, and headaches.
Pitta is associated with fire and water. In the body, it is
responsible for metabolism and digestion. Pitta characteris-
tics are medium-built bodies, fair skin, strong digestion,
and good mental concentration. Pitta imbalances show up
as anger and aggression and stress-related conditions like
gastritis, ulcers, liver problems, and hypertension.
The kapha dosha is associated with water and earth.
People characterized as kapha are generally large or
heavy with more oily complexions. They tend to be slow,
calm, and peaceful. Kapha disorders manifest emotional-
ly as greed and possessiveness, and physically as obesity,
fatigue, bronchitis, and sinus problems.
Diagnosis
In Ayurvedic medicine, disease is always seen as an
imbalance in the dosha system, so the diagnostic process
strives to determine which doshas are underactive or over-
active in a body. Diagnosis is often taken over a course of
days in order for the Ayurvedic physician to most accu-
rately determine what parts of the body are being affected.
To diagnose problems. Ayurvedic physicians often use
long questionnaires and interviews to determine a person’s
dosha patterns and physical and psychological histories.
Ayurvedic physicians also intricately observe the pulse,
tongue, face, lips, eyes, and fingernails for abnormalities
or patterns that they believe can indicate deeper problems
in the internal systems. Some Ayurvedic physicians also
use laboratory tests to assist in diagnosis.
Treatment
Ayurvedic treatment seeks to re-establish balance and
harmony in the body’s systems. Usually the first method of
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
AYURVEDIC BODY TYPES
Vata
Pitta
Kapha
Physical characteristics
Thin
Average build
Large build
Prominent features
Fair, thin hair
Wavy, thick hair
Cool, dry skin
Warm, moist skin
Pale, cool, oily skin
Constipation
Ulcers, heartburn, and hemorrhoids
Obesity, allergies, and sinus
problems
Cramps
Acne
High cholesterol
Emotional characteristics
Moody
Intense
Relaxed
Vivacious
Quick tempered
Not easily angered
Imaginative
Intelligent
Affectionate
Enthusiastic
Loving
Tolerant
Intuitive
Articulate
Compassionate
Behavioral characteristics
Unscheduled sleep
and meal times
Orderly
Slow, graceful
Nervous disorders
Structured sleep and meal times
Long sleeper and slow eater
Anxiety
Perfectionist
Procrastination
treatment involves some sort of detoxification and cleans-
ing of the body, in the belief that accumulated toxins must
be removed before any other methods of treatment will be
effective. Methods of detoxification include therapeutic
vomiting, laxatives, medicated enemas, fasting, and
cleansing of the sinuses. Many Ayurvedic clinics combine
all of these cleansing methods into intensive sessions
known as panchakarma. Panchakarma can take several
days or even weeks and they are more than elimination
therapies. They also include herbalized oil massage and
herbalized heat treatments. After purification. Ayurvedic
physicians use herbal and mineral remedies to balance the
body as well. Ayurvedic medicine contains a vast knowl-
edge of the use of herbs for specific health problems.
Ayurvedic medicine also emphasizes how people
live their lives from day to day, believing that proper
lifestyles and routines accentuate balance, rest, diet, and
prevention. Ayurveda recommends yoga as a form of ex-
ercise to build strength and health, and also advises mas-
sage therapy and self-massage as ways of increasing cir-
culation and reducing stress. Yogic breathing techniques
and meditation are also part of a healthy Ayurvedic regi-
men, to reduce stress and improve mental energy.
Of all treatments, though, diet is one of the most basic
and widely used therapies in the Ayurvedic system. An
Ayurvedic diet can be a very well planned and individual-
ized regimen. According to Ayurveda, there are six basic
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
tastes: sweet, sour, salty, pungent, bitter, and astringent. Cer-
tain tastes and foods can either calm or aggravate a particular
dosha. For instance, sweet, sour, and salty decrease vata
problems and increase kapha. Sour, salty, and pungent can
increase pitta. After an Ayurvedic physician determines a
person’s dosha profile, he or she will recommend a specific
diet to correct imbalances and increase health. The
Ayurvedic diet emphasizes primarily vegetarian foods of
high quality and freshness, tailored to the season and time of
day. Cooling foods are eaten in the summer and heating ones
in the winter, always within a person’s dosha requirements.
In daily routine, the heaviest meal of the day should be
lunch, and dinner should be eaten well before bedtime, to
allow for complete digestion. Also, eating meals in a calm
manner with proper chewing and state of mind is important,
as is combining foods properly and avoiding overeating.
Cost
Costs of Ayurvedic treatments can vary, with initial con-
sultations running anywhere from $40 to over $100, with fol-
low-up visits costing less. Herbal treatments may cost from
$10 to $50 per month, and are often available from health
food or bulk herb stores. Some clinics offer panchakarma, the
intensive Ayurvedic detoxification treatment, which can in-
clude overnight stays for up to several weeks. The prices for
these programs can vary significantly, depending on the ser-
vices and length of stay. Insurance reimbursement may de-
pend on whether the primary physician is a licensed M.D.
175
Ayurvedic medicine
Ayurvedic medicine
DEEPAK CHOPRA 1946-
(APAA/ide World Photos. Reproduced by permission.)
Deepak Chopra was born in India and studied medi-
cine at the All India Institute of Medical Science. He left
his home for the United States in 1970 and completed
residencies in internal medicine and endocrinology. He
went on to teaching posts at major medical institutions —
Tufts University and Boston University schools of medi-
cine — while establishing a very successful private prac-
tice. By the time he was thirty-five, Chopra had become
chief of staff at New England Memorial Hospital.
Disturbed by Western medicine's reliance on med-
ication, he began a search for alternatives and discovered
one in the teachings of the Maharishi Mahesh Yogi, an In-
dian spiritualist who had gained a cult following in the
late sixties teaching Transcendental Meditation (TM).
Chopra began practicing TM fervently and eventually met
the Maharishi. In 1 985 Chopra established the Ayurvedic
Health Center for Stress Management and Behavioral
Medicine in Lancaster, Massachusetts, where he began
his practice of integrating the best aspects of Eastern and
Western medicine.
In 1993, he published Creating Affluence: Wealth
Consciousness in the Field of All Possibilities , and the enor-
mously successful best seller, Ageless Body. Timeless Mind.
In the latter he presents his most radical thesis: that aging
is not the inevitable deterioration of organs and mind that
we have been traditionally taught to think of it as. It is a
process that can be influenced, slowed down, and even
reversed with the correct kinds of therapies, almost all of
which are self-administered or self-taught. He teaches
that applying a regimen of nutritional balance, medita-
tion, and emotional clarity characterized by such factors
as learning to easily and quickly express anger, for in-
stance, can lead to increased lifespans of up to 120 years.
Preparations
Ayurveda is a mind/body system of health that con-
tains some ideas foreign to the Western scientific model.
Those people considering Ayurveda should approach it
with an open mind and willingness to experiment. Also,
because Ayurveda is a whole-body system of healing and
health, patience and discipline are helpful, as some con-
ditions and diseases are believed to be brought on by
years of bad health habits and require time and effort to
correct. Finally, the Ayurvedic philosophy believes that
each person has the ability to heal themselves, so those
considering Ayurveda should be prepared to bring re-
sponsibility and participation into the treatment.
Precautions
An Ayurvedic practitioner should always be consult-
ed, particularly when using herbal preparations. Care
should be taken to ensure that a trained practitioner pre-
pares individualized remedies. In 2002, a New York City
hospital emergency department cautioned other hospitals
176
when they encountered a case of a patient who came in
with severe abdominal pain, occasional vomiting, and
eventually seizures. She had suffered severe lead toxicity
from an ayurvedic compound.
Side effects
During Ayurvedic detoxification programs, some
people report fatigue, muscle soreness, and general sick-
ness. Also, as Ayurveda seeks to release mental stresses
and psychological problems from the patient, some peo-
ple can experience mental disturbances and depression
during treatment, and psychological counseling may be
part of a sound program.
Research & general acceptance
Because Ayurveda had been outside the Western sci-
entific system for years, research in the United States is
new. Another difficulty in documentation arises because
Ayurvedic treatment is very individualized; two people
with the same disease but different dosha patterns might
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
be treated differently. Much more scientific research has
been conducted over the past several decades in India.
Much research in the United States is being supported by
the Maharishi Ayur-Ved organization, which studies the
Ayurvedic products it sells and its clinical practices.
In 2002, India took steps to make some of its most
important ayurvedic knowledge more widely available.
Many outside groups had begun to exploit the ancient
holistic practice’s remedies and companies were dupli-
cating processes and formulas, but calling them their
own. The Indian government appointed a task force in
January 2000 to promote and develop traditional medi-
cines and to prevent piracy of the country’s traditional
medical knowledge. The task force developed a digital
library with international and Indian languages describ-
ing about 35,000 ayurvedic herbal processes and formu-
lations to cure all kinds of diseases. The library became
available in early 2003 on the Internet.
Some Ayurvedic herbal mixtures have been proven
to have high antioxidant properties, much stronger than
vitamins A, C, and E, and some have also been shown in
laboratory tests to reduce or eliminate tumors in mice
and to inhibit cancer growth in human lung tumor cells.
In a 1987 study at MIT, an Ayurvedic herbal remedy was
shown to significantly reduce colon cancer in rats. An-
other study was performed in the Netherlands with Ma-
harishi Ayur-Ved products. A group of patients with
chronic illnesses, including asthma, chronic bronchitis,
hypertension, eczema, psoriasis, constipation, rheuma-
toid arthritis, headaches, and non-insulin dependent di-
abetes mellitus, were given Ayurvedic treatment. Strong
results were observed, with nearly 80% of the patients
improving and some chronic conditions being complete-
ly cured.
Other studies have shown that Ayurvedic therapies
can significantly lower cholesterol and blood pressure in
stress-related problems. Diabetes, acne, and allergies have
also been successfully treated with Ayurvedic remedies.
Ayurvedic products have been shown to increase short-
term memory and reduce headaches. Also, Ayurvedic
remedies have been used successfully to support the heal-
ing process of patients undergoing chemotherapy, as these
remedies have been demonstrated to increase immune sys-
tem activity. The herb gotu kola has been reported to re-
lieve anxiety and enhance memory.
Training & certification
In the United States, there is no standardized pro-
gram for the certification of Ayurvedic practitioners.
Many practitioners have primary degrees, either as
M.D.s, homeopaths, or naturopathic physicians, with ad-
ditional training in Ayurveda.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Dosha — One of three constitutional types, either
vata, pitta, or kapha, found in Ayurvedic medi-
cine.
Meditation — Technique of calming the mind.
Panchakarma — Intensive Ayurvedic cleansing and
detoxification program.
Prakriti — An individual's unique dosha pattern.
Prana — Basic life energy found in the elements.
Yoga — System of body and breathing exercises.
Resources
BOOKS
Gerson, Scott M.D. Ayurveda: The Ancient Indian Healing Art.
Boston: Element Books, 1993.
Lad, Dr. Vasant. Ayurveda: The Science of Self-Healing. Wis-
consin: Lotus Press, 1984.
Lad, Dr. Vasant. The Complete Book of Ayurvedic Home Reme-
dies. Minneapolis: Three Rivers Press, 1999.
Tiwari, Maya. Ayurveda: A Life of Balance. Vermont: Healing
Arts Press, 1995.
PERIODICALS
“India to Publish Ayurvedic Tracts on the Internet in Six Lan-
guages.” Nutraceuticals International (May 2002).
Mandile, Maria Noel. “Gotu Kola: This Ayurvedic Herb May
Reduce Your Anxiety Without the Side Effects of Drugs.”
Natural Health (May-June 2002): 34.
Traub SJ. et al. “85 Lead Toxicity Due to use of an Ayurvedic
Compound.” Journal of Toxicology : Clinical Toxicology
(April 2002): 322.
ORGANIZATIONS
American Institute of Vedic Studiess. P.O. Box 8357, Santa Fe,
NM 87504. (505) 983-9385.
Ayurveda Holistic Center. Bayville, Long Island, NY. (516) 759-
7731 mail@Ayurvedahc.com. <http://www.Ayurvedahc.
com>.
The Ayurvedic Institute. 11311 Menaul, NE Albuquerque, New
Mexico 87112. (505)291-9698. info@Ayurveda.com
<http://www.Ayurveda.com>
Ayurvedic and Naturopathic Medical Clinic. 10025 NE 4th
Street, Bellevue, WA 98004. (206) 453-8022.
Bastyr University of Natural Health Sciences. 144 N.E. 54th
Street, Seattle, WA 98105. (206) 523-9585.
Center for Mind/Body Medicine. P.O. Box 1048, La Jolla, CA
92038. (619) 794-2425.
The College of Maharishi Ayur-Ved, Maharishi International
University. 1000 4th Street, Fairfield, IA 52557. (515)
472-7000.
National Institute of Ayurvedic Medicine. (914)278-8700.
drgerson@erols.com. <http://www.niam.com>
177
Ayurvedic medicine
Ayurvedic medicine
The Rocky Mountain Institute of Yoga and Ayurveda. RO. Box OTHER
1091, Boulder, CO 80306. (303)443-6923. “Inside Ayurveda: An Independent Journal of Ayurvedic Health
Care.” P.O. Box 3021, Quincy, CA 95971. <http://www.
insideayurveda.com.>
Douglas Dupler
178
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Bach flower remedies see Flower remedies
Back pain see Low back pain
Bad breath
Definition
Bad breath, also called halitosis, is an unpleasant
odor of the breath. Usually it is due to poor hygiene, but
it can be an indication of underlying health problems.
Description
Bad breath is likely to be experienced by most
adults and many children, at least occasionally. Some
people are strongly convinced that bad breath is present
when it is not. Bad breath can have a significant impact
on a person's social and professional life.
Causes & symptoms
Accumulation of plaque on the teeth is a major
cause of bad breath. Plaque is a mucus film that mixes
with food particles, saliva, and bacterial residue in the
mouth. Bad breath can also be caused by any number
of other problems. These include sores in the mouth,
infected tonsils, tooth or gum disease, fermentation of
food particles in the mouth, sinus infections, and
badly cleaned dentures. Conditions that may cause
bad breath are not only limited to the oral and nasal
areas. Other possible sources of the problem might be
indigestion, lung infection, kidney failure, tuberculo-
sis, syphilis, liver disease, stomach and intestinal
problems, stress, dehydration, zinc deficiency, and
cancer.
Cigarette smoking can also lead to bad breath, not
only in the smoker, but also in someone constantly ex-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
posed to secondhand smoke. A diet high in fats, spicy
foods, or one that includes coffee may contribute to un-
pleasant breath odors. Medications causing dry mouth
or dehydration may also be a source of problems, since
the flow of saliva helps clean out the mouth. Antihista-
mines, decongestants, antidepressants, anti-anxiety med-
ications, diuretics, and some heart medications may have
a dehydrating effect, and could be a cause of bad breath.
Diagnosis
The easiest way to determine if one has bad breath is
to ask a friend who is trustworthy and discrete, or to ask a
doctor or dentist. A test that can be attempted on one’s
own, is to cup a hand over the mouth, exhale, and then in-
hale through the nose while smelling the breath. A physi-
cal examination by a doctor or dentist may be used to di-
agnose other problems that may be causing the bad breath.
Treatment
Leaves of parsley, Petroselinum crispum; winter-
green, Gaultheria procumbens; or peppermint. Mentha
piperita; can be chewed to freshen the breath by the in-
troduction of their aromatic substances into the lungs. A
strong tea made of Echinacea spp.; myrrh, Commiphora
molmol; and bloodroot, Sanguinaria canadensis; can be
used as a daily mouthwash. Fresh apples, citrus fruits,
and celery are also good foods for helping to clean out
the mouth. Possible homeopathic remedies that may be
useful for bad breath include Nux vomica and Kali phos-
phoricum. Supplementing with zinc and vitamin C may
also be of benefit.
Allopathic treatment
The most effective treatment of bad breath is to treat
the cause. If bad breath is a continuing problem or there
are other symptoms, such as bleeding gums, a doctor or
dentist should be consulted. A medication change may
be warranted if a prescription drug is contributing to bad
179
Balm of Gilead
breath. A physician should be consulted any time a
change in medication is planned.
Expected results
Most bad breath can be treated successfully with
good oral hygiene or medical care. Occasionally, a per-
son may develop delusional or obsessive behavior re-
garding breath odor problems, and mental health coun-
seling may be appropriate.
Prevention
A healthy diet, high in fresh fruits and vegetables
and whole grains, should be eaten. Processed foods such
as sugar and white bread and grains contribute to plaque
formation and should be avoided. Spicy foods such as
onions, peppers, garlic, pastrami, salami, pepperoni, an-
chovies, and others should be avoided. Plenty of water
should be consumed throughout the day to avoid dehy-
dration and dry mouth. Water should be consumed after
taking any food or drink to wash away residues that may
accumulate with plaque.
The teeth should be brushed and flossed daily after
meals. Toothbrushes should be changed monthly, since
there may be a tendency for bacteria to accumulate on
them. Baking soda is a good choice to use for cleaning
the teeth when bad breath is a problem. The baking soda
makes the mouth pH less hospitable to odor-causing bac-
teria. Gentle brushing of the tongue should also be in-
cluded in the routine of daily oral hygiene, since the
tongue itself may harbor tiny particles of food. A device
called a tongue blade can be useful for cleaning the
tongue. It may be available from a store that sells Asian
or Middle Eastern products. An oral irrigation device,
such as a Water Pik, is recommended to more thoroughly
remove food and debris from the teeth. Mouthwashes are
often helpful, especially those containing zinc. A dentist
should regularly check the health of the gums and teeth
for disease. A dental hygienist should clean the teeth reg-
ularly, especially if there is an increased tendency to
form plaque.
Resources
PERIODICALS
Rosenberg, M. “Clinical Assessment of Bad Breath: Current
Concepts.” Journal of the American Dental Association
127 (April 1996): 475-482.
ORGANIZATIONS
American Dental Association. Box 776, St. Charles, IL 60174-
0776. http://www.ada.org.
Patience Paradox
180
Bai gou see Ginkgo biloba
Bai thu see Atractylodes (white)
Balding see Hair loss
Balm of Gilead
Description
Balm of Gilead ( Commiphora opobalsamum,
known as Populus candicans in the United States) is a
substance used in perfumes that is derived from the
resinous juices of the balsam poplar tree. The tree is a
member of the Bursera family. The variety that is native
to the continents of Africa and Asia is a small tree of
10-12 ft (3-3.6 m)in height. The cultivated North Ameri-
can variety can grow to heights of 100 ft (30 m).
The herb’s name derives from the ancient region of
Gilead in Palestine, known for the great healing powers
of its balm. Balm of Gilead is mentioned several times in
the Bible (e.g., Jeremiah 8:22). The writings of Pliny the
Elder indicate that the tree was brought to Rome in the
first century a.d. The historian Josephus recorded that
the Queen of Sheba made a gift of balm of Gilead to
King Solomon.
General use
In addition to being used in the composition of per-
fumes, balm of Gilead is used to soothe ailments of the
mucous membranes. It is taken internally to ease coughs
and respiratory infections. The balm is also said to re-
lieve laryngitis and sore throats. It can also be combined
with coltsfoot to make a cough suppressant.
Preparations
The resin of the balsam poplar tree is collected
when it seeps out of the tree during the summer months.
Seepage increases when humidity levels are high. Slits
may be made in the tree’s bark to collect the resin more
rapidly. The bark and leaf buds are also collected.
For the internal treatment of chest congestion, balm
of Gilead is made into a tincture or a syrup. To make a
syrup, the balm is combined with equal parts of elecam-
pane, wild cherry bark and one-half part of licorice
mixed with honey. The syrup can be taken by table-
spoons as needed.
For external treatment of bruises, swellings and
minor skin irritations, the balm is combined with lard or
oil and applied as needed. The bark, which contains
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Coltsfoot — A common weed, Russilago farfara,
used to treat chest complaints.
Elecampane — A perennial herb with large yellow
flowers used primarily as a digestive stimulant.
Resin — A sticky substance used for medicinal pur-
poses and in the manufacture of varnishes, ob-
tained from the bark of certain trees.
Salicylic acid — A crystalline substance that is the
active ingredient in aspirin.
traces of salicylic acid, can be combined with willow and
rosemary and used as a analgesic to relieve fevers, mus-
cle aches and arthritic pain.
Precautions
The sale and use of herbs as medicines, including
balm of Gilead, are not regulated by government
agencies. Therefore, consumers should exercise cau-
tion in purchasing and using herbs in this manner.
Consultation with a physician or pharmacist is always
recommended.
Side effects
In general, balm of Gilead is safe to use in small
amounts for coughs and other minor health problems.
Some people, however, may have allergic reactions to
the resin. In addition, patients with kidney and liver dis-
ease, as well as pregnant and nursing women, should
avoid the internal use of balm of Gilead.
Interactions
Balm of Gilead has no known interactions with stan-
dard pharmaceutical preparations.
Resources
BOOKS
Elias, Jason, and Shelagh Ryan Masline. Healing Herbal
Remedies. New York: Dell, 1995.
Tierra, Michael. The Way of Herbs. New York: Pocket Books,
1990.
OTHER
Grieve, M. “Balsam of Gilead.” (December 2000). <http://
www.botanical.com/ >
Mary McNulty
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Balneology see Hydrotherapy
Ban xia see Pinellia
Barberry
Description
Barberry, Latin name Berberis vulgaris, is native to
Europe, where it is commonly used as an ornamental
shrub. It is also commonly grown in North America. Its
close relative, Berberis aquifolium, is a native of North
America, and is also known as Oregon grape. Native
Americans originally taught settlers its value as a medic-
inal herb. Two other species of the plant, Nepalese and
Indian barberry, are native to those areas and possess
similar qualities.
Barberry is a perennial herb that is usually around 8
ft (2.4 m) tall, but can grow up to 10 ft (3 m) high. It
bears yellow flowers, red or black berries, and small
rounded fleshy leaves. It flourishes in dry sandy soil, and
prefers a sunny location. Research has established that
the active alkaloids in barberry belong to the isoquinoline
family. They are berberine, berbamine, oxyacanthine,
bervulcine, columbamine, isotetrandrine, jatrorrhizine,
magnoflorine, and vulvracine. Other components include
resin, tannin, and chelidonic acid, among others.
General use
Barberry and other berberine-containing plants have
been used throughout history for their medicinal proper-
ties. Chinese medicine has records of such use dating back
over 3,000 years. In addition to the fact that these plants
have been tried and tested over time, recent research has
indeed confirmed what herbalists have been teaching for
millennia — berberine has remarkable properties.
The berries of the barberry plant are traditionally
used to make jams and jellies, and the plant is used to
make a dye. However, its culinary use is only minor
compared to its importance as a member of the herbal
Materia Medica.
The medicinal actions of barberry are traditionally
classified as being cholagogue, hepatic, antiemetic, bitter
and laxative. Its main active constituent, berberine, has
recently been the subject of much research (it is the ac-
tive constituent of a number of valuable herbs, barberry
and goldenseal being two important examples), and has
been proven effective against a variety of ailments.
Barberry is chiefly valued as an efficient liver
cleanser, due to its ability to correct liver function and
promote the flow of bile. It is good for heartburn, stom-
181
Barberry
Barberry
Barberry plant. (© PlantaPhile, Germany. Reproduced by permission.)
ach upsets, including gastritis, ulcers and ulcerative
bowel conditions, and is an effective appetite stimulant.
It has also been recommended for renal colic and the
treatment of renal calculi, where it is claimed to allay
burning and soreness.
The herb has significant antibacterial, antiviral
and antifungal properties, and has even demonstrated
antiprotozoal properties, so it is an extremely valuable
weapon against infection and fever. It is recommend-
ed for use against diarrhea, whether of non-specific
type, such as gastroenteritis, or from an identified
source such as cholera. It is also capable of inhibiting
the growth of Giardia lamblia, Trichomonas vagi-
nalis. and Entamoeba histolytica. In fact, barberry is
capable of similar action to Metronidazole, a common
antiprotozoal medication, but has the advantage of no
side effects.
Berberine, the active constituent of barberry, inhibits
Candida and other fungal growth, but does not affect
beneficial bacteria such as Acidophilus and Bifidus. Bar-
berry is particularly useful for skin infections, for which
it is often taken internally, and has even been found ef-
fective against psoriasis.
182
It is often used against bronchial infections, as it is
capable of breaking down and dispersing mucous accu-
mulations, and controlling further secretions. It is an ef-
fective sedative, is capable of lowering blood pressure,
and is an effective uterine stimulant. Barberry is also
taken for gallstones and inflammation of the gallbladder.
It has the ability to correct an enlarged spleen.
Barberry is useful for correcting menstrual irregu-
larities, correcting anemia, as a treatment for vaginitis,
and even as a tonic for a hangover. It is a suitable med-
ication for gouty constitutions. It is recommended for
strengthening the patient during convalescence, as it acts
as an immune stimulant.
Barberry can be used to treat malaria and even
Leishmaniasis, which is a protozoal infection. Nicholas
Culpeper praised the barberry plant highly, and stated
that the berries are just as useful as the bark. He recom-
mended their use for the cure of ringworm, in addition to
the ailments already mentioned.
Because it is capable of increasing blood supply,
barberry may be of use to those suffering from ventricu-
lar heart defects. Berberine is used in China to treat
white blood cell depression when caused by chemothera-
py or radiation treatments.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Preparations
The bark of the roots or stems are the parts used
medicinally.
The dried herb may be taken in a decoction, for
which place one teaspoonful of the herb in a cup of water
and bring to the boil. Leave for about fifteen minutes and
drink. This may be taken three time daily. The decoction
may also be used as a gargle in cases of sore throat.
If a tincture is being used, 1-2 ml may be taken three
times daily.
Herbalists recommend that in cases of gallbladder
disease, barberry combined with fringe tree bark and
black root are an effective treatment.
For an effective liver cleanse, herbalists recommend
a combination of one part barberry, one part wild yam,
one part dandelion, and one half part licorice root, sim-
mered in one pint of water for ten minutes, then strained
through a coffee filter.
The bark is sometimes made into a poultice for the
treatment of skin lesions, and a compress is useful for
swollen eye lids and conjunctivitis.
Precautions
Barberry root should not be taken by pregnant
women because of its stimulant effect on the uterus.
Those with heart disease or chronic respiratory prob-
lems should only take barberry after consultation with a
herbalist, naturopath, or medical specialist.
The cultivation of barberry is restricted in some areas,
as it hosts and promotes stem rust, a scourge to cereal crops.
If in any doubt, it is always best to consult a herbal
practitioner regarding dosage of herbs.
Side effects
Berberine (an active ingredient of barberry), has
been found to affect normal bilirubin in infants, so in
theory, it may have an adverse effect on jaundice.
Strong extracts may cause stomach upsets, so use of
barberry for a period of more than two consecutive
weeks is not recommended.
Barberry, if taken to excess may cause nose bleeds,
lethargy, kidney irritation, skin and eye inflammation, in
addition to headaches and low blood sugar.
Interactions
Barberry, or any herb containing berberine, has been
found to interact with Sumycin, Helidac (Tetrecycline),
Vibramycin, Helidac (Tetracycline), Doxycycline, and
Achromycin, causing them to be less effective, and to af-
fect their absorption.
KEY TERMS
GW
Antiemetic — Prevents or alleviates nausea or 3
C/5
vomiting. “
Bitter — Reduces toxins, fights infection and fever,
and acts as a mild tonic.
Cholagogue — Stimulates the flow of bile from the
liver to the intestines.
Decoction — A strong infusion of a herb in water,
usually denoting that it is left to stand for longer
than an infusion.
Hepatic — Promotes the well being of the liver.
Leishmaniasis — A disease of the tropics transmit-
ted by sandflies.
Laxative — Promotes evacuation of the bowels.
Materia medica — A list of drugs or herbs used
medicinally.
Protozoa — Single-celled organisms, many of them
intestinal parasites.
Ventricular — Pertaining to the two lower cham-
bers of the heart.
Resources
BOOKS
Culpeper, Nicholas. Culpeper’ s Complete Herbal. London:
Bloomsbury Books, 1992.
Duke, James A. The Green Pharmacy. New York: St. Martin's
Paperbacks, 1998.
Grieve, M. A Modern Herbal. London: Tiger Books Interna-
tional, 1992.
OTHER
Hoffman, David L. "Barberry.” Healt World Online. <http://
www.healthy.net/asp.>
Birdsall, Timothy and Gregory Kelly. "Berberine: Theraputic
Potential of an Alkaloid found in several Medicinal plants.”
In Alternative Medicine Review [online database] Vol. 2,
no. 2 (March 1997). <http://www.thorne.com/altmed
rev/fulltext/berb.html.>
Patricia Skinner
Barley grass
Description
Barley grass is the leaf portion of the barley plant
( Hordeum vulgare) that remains after the seeds have
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
183
Barley
Barley grass
been removed. As a grass, it is also known as a distichon,
meaning that it grows in two separate ranks, or rows. The
rows of barley grass are parallel to the central axis, form-
ing a loose sheath over the stem, which is sometimes
called the culm. This stem is hollow and jointed, and the
seeds are ellipitical and furrowed. The barley plant, an
annual that requires reseeding each year, reaches a
height of up to 3 ft (about 1 m). The plant has an exten-
sive history in human and animal nutrition. As a nutri-
tional supplement, it is preferable to use young barley
plants that have not yet developed seeds.
General use
The barley plant appears to have been used by the
ancient Egyptians, Romans, and Vikings. It is believed
that Columbus brought it to the Americas in 1493. Bar-
ley seeds have been used in both human nutrition and
medicine. When the seeds are boiled, they release a thick
substance that soothes sore throats. Barley seeds are used
for the preparation of malt extract, which has a high
sugar content that makes it suitable as a flavoring agent
in pharmaceutical preparations.
Marketers make a number of claims regarding bar-
ley grass, including:
• It is the only vegetation on earth that can supply sole
nutritional support from birth to old age.
• Barley grass juice contains nutrients such as vitamins C
and E, which are much more potent together than when
taken separately.
• Barley grass is high in calcium, iron, all essential
amino acids, vitamin C, the flavonoids, vitamin B 12 ,
and a number of enzymes and minerals.
• Barley grass can be used to treat disorders of the stom-
ach and duodenum; pancreatitis; and as an anti-in-
flammatory agent.
• Barley grass contains superoxide dismutase (SOD), a
powerful antioxidant enzyme that protects the cells
against toxic free radicals.
Although not substantiated, one source has claimed
that barley grass is good for the following conditions:
• skin diseases
• hepatitis
• asthma
• anemia
• diabetes
• arthritis
• obesity
Barley grass contains vitamins, particularly B vita-
mins, as well minerals such as potassium, calcium, iron,
184
phosphorus, and magnesium. Enzymes contained in
the plant include SOD and nitrogen reductase. The latter
reduces nitrogen — an element commonly found in pro-
tein — in a biological process. Although barley grass con-
tains enzymes, the health benefits of these substances re-
main unclear. Enzymes are proteins, which are normally
broken down into their component chemicals during di-
gestion. However, the enzymes found in raw foods re-
main technologically unprotected from normal digestive
processes. The medical literature is not consistent on
whether any SOD is actually absorbed intact through the
digestive tract. In fact, the percentage absorbed may be
very small. Techniques are being developed to encapsu-
late enzymes into other molecules. This will allow the
enzymes to be absorbed intact, so that they will remain
active following digestion.
Barley grass and other cereal grasses may or may
not be useful sources of natural vitamins and minerals.
Evidence may be insufficient to justify claims that these
products improve physical health or cure disease. Barley
grass has not been reviewed by the United States Food
and Drug Administration (FDA) or the German Commis-
sion E. Nutrient concentration in barley grass products
varies with the conditions under which the plant is
grown. Like other natural supplements, commercial bar-
ley grass is not standardized; therefore, different crops
contain varying amounts of nutrients. Young barley grass
plants appear to contain higher concentrations of nutri-
ents than older plants.
One well-publicized Chinese study reported that
barley grass was beneficial in lowering cholesterol lev-
els in patients with type 2 diabetes. This may be due to
the plant’s antioxidant abilities. Similar results were
achieved by other researchers who studied the antioxi-
dant effects of red wine and tomato juice.
Other health claims made for barley grass remain
unconfirmed. For example, chlorophyll, the pigment
found in barley grass and all green plants, may have
some antibacterial effects. Chlorophyll reportedly in-
hibits the growth of cancer cells under laboratory condi-
tions, but its value in human health is unknown.
Similarly, the claim that barley grass can provide
full nutrition is subject to dispute. One researcher found
that people on a vegan diet that included barley grass
were likely to show reduced levels of vitamin B 12 , and to
require supplementation with this essential nutrient.
Preparations
Barley grass is available in capsule, powder, and
tablet formulations. Capsules are sold in strengths of 470
mg, 475 mg, and 500 mg. Tablets are available in 350
mg and 500 mg strengths.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Amino acid — An organic compound containing
an amino group (NH 2 ), a carboxylic acid group
(COOH), and various side groups. Amino acids
are bound together to form proteins.
Diabetes type 2 — A form of diabetes mellitus that
usually occurs in adults. The pancreas produces
insulin, but the muscle cells are resistant to the ef-
fects of the insulin. This was formerly called matu-
rity (or adult) onset diabetes.
Enzyme — A protein, produced by a living organ-
ism, that functions as an organic catalyst (a chemi-
cal that increases the speed of a reaction without
being involved in the reaction itself).
Vitamin — Any of various organic carbon-contain-
ing substances that are essential in minute
amounts for normal growth and activity of the
body, and are obtained naturally from plant and
animal foods.
Precautions
Barley grass may sometimes be rich in vitamin K,
which interferes with the action of anticoagulants such
as Coumadin (the brand name for warfarin, a drug used
to treat and prevent blood clots). Other than an allergic
reaction, there are no known adverse effects attributed to
barley grass.
Side effects
There are no known side effects attributed to barley
grass.
Interactions
No drug interactions have been associated with bar-
ley grass, with the exception of samples that are high in
vitamin K (interferes with Coumidin).
Resources
BOOKS
Lust J. The Herb Book. New York, NY: Bantam Books, 1984.
Reynolds J., ed. Martindale The Extra Pharmacopoeia. 30th
ed. London: The Pharmaceutical Press, 1993.
Seibold, R. Cereal Grass, Nature’s Greatest Health Gift. New
Canaan, CT: Keats Publishing Inc., 1991.
PERIODICALS
Donaldson, M.S. “Metabolic Vitamin B 12 Status on a Mostly
Raw Vegan Diet with Follow-up Using Tablets, Nutrition-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
al Yeast, or Probiotic Supplements.” Annals of Nutrition
and Metabolism 44 (2000): 229-34.
Gowri, J. W.. M. S. Turner, J. Nichols, et al. “Lipoprotein Oxi-
dation for Individuals with Type 2 Diabetes Mellitus.”
Journal of the American Colleee of Nutrition 18 (October
1999): 451-61.
Yu, Y. M„ Chang, W. C., Chang, C. T„ et al. "Effects of Young
Barley Leaf Extract and Antioxidative Vitamins on LDL
Oxidation and Free Radical Scavenging Activities in Type
2 Diabetes.” Diabetes Metab. (April 28, 2002): 107-14.
OTHER
Alberta Barley Commission. #200, 3601A - 21 Street N.E. Cal-
gary, Alberta T2E 6T5 CANADA. (403) 291-9111. (800)
265-9111. Fax: (403) 291-0190. <http://www.
albert abarley. com/kids/about . shtml> .
Green Green Grass.com. 7925-A N Oracle Rd #281 Tucson,
AZ 85704. (888) 773-9808. info@greengreengrass.com.
<http://www.greengreengrass.com/barleygreen_premium.
html>.
Herbal Information Center. 3507 Marsala Ct. Punta Gorda, FL
33950 <http://www.kcweb.com/herb/barley.htm>.
Samuel Uretsky, Pharm.D.
Bates method
Definition
The Bates method, popularized in the early twenti-
eth century by ophthalmologist William Horatio Bates,
involves the use of therapeutic eye exercises. Bates
claims these exercises will correct vision problems, thus
alleviating the need for glasses or contact lenses. Patients
practice eye exercises aimed at strengthening and train-
ing their eye muscles in an effort to overcome such prob-
lems as farsightedness (hyperopia), nearsightedness
(myopia), and astigmatism.
Origins
The method was devised by Bates, who was born in
1860 in Newark, New Jersey. In 1885. he received his
medical degree and began practicing in New York City.
Over the years, he began to notice that eye conditions
like myopia, which is caused by a refractive error, could
become better or worse for no apparent reason. Based on
this observation, he began to question a basic tenet of
traditional ophthalmology, which held that once a person
had a refractive error like myopia, the only way to cor-
rect it was by wearing glasses.
While traditional ophthalmologists believed that the
lens was responsible for the eye’s focus. Bates main-
185
Bates method
Bates method
tained that it was the muscles around the eye that caused
the eye to focus. Thus, traditional ophthalmologists
blamed problems like nearsightedness on a failure of the
lens to properly focus, while Bates believed it was due to
a dysfunction of the muscles surrounding the eyeball.
Bates had come to this conclusion after performing eye
surgery on cataract patients and finding that some of
them could still see distance without glasses even though
he had removed the lens from their eyes; therefore, he
determined that the lens did not play a role in refractive
errors such as myopia.
At this point. Bates broke from his counterparts and
began focusing his attention on the muscles surrounding
the eye. He came to view eye problems as a result of
poor evolution, believing that the eye had not kept up
with human progress and had not evolved to allow read-
ing. He also blamed problems on artificial light, which
kept the eyes working longer hours each day than they
were intended to. Bates developed a series of eye exer-
cises to retrain the optic muscles to solve this evolution-
ary glitch.
Bates believed that eye strain caused vision to dete-
riorate, and his treatment was simple: like any other
muscles, the eye muscles need periods of rest and exer-
cise in order to achieve optimal performance. He focused
on the functioning of the six small muscles that control
the eye’s shape. When they become tense, they gradually
grow weak and result in nearsightedness, farsightedness,
astigmatism, or “lazy eye.”
The Bates method received acclaim several years
after Bates’s death (1931), when author Aldous Huxley
boasted that after two months on the Bates program, he
went from being almost blind to being able to read with-
out wearing glasses.
Benefits
An advantage of the Bates method is that the treat-
ment is relaxing. Also, if patients stick to the routine and
eye improvement is gained, they may benefit by being able
to discard their corrective lenses, escaping a lifetime of
costs for glasses, lenses, and contact solutions. The treat-
ment is also much less invasive than refractive surgery,
which is costly and has risks, just like any other operation.
Description
The Bates method maintains that vision problems
are caused by physiological and psychological strains
and therefore cannot be corrected by wearing glasses. He
believed that a combination of rest and exercise would
mend the eyes and devised several exercises aimed at
strengthening and retraining the eye muscles.
186
The exercises themselves are simple, but Bates
stressed that it takes discipline and attention to detail in
order to achieve improvement. Some of the principal ex-
ercises of the Bates method are described below.
Palming
Palming is aimed at calming the visual system. In
this exercise, patients close their eyes and cover them
with the palms of their hands, allowing the fingers to
cross on the forehead. The hands should be cupped so
that no pressure is put on the eyeballs. Next, the patient
should open his or her eyes and see if any light is getting
in. If so, the hands should be moved so that no light en-
ters and then close the eyes again. The warmth of a per-
son’s hands, combined with blocking out all light, will
relax a pair of tense eyeballs.
Sitting at a table is a good palming position. A per-
son can place a cushion on the table on which to rest
their arms, and should check the height to be sure their
hands are not too high or too low. Lying on the back,
with knees raised and feet flat on the floor, is also a good
position. While palming, patients should imagine a re-
laxing scene, such as a sunrise or ocean.
A description of the exercise posted on the Bates As-
sociation for Vision Education website suggests palming
in 5- 10-minute sessions, at least once a day. If this is
found unpleasant, a person can try mini-sessions, palm-
ing for a period of 15 breaths, up to 20 times a day. Palm-
ing may also help when the eyes become tired and bleary.
Swinging
Swinging is meant to train the eyes not to stare.
Bates maintained that the rigidity of staring was bad for
the eyes. To do this exercise, the patient should focus on
a fixed object, then swing the head or the entire body
from side to side while keeping the object in view by
moving the head instead of the eyes.
Test-card practice
Based on the idea that practice makes perfect, this
exercise involves practicing eye charts. Patients are
asked to focus on a letter, then close their eyes and visu-
alize the black letter for several seconds. After several
sessions. Bates maintains, the letters will appear blacker
and clearer.
Sunning
Sunning is aimed at reducing light sensitivity. Bates be-
lieved the sun has a therapeutic effect, so patients are asked
to close their eyes and face the sun. It is advised to sun only
in the morning or evening and only for short periods of time.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Centralization
Centralization, or central fixation, is aimed at
training the eye not to overstrain itself by taking in too
much at once. This exercise involves training the eyes
to focus on a single point, rather than an entire pic-
ture. The eye has a point in the middle of the vision
field where vision is sharpest. This exercise is aimed
at training people to look only at that point. Patients
are asked to look at an object piece by piece instead of
trying to look at it in its entirety, which Bates main-
tains is beyond the physical capabilities of the eye.
Bates believed that looking at an entire picture created
strain, causing bad eyesight. This is not an exercise
per se, but rather something patients are asked to do
all day long.
Color days
This involves spending the day focused on looking
for a specific color. When looking at a color, patients are
asked to focus on the color, not the form. Colors change
every day.
People interested in the Bates method can pay a pro-
fessional trained in the method to teach them the exercis-
es or they can simply read about them in books or on the
internet for no cost. Bates believed that improvement
would vary, depending on the degree of problem and a
person’s devotion to doing the exercises.
Preparations
There are no pre-therapy procedures.
Precautions
People should be aware that the theory remains un-
proven. This method should not be a substitute for ap-
propriate medical treatment in the case of cataracts,
glaucoma, and other eye diseases.
Side effects
There are no side effects, but patients should be cau-
tious when using the sunning exercise, which may cause
solar retinitis, or inflammation of the retina, causing per-
manent damage.
Research & general acceptance
Though the Bates method was devised a century
ago, it has never been tested in a clinical setting. At best,
anecdotal evidence is all there is to substantiate its use.
The orthodox ophthalmologists of Bates’s time, as
well as those of today, have largely dismissed his theo-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Astigmatism — An eye condition that causes a per-
son to see distorted images due to an abnormality
in the curvature of the eye's lens.
Farsightedness — Being able to see more clearly
those objects far away as opposed to those that
are near. Also called hyperopic.
Nearsightedness — Being able to see more clearly
those objects that are near as opposed to those in
the distance. Also called myopia.
lies as based on flawed science. Traditional ophthalmol-
ogists hold that the lens — not the eye muscles — is re-
sponsible for focus and therefore cannot be fixed
through a series of exercises. Traditional ophthalmolo-
gists believe that problems like nearsightedness are
anatomic conditions that cannot be fixed by strengthen-
ing the eye muscles.
As Philip Pollack noted in his book The Truth About
Eye Exercises, Bates used testimonials and case histories
depicting successful treatment as scientific proof his the-
ory was sound. Pollack also lambasted Bates for describ-
ing rare cases as the norm, using them as justification for
his methods.
The Bates method has not found widespread use
and is generally not accepted by the medical establish-
ment. In his book Health Education Authority Guide to
Complementary Medicine and Therapies, A. Woodham
cautions that the medical consensus is that “eye exer-
cises can improve the sight in some cases, but these
need a lot of dedication and perseverance. Do not ex-
pect miracles.”
Training & certification
Natural vision improvement techniques, such as the
Bates method, are generally taught by behavioral op-
tometrists or vision therapists. Vision therapists may not
necessarily be trained in optometry. It is possible, how-
ever, to find practicing optometrists trained by the Bates
Association for Vision Education, which offers courses
on the method.
Resources
BOOKS
Bates, W. The Bates Method for Better Eyesight without Glass-
es. New York: Henry Holt & Co., 1987.
Cheney, E. The Eyes Have It: A Self-Help Manual for Better
Vision. York Beach, Maine: Samuel Weiser, Inc., 1987.
187
Bates method
Bayberry
PERIODICALS
Booth, Brian. “Nature Cures: Hydrotherapy, Bates Method."
Nursing Times 91 no. 20 (May 1995): 42-43.
Karatz, May Annexton. “William Horatio Bates, M.D., and the
Bates Method of Eye Exercises.” New York State Journal
of Medicine 75 no. 7 (June 1975): 1105-1110.
ORGANIZATIONS
College of Optometries in Vision Development. P.O. Box 285,
Chula Vista, CA 91912. (619) 425-6191. Fax: (619) 425-0733.
OTHER
“Bates Method.” The Vision Improvement Site. 16 July
2000. <http://lightning.prohosting.com/-hanwen/vision/
bates.htmx
“Fallacies of the Bates System.” 14 July 2000.
Quackwatch.com. <http:// www.quackwatch.com>.
“Who Was Dr. Bates?” Bates Association for Vision Education.
<http://www.seeing.org/intro/faq/faq01.htm>. 14 July 2000.
Lisa Frick
Bayberry
Description
Bayberry, also known as wax myrtle, waxberry, or
candelberry, is both a shrub and a tree. All members of
the bayberry family are classified botanically as Myri-
caceae, and many varieties are found all over the world,
including Japan, South America, the West indies, the
United Kingdom, and in the United States.
American bayberry ( Myrica cerifera ) is a shrub that
grows 3-8 ft (1-2.4 m) high. It is found in eastern North
America, in marshes and bogs near sandy Atlantic
coastal areas, as well as in similar areas along the shores
of the Great Lakes. American bayberry is the variety
most often mentioned by herbalists.
American bayberry and its British Isles cousin, Eng-
lish bog myrtle, are very alike in appearance, and grows
to a similar height. Foliage is evergreen and consists of
knife -blade shaped shiny leaves that have small spots on
them. When crumpled in one’s hand, bayberry leaves
and its bark produce a pleasant, balsamic aroma. Howev-
er, they have a very bitter, astringent taste. The small
berries are in globular clusters at stem junctions, crusted
with a greenish-white waxy substance sprinkled with
small black flecks. The exterior of bayberry root bark is
mottled, with smooth reddish-brown cork underneath.
General use
Both American bayberry and English bog myrtle,
besides sharing a similar appearance, have similar medi-
188
cinal qualities. Like all bayberry varieties, they are clas-
sified as astringent herbs. Some evidence suggests that
these herbs have antimicrobial capabilities, in that they
are able to prevent the development of pathogenic activi-
ty from microbes, and are useful in regulating mucus in
the body.
Both varieties’ bark and roots contain starch, lignin,
gum, albumen, tannic and gallic acids, astringent resin, a
red coloring substance, a vaporous oil, and an acid simi-
lar to saponin. Powdered bayberry root is useful as a
bowel astringent in the treatment of diarrhea and colitis,
a soothing and helpful gargle for the common cold or a
sore throat, and as a douche in the treatment of leukor-
rhea, an abnormal white or yellow mucoid discharge
from the vagina or cervix. In the Herbal Materia
Medica, bayberry root bark is classified as an astringent,
a circulatory stimulant, as well as a diaphoretic, a reme-
dy which dilates superficial capillaries and induces per-
spiration, sometimes used to reduce fevers.
The berries of both American bayberry and English
bog myrtle, when boiled in water, produce myrtle wax,
which is composed of stearic, palmitic, myristic, and
oleaic acids. This is used in making bayberry-scented
soaps and bayberry candles, which are fragrant, more
brittle than bees’ wax candles, and are virtually smoke-
less. Four pounds of berries produce approximately one
pound of wax. A briskly stimulating shaving cream was
also made from this bayberry wax.
The wax’s modern medicinal uses were first discov-
ered and came into use in 1722, and included the mak-
ing of surgeon’s soap plasters. The water that the berries
were boiled in during wax extraction, when boiled down
to an extract, has been used in the North Country of
England and Scotland for centuries as a treatment for
dysentery. Narcotic properties are also attributed to bay-
berry wax.
In A Modern Herbal, that the leaves of English bog
myrtle were commonly used in France to induce both
menstruation and abortion.
In China, bayberry leaves are infused to make a tea
which is used both to relieve stomach problems, and as a
cordial, which is a stimulating medicine or drink.
A mouthwash particularly useful in inhibiting halli-
tosis can be made from either the powdered root or
leaves.
Bayberry bark has traditionally been used to tan
leather and dye wool.
Bayberry branches have been used in lieu of hops in
the fermentation of gale beer , popular in northern Eng-
land, and reported to have more than the usual “thirst-
quenching” ability.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Bayberries. (Photo Researchers, Inc. Reproduced by permission.)
Bayberries can be ground to use as spice, or added
to broths.
In the West Indies, Pimento acris, commonly called
wild cinnamon or bayberry, is used in making both bay
rum and oil of bayberry.
M. pennsylvanica’ s root can be used to induce vom-
iting.
The Brazilian species, Tabocas combicurdo , is de-
scribed in A Modem Herbal as a “pick-me-up.”
Preparations
Bayberry preparations are made by collecting root
bark in late fall or early winter, drying thoroughly, and
either pulvarizing into a powder or chopping the bark. It
should be stored in a tightly sealed containers, away
from light.
A decoction or tea is prepared by adding a teaspoon-
ful of powdered bayberry bark to a cup of cold water and
bringing this to a boil. If using chopped, not powdered,
bark, the decoction is simmered. This tea is then left to
steep for 15-20 minutes before drinking. It may be taken
up to three times a day for a limited period of time, as
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
chronic use at this dosage could damage a person’s kid-
neys and liver. The same preparation can be used as a
gargle for sore throat.
Tincture of bayberry preparations are also available in
some locales. Usual dosage is one-half teaspoonful in water.
Precautions
As noted previously, English bog myrtle has histori-
cally been shown as having characteristics capable of in-
ducing abortion. Its leaves, in nature, also have a poiso-
nous, volatile oil present, which can be removed by boil-
ing. Though no studies were found indicating the same
capabilities for American bayberry, because of their
many similarities, it should be assumed that neither Eng-
lish bog myrtle nor American bayberry leaves should be
ingested in their natural, unprepared state. Additionally,
aforementioned dosages of a bayberry decoction or tea
should not be taken on a chronic basis, as damage to the
kidneys and liver could occur.
Side effects
Powdered bayberry root, if inhaled, can cause con-
vulsive episodes of both sneezing and coughing.
189
Bayberry
Bedsores
Several varieties of the bayberry family are used as
emetics, which are agents used to induce vomiting, and
can also cause nausea.
Interactions
To date, no reported interactions with either food,
drug, or other herbal preparations have been found.
Resources
BOOKS
Grieve, M. and C.F. Leyel Barnes. A Modern Herbal: The
Medical, Culinary, Cosmetic and Economic Properties,
Cultivation and Folklore of Herbs, Grasses, Fungi, Shrubs
and Trees With All of Their Modern Scientific Uses.
Bames and Noble Publishing, 1992.
Hoffman, David and Linda Quayle. The Complete Illustrated
Herbal: A Safe and Practical Guide to Making and Using
Herbal Remedies. Bames and Noble Publishing, 1999.
Thayer, Henry. Fluid and Solid Extracts. Geo.C. Rand &
Avery, 1866.
Joan Schonbeck
Bearberry see Uva ursi
Beard moss see Usnea
Bedsores
Definition
Bedsores are the result of inflammation and damage
caused by irritation to the skin and inhibited blood flow.
The condition occurs when skin is rubbed against a bed,
chair, cast, or other hard object for an extended period of
time. Bedsores can range from mild inflammation to
deep wounds that involve muscle and bone. Infections
can be a serious complication to the condition.
Description
Bedsores are also called decubitus ulcers, pressure
ulcers, or pressure sores. They often start out with shiny
red skin that becomes itchy or painful, then quickly blis-
ters and deteriorates into open sores. Once there is a
break in the skin, there is a strong possibility of the sore
becoming infected, causing further medical problems.
Bedsores are most apt to develop over the bony promi-
nences of the ankles, the hip bones, the lower back, the
shoulders, the spinal column, the buttocks, and the heels
of the feet. Bedsores are most likely to occur in people
who must use wheelchairs or who are confined to bed.
190
Bedsores are medically categorized by stages:
• Stage I: The skin reddens, but it remains unbroken.
• Stage II: Redness, swelling, and blisters develop. There
is possibly peeling of the outer layer of the skin.
• Stage III: A shallow open wound develops on the skin.
• Stage IV: The sore deepens, spreading through layers
of skin and fat down to muscle tissue.
• Stage V: Muscle tissue is broken down.
• Stage VI: The underlying bone is exposed, and there is
danger of severe damage and infection.
Causes & symptoms
Bedsores most often happen when the most superfi-
cial blood vessels are pressed against the skin and
squeezed shut, closing off the flow of blood. If the sup-
ply of blood to an area of skin is cut off for more than an
hour, the tissue will began to die due to lack of oxygen
and nutrients. Ordinarily, the layer of fat under the bony
areas of the skin helps keep the blood vessels from being
compressed in this way. Also, people have a normal im-
pulse to change positions frequently when they are sit-
ting or lying down, so the blood supply is usually not
kept from any area of the skin for very long. Bedsores
are most likely to occur in people who have lost the pro-
tective fat layer or whose movement impulse is hindered.
Friction or rubbing from poorly fitted shoes or
clothing and wrinkled bedding often cause a sore to de-
velop. Constant exposure to the moisture of urine, feces,
and perspiration may also cause the skin to deteriorate.
In such cases there is an increased the risk of skin infec-
tion as well as sores.
Risk factors for bedsores:
• older than 60 years of age
• heart disease
• diabetes
• diminished tactile sensation
• incontinence
• malnutrition
• obesity
• paralysis or immobility
• poor circulation
• prolonged bed rest
• spinal cord injury
• anemia
• disuse atrophy
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Diagnosis
Physical examination of the skin, medical history,
and patient and caregiver observations are the basis of
diagnosis. Any sign of reddening of the skin will be
closely monitored.
Treatment
Contrasting hot and cold local applications can increase
circulation to problem areas and help flush out waste prod-
ucts, speeding the healing process. Hot compresses should
be applied for three minutes, followed by 30 seconds of cold
compress application, repeating the cycle three times. The
cycle should always end with the cold compress. In addition,
zinc and vitamins A, C, E, and B-complex should be taken
to help maintain healthy skin and repair injuries.
Herbal remedies
A poultice can be made of equal parts of powdered
slippery elm, Ulmus fulva: marsh mallow root. Althaea
officinalis ; and Echinacea spp. The herbs should be
blended together with a small amount of hot water and
applied to the skin three or four times per day to relieve
inflammation. Poultices used on broken skin or infected
areas should never be reused.
An infection-fighting rinse can be made by diluting
two drops of essential tea tree oil, Melaleuca spp., in
eight ounces of water. This should be used to bathe the
wound when bandages are changed.
An herbal tea made from Calendula officinalis can
be used as an antiseptic wash and a wound healing agent.
Calendula cream can also be applied to the affected area.
A poultice made from goldenseal, Hydrastis
canadensis, and water or goldenseal ointment can be ap-
plied to areas of inflammation several times per day to
heal the skin and prevent infection.
Allopathic treatment
A healthcare provider should be consulted whenever
a person develops bedsores. An emergency situation may
be indicated if sores become tender, swollen, or warm to
the touch, if the patient develops a fever, or if the sore
has pus or a foul-smelling discharge.
For mild bedsores, treatment basically involves re-
lieving pressure on the area and keeping the skin clean
and dry. When the skin is broken, a non-stick covering
may be used. A saline solution is often used to clean the
wound site whenever a fresh bandage is applied. Disin-
fectants are applied if the site is infected. The doctor may
also prescribe antibiotics, special dressings or drying
agents, and ointments to be applied to the wound. Heat
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
A Bedsore. (Photograph by Michael English, M.D., Custom
Medical Stock Photo. Reproduced by permission.)
lamps are used quite successfully to dry out and heal the
sores. Warm whirlpool treatments are sometimes also rec-
ommended for sores on the arm, hand, foot, or leg.
In a procedure called debridement, a scalpel may be
used to remove dead tissue or other debris from the wound.
Deep sores that don’t respond to other therapy may require
skin grafts or plastic surgery. If there is a major infection,
oral antibiotics may be given. If a bone infection, called os-
teomyelitis, develops or infection spreads through the
bloodstream, aggressive treatment with antibiotics over the
course of several weeks may be required.
Expected results
With proper treatment, bedsores should begin to
heal two to four weeks after treatment begins. Left un-
treated, however, gangrene, osteomyelitis, or a systemic
infection may develop. In the United States, about
60,000 deaths a year are attributable to complications
caused by bedsores.
Prevention
Prompt medical attention can prevent pressure sores
from deepening into more serious infections. People
whose movement or sense of touch is limited by disabili-
ty and disease should be monitored to insure that the skin
remains clean, dry, healthy. A bedridden patient should be
repositioned at least once every two hours while awake. A
person who uses a wheelchair should remember to shift
the body’s position often or they should be helped to
reposition the body at least once an hour. To avoid injury,
it is important to lift, rather than drag, a person being
repositioned. Wheelchair users should sit up as straight as
possible, with pillows behind the head and between the
legs if needed. Donut-shaped seat cushions should not be
used because they may restrict blood flow.
191
Bedsores
Bedwetting
KEY TERMS
Disuse atrophy — Condition of muscles that have
lost size, strength, and function due to lack of mo-
bility.
Gangrene — A serious condition where there is
decay or death of an organ, tissue, or bone caused
by a lack of oxygen and nutrients and by bacterial
infections.
Incontinence — Inability to control bladder or
bowel movements.
Inflammation — An immune reaction to tissue in-
jury or damage, usually characterized by pain,
swelling and redness.
Poultice — Moistened herbs applied directly to a
site of injury or infection.
Tactile sense — Receiving information about the
body and the environment via contact with the
skin. When this is lost through illness, a person
may receive injuries without being aware of it.
Even slight friction can remove the top layer of skin
and damage the blood vessels beneath it. Pillows or foam
wedges can be used to keep the ankles from rubbing to-
gether and irritating each other; pillows placed under the
lower legs can raise the heels off the bed. To minimize
pressure sores, there should be adequate padding in beds,
chairs, and wheelchairs. Those who are bed-ridden can
be protected by using sheepskin pads, specialized cush-
ions, and mattresses filled with air or water. In addition,
a 1997 study indicates that topical use of essential fatty
acids can help the skin stay healthy.
Resources
BOOKS
Berkow, MD, Robert, editor-in-chief, et al The Merck Manual
of Medical Information, Home Edition. New York: Pocket
Books, 1997.
The Editors of Time-Life Books The Medical Advisor: The
Complete Guide to Alternative and Conventional Treat-
ments Virginia: Time-Life, Inc., 1996.
PERIODICALS
Declair, V. Ostomy Wound Management 43, no. 5 (1997): 48-52.
ORGANIZATIONS
International Association of Enterstomal Therapy, 27241 La
Paz Road, Suite 121, Laguna Niguel, CA 92656
National Pressure Ulcer Advisory Panel, SUNY at Buffalo,
Beck Hall, 3435 Main Street, Buffalo, NY 14214
<http://www.npuap.org.>
Patience Paradox
192
Bedwetting
Definition
Bedwetting, or enuresis, is a childhood condition of
urinating in bed while asleep at night. It is a chronic condi-
tion that often resolves by itself before the teenage years.
Description
One of the major tasks of toddlerhood is to learn
how to achieve conscious control over the timing of uri-
nation. Most children do not become fully toilet trained
until they are about two to four years old. Before then,
the parts of the nervous system in charge of bladder con-
trol are not fully developed and functional. In general,
boys take longer to learn to control their bladders than
girls, and daytime bladder control is easier for a child
than overnight bladder control. There is a genetic aspect
to bedwetting, so that parents who once had the condi-
tion often have children who wet the bed at night.
Causes & symptoms
Bedwetting is often due to the normal immaturity of
the nervous system and the urinary system. For instance,
up to age six, bedwetting is often due to nothing more
than the bladder having a small capacity. In addition, the
muscles that control the opening and closing of the ure-
thra may not be sufficiently developed. Often it takes a
while for a child learn recognition of bladder fullness,
waking up, and going to the toilet. In most cases, urinary
capacity and control increase over time, and the bedwet-
ting problem will eventually be outgrown.
Surprisingly, a big cause of bedwetting is lack of sleep.
If a child is not sleeping enough hours, then there will be less
of the light, rapid eye movement (REM) sleep, and more pe-
riods of heavy, deep sleep. During the periods of deep sleep
some children will have difficulty becoming aware of the
urge to urinate and awakening to go to the toilet.
Bedwetting may be a sign of allergic reactions,
which end up irritating sphincter muscles around the ure-
thra. This contributes to a loss of bladder control during
sleep. Heavy snoring, mouth breathing, and night sweats
may all be indications of the presence of allergies.
Bedwetting can sometimes be due to emotional and
psychological stress, including major life changes such as
moving or a divorce. This usually leads to the type of bed-
wetting called secondary enuresis, in which a previous
level of accomplishment with bladder control is lost. In
other words, a child who has been dry at night will sud-
denly start wetting the bed again. This may indicate an un-
derlying problem such as constipation, diabetes, physical
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
defects in the urinary tract, sacral nerve disorders, a pelvic
growth, urinary stasis, infection, kidney stones, or kidney
damage. Secondary enuresis also frequently occurs in
children who are being physically or sexually abused. A
pediatrician should be consulted if the condition persists.
Only about 1% of bedwetting is caused by a serious
underlying problem. If the following symptoms are pre-
sent, a pediatrician or a pediatric urologist should be
consulted:
• straining during urination
• a burning feeling or other discomfort during urination
• constant or recurrent dribbling of urine
• cloudy or pink urine
• bloodstains or other discharge on underpants or night-
clothes
• an unpleasant urine odor
• onset of abdominal pain, backache, or fever
• constant thirst, especially at night
• sudden loss of bladder control previously mastered
• a child over the age of two who still shows no signs of
being ready to learn bladder control
Diagnosis
When bedwetting is resistant to home treatments or
when more serious symptoms are present, a visit should
be made to a healthcare provider. This is especially war-
ranted if the child is older than six. A thorough history and
physical exam should be taken along with a urine sample.
Analysis and culture tests can be done on the urine to de-
termine if an infection is present. Further evaluations may
be made using ultrasound, an x ray of the kidney, or a con-
sultation with a urologist. If the bedwetting appears to be
connected with issues of stress or family problems, a men-
tal health consultation may be recommended.
Treatment
Sitting in a cool sitz bath (pelvic area only im-
mersed) for about five minutes daily can tone up the ure-
thral sphincter. This can be done using a bathtub filled
with about two or three inches of water, having the child
sit in a large basin of water or using a sitz basin (avail-
able from larger drugstores and medical supply stores).
“Hands-on” treatments such as acupressure, reflex-
ology, and shiatsu can be used to relax the child, coun-
teract stress, and improve the actions of the nervous sys-
tem. Hypnotherapy can also be helpful in improving
bedwetting. Among other things, the child will be given
positive goal affirmations to say before going to bed.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
This should help make the urge to urinate during the
night more conscious, and therefore encourage the child
to awaken and go to the toilet.
The best way to use homeopathy is o see a home-
opath for individual prescribing. Equisetum 6c, may be
useful, especially if there are dreams or nightmares con-
nected with the bedwetting. For bedwetting in very ex-
citable, outgoing children, which occurs soon after
falling asleep, Causticum 6c may be recommended. The
remedies should be given once per day at bedtime for up
to two weeks. A practitioner should be consulted for
more specific remedies.
Herbal medicine
A strong tea can also be made using equal parts of
horsetail, Equisetum arvense; St. John’s wort; cornsilk,
Zea mays; and lemon balm, Melissa ojfinalis. Two to
three handfuls of the mixture should be placed in a quart
or liter jar and then covered with boiling water. The tea
should be allowed to steep overnight. The child should be
given half a cup of the tea three times per day, with the
last dose being given at least two hours before bedtime.
Nettles, Urtica dioica, can be made into a pleasant
tea and consumed throughout the day as a tonic for the
kidneys. The tea can be mixed with equal parts of fruit
juice as a pleasant drink for the child.
Aromatherapy uses the essential oil of cypress, Cu-
pressus sempervirens to treat chronic bedwetting. Sever-
al drops of cypress oil should be put in olive oil for mas-
sage. The oil should be rubbed onto the child’s stomach
right before bedtime.
Behavior modification programs may be suggested.
In one type, alarms that are triggered by body moisture
are worn overnight, waking the child at the first sign of
bedwetting. The child can then go use the toilet to finish
emptying the bladder. This will eventually train the child
to awaken and use the toilet upon experiencing the sen-
sation of a full bladder. Nighttime toilet training using
the alarm may take up to four or five months to be effec-
tive, however. Another program uses the child’s help
with urinating before going to bed, recording wet and
dry nights, changing wet clothing and bedding, and dis-
cussing progress. Positive reinforcements, such as gold
stars on a chart and other rewards, are given for nights
that the child does not urinate in bed.
Allopathic treatment
If other treatments fail to work, treatment with medica-
tion may be suggested. With the use of the drug
imipramine, improvement will usually occur in the first
week of treatment if it is going to be helpful. The drug can
193
Bedwetting
Bee pollen
KEY TERMS
Antidiuretic — A substance that diminishes the for-
mation of urine.
Behavior modification — Therapy aimed at chang-
ing behavior by substituting problem behaviors
with more useful activities.
Culture test — A laboratory test to grow samples of
an infecting organism from discharge or samples
of affected tissue.
Diuretic — A substance that stimulates the forma-
tion and excretion of urine.
Rapid eye movement sleep — A stage of sleep dur-
ing which dreams occur. This stage usually alter-
nates with a heavier, more restful stage of sleep.
Sitz bath — A hydrotherapy treatment for soaking
the pelvic or genital areas.
Urethra — The tube that drains urine from the
bladder.
Urologist — A physician who specializes in treat-
ing problems of the urinary tract.
be discontinued if it does not work within a week or after a
month has gone by with no bedwetting. Unfortunately, re-
lapses are very common with this treatment. Also, since
imipramine is a strong drug, the blood needs to be tested
every other week for abnormal side effects. A nasal spray
containing Demopressin, an antidiuretic drug, has been
shown to be effective in diminishing bedwetting. It is neces-
sary to use the spray at least four to six weeks for maximum
effectiveness. Demopressin also has negative side effects
and is, therefore, only recommended for short-term use.
Expected results
Bedwetting is usually outgrown at some point.
However, underlying disease conditions may have to be
assessed and treated.
Prevention
Caffeine has a diuretic effect, and should be avoided.
It is found in coffee, chocolate, tea, and many sodas. Food
labels should be examined to determine caffeine content.
Resources
BOOKS
The Editors of Time-Life Books. The Medical Advisor: The
Complete Guide to Alternative and Conventional Treat-
ments. Virginia: Time-Life, Inc., 1996.
Kirchheimer, Sid and the editors of Prevention Magazine
Health Books. The Doctors Book of Home Remedies II:
Over 1 .200 New Doctor-Tested Tips and Techniques Any-
one Can Use to Heal Hundreds of Everyday Health Prob-
lems. Pennsylvania: Rodale Press, 1993.
Lockie, Dr. Andrew and Dr. Nicola Geddes. The Complete
Guide to homeopathy: The principles and Practice of
Treatment with a Comprehensive Range of Self-Help
Remedies for Common Ailments. London: Dorling
Kindersley, Ltd., 1995.
OTHER
AlternativeMedicine.com. http://www.alternativemedicine.com
American Academy of Pediatrics, <http://www.aap.org/family/
bedwet.htm. >
Medicinal Herbs Online, <http://www.egregore.com/diseases/
bedwetting.html.>
Patience Paradox
Bee pollen
Description
Bee pollen is the dust-size male seed found on the
stamen of any flower blossom. The pollen collects on the
legs of honeybees as they move from flower to flower.
The bees secrete a number of enzymes into the pollen.
Pollen is usually collected commercially by placing a spe-
cial device at the entrance of beehives that brushes the
substance from their hind legs into a collection receptacle.
General use
Bee pollen is among the oldest known dietary sup-
plements. Its use as a rejuvenator and medicine date back
to the early Egyptians and ancient Chinese. It has been
called many things, from a fountain of youth to an “am-
brosia of the gods.” The Greek physician Hippocrates,
sometimes called the father of modern medicine, used it
as a healing substance 2,500 years ago. It is rich in vita-
mins, especially B vitamins, and contains trace amounts
of minerals, elements, amino acids, and enzymes.
The pollen is composed of 55% carbohydrates, 35%
protein, 3% minerals and vitamins, 2% fatty acids, and
5% other substances. It contains very small amounts of
many substances considered to be antioxidants, includ-
ing betacarotene, vitamins C and E, lycopene, selenium,
and flavonoids.
Proponents of bee pollen offer a wide range of claims
regarding its nutritional and healing properties. These in-
clude enhancing the immune system, controlling weight,
relieving allergy symptoms, increasing strength, improv-
ing sexual function, enhancing vitality and stamina, slow-
194
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
mg the aging process, and prolonging life. None of these
claims have been substantiated by scientific studies.
Bee pollen is said to strengthen the immune system
through its antioxidant properties. Antioxidants are used
to deactivate free radicals in the body. Free radicals are
byproducts of oxygen that can damage cells and are
linked to many degenerative diseases, especially those
associated with aging. They are also associated with the
aging process itself. Antioxidants may block further
damage and even reverse much of the cell oxidation al-
ready done. Bee pollen is suggested to help counteract
the effects of radiation and environmental pollutants that
weaken the immune system, supporters say.
In the January 2000 issue of Bee Online , an Internet
publication of the American Apitherapy Society, Steve
Schecter, naturopathic doctor, said bee pollen is benefi-
cial in reducing the effects of radiation treatment in
women with cancer. A group of 25 women undergoing
treatment for uterine cancer also took 20 g (about two
teaspoons) of bee pollen three times a day. The women
reported improvements in their appetites and sense of
well being, and less severe nausea associated with radia-
tion therapy. Their serum protein levels increased and
red and white blood cell counts also improved.
Although many plant pollens can cause or exacer-
bate allergies and hay fever, bee pollen can actually
help reduce the symptoms of these conditions. Local bee
pollen therapy is recommended to start before the allergy
season begins and it may take a few weeks for the pollen
to work. According to an article in the February 1998
issue of Better Nutrition , an Oklahoma allergist success-
fully used bee pollen to treat 22,000 patients with aller-
gies. However, those allergic to bee stings may experi-
ence severe (anaphylactic) reactions to the pollen.
Bee pollen is often used by athletes to improve
strength, endurance, energy, and speed. It is said to help
muscles recover more quickly from exercise and to in-
crease mental stamina. “Bee pollen is used by almost
every Olympic athlete in the world,” said James Higgins,
treasurer of the American Apitherapy Society, in an inter-
view in the August 1999 issue of Better Nutrition. “It
gives them more energy and better performance for events
like marathons, and they aren’t as exhausted the next day.”
Preparations
It takes about two hours for bee pollen to be absorbed
into the bloodstream. It is available in health food stores in
gelatin capsules, tablets, and granules. Capsules and tablets
generally contain 500-1000 mg of bee pollen. A 100-count
bottle costs $5-8 on average. Granules are sold by the
ounce or pound. A one-pound bag costs about $20. The
recommended dosages for preventative purposes are an
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Bee pollen of various types. (Photo Researchers, Inc. Repro-
duced by permission.)
eighth to a quarter teaspoon of granules once a day to start,
gradually increasing over a month to one to two teaspoons,
one to three times a day. The dosage for short-term thera-
peutic use is 3/8-3/4 teaspoon to start, increasing to three to
six teaspoons, one to three times a day. The recommended
preventative dosage for capsules is two 450-580 mg cap-
sules, three to four times a day, and three times that dosage
for therapeutic purposes. Bee pollen is also available in liq-
uid, cream, salve, and tincture form, mainly for use on skin
conditions, sores, pounds, and bruises. Bee pollen should
not be heated, since it will lose its potency.
Precautions
Persons who are allergic to bee stings or products
should not use bee pollen since it may cause a serious aller-
gic reaction, including death. Anyone uncertain if they are
allergic to bee pollen should sample only a few granules
first to see if there is any type of reaction, or have an allergy
test. Those using bee pollen to reduce hay fever should be
sure to consume local bee pollen to obtain the best results.
Side effects
There are rare cases of minor side effects, such as
gastrointestinal irritation and diarrhea, associated with
ingesting bee pollen.
Interactions
Bee pollen has no known negative interactions with
other drugs, vitamins, or supplements.
Resources
BOOKS
Balch, James F. Prescription for Nutritional Healing. Avery
Publishing Group, 1997.
Elkins, Rita. Bee Pollen, Royal Jelly, Propolis, and Honey: An
Extraordinary Energy and Health-Promoting Ensemble.
Woodland Publishing, 1999.
195
Bee pollen
Behavioral optometry
KEY TERMS
Antioxidant — A substance that opposes oxidation
damage anywhere in the body caused by free oxy-
gen radicals.
Flavonoids — A group of about 5,000 substances,
mostly derived from food, that have super antioxi-
dant qualities.
Free oxygen radicals — Also called free radicals,
these are by-products of oxygen that cause oxida-
tive damage to the body's cells.
Gout — A disease causing inflammation of the
joints, especially the knees, toes, and fingers due
to the deposit of crystallized uric acid in the
joints.
Stamen — The male fertilizing organ of flowering
plants, bearing pollen.
Uric acid — A compound that can form deposits in
joints and tissues. This disease is known as gout or
hyperuricemia.
Geelhoed, Glenn W. and Jean Barilla. Natural Health Secrets
From Around the World. Keats Publishing, 1997.
Jensen, Bernard. Bee Well. Bee Wise. Bernard Jensen Publisher,
1994.
Wade, Carlson. Carlson Wade's New Fact Book on Bee Pollen
and Your Health. Keats Publishing, 1994.
PERIODICALS
Adderly, Brenda. “The Latest Buzz on Products of the Hive.”
Better Nutrition (August 1999): 42.
Hovey, Sue. "One Pill Makes You Larger.” Women's Sports and
Fitness (April 1997): 79-80.
Satel, Sally and James Taranto. “Bogus Bee Pollen.” The New
Republic (January 8, 1996): 24-26.
Scheer, James.“Products of the Hive: Sticky, Sweet and Health-
ful." Better Nutrition (February 1998): 60-63.
Somer, Elizabeth.“Tasty Relief: The Benefits of Using Food as
Nutrition." Men's Fitness (July 1998): 44-46.
ORGANIZATIONS
American Apitherapy Society. 5390 Grande Road, Hillsboro,
OH 45133. (937) 364-1108. aasoffice@in-touch.net.
http ://www. apitherapy. org .
Ken R. Wells
Bee sting therapy see Apitherapy
Bee stings see Bites and stings
Behavioral medicine see Mind/Body
medicine
196
Behavioral optometry
Definition
Behavioral optometry is a system of eye care that
emphasizes visual training as a way to improve the way
a patient uses his or her eyes. Rather than simply pre-
scribe lenses to compensate for eyesight weaknesses, be-
havioral optometrists attempt to train the patient to see
better across a range of different circumstances.
Origins
Behavioral optometry traces its roots to the writings
of Dr. William H. Bates, a New York City ophthalmolo-
gist. Bates began writing in the 1920s about alternatives
to the use of corrective lenses. He believed that many
physical and emotional stresses caused vision problems,
and that alleviating these stresses could improve vision.
He noted that modern humans spend an inordinate
amount of time doing close work such as reading, while
the human eye may have been originally adapted for dis-
tance vision. Bates devised a program of eye training
that allowed patients to gradually improve their vision
without glasses. The English novelist Aldous Huxley re-
covered from near-blindness using Bates’s system, and
wrote a book about his experience. Other optometrists
built on Bates’s insights, supplementing his research and
ideas. Some researchers focused on the fact that the need
for corrective lenses rises in proportion to a person’s
level of education. They concluded that the stress of
reading was probably responsible for poor eyesight. Oth-
ers noted that vision problems increase as cultures be-
come increasingly industrialized and developed. Practi-
tioners of behavioral optometry who built on and extend-
ed Bates’s ideas include Dr. Raymond L. Gottlieb and
Dr. Jacob Liberman, both influential authors and teach-
ers. Behavioral optometrists are distinctly a minority in
the field of optometry, but they can be found across the
United States and worldwide.
Benefits
Behavioral optometrists promise many benefits
from this way of treating vision problems. Perhaps the
foremost is that people can learn to live without the dis-
comfort and bother of wearing eyeglasses or contact
lenses. Behavioral optometry also focuses on children,
particularly those with learning difficulties. These chil-
dren can benefit from learning to train their eyes and so
overcome reading problems due to inability to concen-
trate or inability to keep the eyes in place on the page.
Behavioral optometry also tries to help patients deal with
stress, so that vision training can lead to a more relaxed
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
and healthy lifestyle. In addition, behavioral optometry
has been used to develop the special visual acuity that is
needed for sports; and some practitioners are trained to
treat patients who have suffered vision trauma such as
stroke, or to work with autistic or disabled children.
Description
Behavioral optometry aims to treat the whole patient,
not just correct his or her vision. The first step in an ex-
amination may be a wide-ranging series of tests and ques-
tions, geared to determine the patient’s overall visual
abilities. This term means not just how well the eyes read
letters on a chart, but such broader areas of visual percep-
tion as hand-eye coordination and color perception. Be-
havioral optometrists will prescribe corrective lenses, but
these are usually somewhat different from traditional
glasses. The lenses are designed to relieve the stress
caused by such close-focus work as reading or working at
a computer. But for distance seeing, the lenses may not
be as accurate as traditional lenses, since the behavioral
optometrist seeks to teach the eyes to relearn distance vi-
sion skills that have atrophied. Many behavioral op-
tometrists prescribe lenses that include a series of small
prisms, which are supposed to help the eyes develop bet-
ter vision patterns. Behavioral optometrists also practice
vision therapy, in which the optometrist works closely
with the patient in step-by-step exercises to help the eyes
relax and relearn lost skills. These are not merely eye ex-
ercises, because exercising the muscles around the eye
can fatigue them instead of strengthen them. The therapy
might involve learning new skills such as juggling, draw-
ing, dancing, or ball games, as well as relaxation tech-
niques. The optometrist may also work with the patient to
alter diet, sleep patterns, and lifestyle stress.
Research & general acceptance
Though behavioral optometrists are definitely a mi-
nority within the field of optometry, a body of research
supports their methods. This can be found in profession-
al journals such as Journal of Behavioral Optometry and
Journal of Optometric Vision Development. Bates’s
method has been in use since the 1920s, and much anec-
dotal evidence attests to its efficacy, including the dra-
matic case of writer Aldous Huxley. Other patients and
practitioners have written of their ability to function
without glasses and overcome learning disabilities
through behavioral optometry. And one of the major con-
tentions of behavioral optometry is that conventional op-
tometry does not cure the eye conditions it treats. My-
opic patients are given glasses, and then a stronger pair
of glasses, and then a stronger, as vision gradually wors-
ens. Behavioral optometrists use this development as ev-
idence that conventional optometry fails its patients.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Ophthalmologist — A physician who specializes in
treating diseases and disorders of the eye.
Optometrist — A professional who examines the
eyes for vision defects in order to fit the patient
with corrective lenses or prescribe other appropri-
ate treatment.
Training & certification
In the United States, there are three major training
institutions for behavioral optometry. The College of Op-
tometrists and Vision Development offers courses and
examinations leading to an international certificate in be-
havioral optometry. Clinical education workshops are of-
fered by the Optometric Extension Program Foundation
in Santa Ana, California. The Baltimore Academy of Be-
havioral Optometry offers in-depth coursework in behav-
ioral optometry to qualified optometrists. Only people
who already have a degree in optometry can take these
courses. Technicians also work with behavioral op-
tometrists. These technicians need have no specific edu-
cational background, but to become certified, they must
work for 2,000 hours under a certified behavioral op-
tometrist and pass a written and oral examination.
Resources
BOOKS
Bates, William. The Bates Method for Better Eyesight Without
Glasses. New York: Henry Holt & Co., 1981.
Liberman, Jacob. Take Off Your Glasses and See. New York:
Crown Publishers, 1995.
ORGANIZATIONS
Baltimore Academy of Behavioral Optometry. 16 Greenmeadow
Drive, Suite 103. Timonium, MD 21093. (800) 447-0370.
College of Optometrists in Vision Development. 353 H. Street,
Suite C. Chula Vista, CA 91910. (888) 268-3770.
Optometric Extension Program Foundation. 2912 South Daimler
Street, Suite 100. Santa Ana, CA 92705. (949) 250-8070.
Angela Woodward
Behavioral therapy
Definition
Behavioral therapy, or behavioral modification, is a
psychological technique based on the premise that spe-
197
Behavioral therapy
Behavioral therapy
cific, observable, maladaptive, badly adjusted, or self-de-
structing behaviors can be modified by learning new,
more appropriate behaviors to replace them.
Origins
Reward and punishment systems have been used
throughout recorded history in an attempt to influence
behavior, from child rearing to the criminal justice sys-
tem. Modern behavioral therapy began in the 1950s with
the work of B.F. Skinner and Joseph Wolpe. Wolpe treat-
ed his patients who suffered from phobias with a tech-
nique he developed called systematic desensitization.
Systematic desensitization involved gradually exposing a
patient to an anxiety-provoking stimuli until the anxiety
response was extinguished, or eliminated.
Skinner introduced a behavioral technique he called
operant conditioning. Operant conditioning is based on
the idea that an individual will choose his behavior based
on past experiences of consequences of that behavior. If
a behavior was associated with positive reinforcements
or rewards in the past, the individual will choose it over
behavior associated with punishments.
By the 1970s, behavior therapy enjoyed widespread
popularity as a treatment approach. Over the past two
decades, the attention of behavioral therapists has fo-
cused increasingly on their clients’ cognitive processes,
and many therapists have begun to use cognitive behav-
ior therapy to change clients’ unhealthy behavior by re-
placing negative or self-defeating thought patterns with
more positive ones.
Benefits
Behavioral therapy can be a useful treatment tool in
an array of mental illnesses and symptoms of mental ill-
ness that involve maladaptive behavior, such as sub-
stance abuse, aggressive behavior, anger management,
eating disorders, phobias, and anxiety disorders. It is
also used to treat organic disorders such as incontinence
and insomnia by changing the behaviors that might be
contributing to these disorders.
Cognitive-behavioral therapy, an offshoot of behav-
ioral therapy that focuses on changing maladaptive be-
haviors by changing the faulty thinking patterns behind
them, is a recommended treatment option for a number
of mental disorders, including affective (mood) disor-
ders, personality disorders, social phobia,
schizophrenia, obsessive compulsive disorder (OCD),
agoraphobia, post-traumatic stress disorder (PTSD),
Alzheimer’s disease, and attention-deficit hyperactivi-
ty disorder (ADHD). It is also frequently used as a tool
to deal with chronic pain for patients with illnesses such
as rheumatoid arthritis, back problems, and cancer.
198
Behavioral therapy techniques are sometimes com-
bined with other psychological interventions such as med-
ication. Treatment depends on the individual patient and the
severity of symptoms surrounding the behavioral problem.
Description
Behavioral therapy, or behavior modification, is
based on the assumption that emotional problems, like
any behavior, are learned responses to the environment
and can be unlearned. Unlike psychodynamic therapies,
it does not focus on uncovering or understanding the un-
conscious motivations that may be behind the maladap-
tive behavior. In other words, behavioral therapists don’t
try to find out why their patients behave the way they do,
they just teach them to change the behavior.
initial treatment sessions are typically spent explain-
ing the basic tenets of behavioral therapy to the patient
and establishing a positive working relationship between
therapist and patient. Behavioral therapy is a collabora-
tive, action-oriented therapy, and as such, it empowers
patients by giving them an active role in the treatment
process. It also discourages overdependence on the ther-
apist, a situation that may occur in other therapeutic rela-
tionships. Treatment is typically administered in an out-
patient setting in either a group or individual session.
Treatment is relatively short compared to other forms of
psychotherapy, usually lasting no longer than 16 weeks
or sessions.
There are a number of different techniques used in
behavioral therapy to help patients change their behav-
iors. These include:
• Behavioral homework assignments. The therapist often
requests that the patient complete homework assign-
ments between therapy sessions. These may consist of
real-life behavioral experiments where patients are en-
couraged to try new responses to situations discussed in
therapy sessions.
• Contingency contracting. In conjunction with the pa-
tient, the therapist outlines a written or verbal contract of
desired behaviors for the patient. The contract may have
certain positive reinforcements (rewards) associated with
appropriate behaviors and negative reinforcements (pun-
ishments) associated with maladaptive behavior.
• Modeling. This is where the patient learns a new be-
havior through observation.
• Rehearsed behavior. The therapist and patient engage
in role-playing exercises in which the therapist acts out
appropriate behaviors or responses to situations.
• Skills training techniques. The patient undergoes an ed-
ucation program to learn social, parenting, or other rel-
evant life skills.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• Conditioning. The therapist uses reinforcement to en-
courage a particular behavior. For example, a child
with ADHD may get a gold star every time he stays fo-
cused on tasks and accomplishes certain daily chores.
The gold star reinforces and increases the desired be-
havior by identifying it with something positive. Rein-
forcement can also be used to extinguish unwanted be-
haviors by imposing negative consequences (this is also
called punishment and response).
• Systematic desensitization. Patients are gradually ex-
posed to a situation they fear, either in a role-playing
situation or in reality. The therapist will employ relax-
ation techniques to help them cope with their fear reac-
tion and eventually eliminate the anxiety altogether.
For example, a patient in treatment for agoraphobia, a
fear of open or public places, will relax and then pic-
ture herself on the sidewalk outside of her house. In her
next session, she may relax herself and then imagine a
visit to a crowded shopping mall. The imagery gets
progressively more intense until eventually, the thera-
pist and patient approach the anxiety-producing situa-
tion in real life by visiting a mall. By repeatedly pairing
a desired response (relaxation) with a fear-producing
situation (open, public spaces), the patient gradually
becomes desensitized to the old response of fear and
learns to react with feelings of relaxation.
• Flooding. Flooding is an accelerated version of system-
atic desensitization, in which the patient is exposed di-
rectly to the anxiety-provoking situation that he fears
most (either through mental visualization or real life
contact) in an effort to extinguish the fear response.
• Progressive relaxation. As the name implies, progres-
sive relaxation involves complete relaxation of the
muscle groups of the body and calm and even breathing
until the body is completely tension free. It is used by
behavioral therapists both as a relaxation exercise to re-
lieve anxiety and stress, and as a method of preparing
the patient for systematic desensitization. Progressive
relaxation is performed by first tensing and then relax-
ing the muscles of the body, one group at a time. The
therapist may suggest that the patient use one of many
available instructional relaxation tapes for practicing
this technique at home.
Cognitive-behavioral therapy (CBT) integrates fea-
tures of behavioral modification into the traditional cog-
nitive restructuring approach. In cognitive-behavioral
therapy, the therapist works with the patient to identify
the thoughts that are causing distress, and employs be-
havioral therapy techniques to alter the resulting behav-
ior. Patients may have certain fundamental core beliefs,
known as schemas, which are flawed and are having a
negative impact on the patient’s behavior and function-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
ing. For example, a patient suffering from depression
may develop a social phobia because he is convinced he
is uninteresting and unlikable. A cognitive-behavioral
therapist would test this assumption, or schema, by ask-
ing the patient to name family and friends that care for
him and enjoy his company. By showing the patient that
others value him, the therapist exposes the irrationality
of the patient’s assumption. He also provides a new
model of thought for the patient to change his previous
behavior pattern (i.e., I am an interesting and likeable
person, therefore I should not have any problem making
new social acquaintances). Additional behavioral tech-
niques such as conditioning (the use of positive and/or
negative reinforcements to encourage desired behavior)
and systematic desensitization (gradual exposure to anxi-
ety-producing situations in order to extinguish the fear
response) may then be used to gradually reintroduce the
patient to social situations.
Additional treatment techniques that may be em-
ployed with cognitive-behavioral therapy include:
• Cognitive rehearsal. The patient imagines a difficult sit-
uation, and the therapist guides him through the step-
by-step process of facing and successfully dealing with
it. The patient then works on practicing, or rehearsing,
these steps mentally. Ideally, when the situation arises
in real life, the patient will draw on the rehearsed be-
havior to address it.
• Journal therapy. Patients are asked to keep a detailed
diary recounting their thoughts, feelings, and actions
when specific situations arise. The journal helps to
make the patient aware of his or her maladaptive
thoughts and to show their consequences on behavior.
In later stages of therapy, it may serve to demonstrate
and reinforce positive behavior.
• Validity testing. Patients are asked to test the validity of
the automatic thoughts and schemas they encounter.
The therapist may ask the patient to defend or produce
evidence that a schema is true. If the patient is unable
to meet the challenge, the faulty nature of that schema
is exposed.
Biofeedback is a patient-guided treatment that is
also associated with behavioral therapy. Biofeedback
teaches an individual to control muscle tension, pain,
body temperature, brain waves, and other bodily func-
tions and processes through relaxation, visualization,
and other techniques. In some cases, positive reinforce-
ments are used to reward patients who generate the cor-
rect biofeedback response during treatment. The name
biofeedback refers to the biological signals that are fed
back to the patient in order for the patient to develop
techniques of controlling them.
199
Behavioral therapy
Behavioral therapy
KEY TERMS
Cognitive-behavioral therapy — An offshoot of be-
havioral therapy that focuses on changing mal-
adaptive behaviors by changing the faulty thinking
patterns behind them.
Cognitive restructuring — A technique used in
cognitive-behavioral therapy. The process of re-
placing maladaptive thought patterns with con-
structive thoughts and beliefs.
Maladaptive — Unsuitable; maladaptive behavior is
behavior that is inappropriate to a given situation.
Psychodynamic therapy — A therapeutic approach
that assumes improper or unwanted behavior is
caused by unconscious, internal conflicts and fo-
cuses on gaining insight into these motivations.
Relapse — A return of behaviors or symptoms after
initial treatment.
Schemas — Fundamental core beliefs or assump-
tions that are part of the perceptual filter people
view the world through. Cognitive-behavioral
therapy seeks to change maladaptive schemas.
Preparations
Patients may seek therapy independently, or be referred
for treatment by a primary physician, psychologist, psychia-
trist, or other healthcare professional. Because the patient
and therapist work closely together to achieve specific thera-
peutic objectives, it is important that their working relation-
ship be comfortable and that their treatment goals are com-
patible. Prior to beginning treatment, the patient and thera-
pist should meet for a consultation session, or mutual inter-
view. The consultation gives the therapist the opportunity to
make an initial assessment (a detailed behavioral analysis of
the particular incidents which lead up to and ensue after a
specific unwanted behavior) of the patient and recommend a
course of treatment and goals for therapy. It also gives the
patient an opportunity to find out important details about the
therapist’s approach to treatment, professional credentials,
and any other relevant issues important to them.
In some managed-care clinical settings, an intake in-
terview or evaluation is required before a patient begins
therapy. The intake interview is used to evaluate the pa-
tient and assign him or her to a therapist. It may be con-
ducted by a psychiatric nurse, counselor, or social worker.
Precautions
Behavioral therapy may not be suitable for some
patients. Those who don’t have a specific behavioral
200
issue they wish to address and whose goals for thera-
py are to gain insight into the past may be better
served by psychodynamic therapy. Patients must also
be willing to take a very active role in the treatment
process.
Behavioral therapy may also be inappropriate for
cognitively-impaired individuals (e.g., patients with or-
ganic brain disease or a traumatic brain injury) depend-
ing on their level of functioning.
Because of the brief nature of behavioral therapy, re-
lapse has been reported in some patient populations.
However, follow-up sessions can frequently put patients
back on track to recovery.
Research & general acceptance
The use of behavioral modification techniques to
treat an array of mental health problems have been ex-
tensively described and studied in medical literature.
There may be some debate among mental health pro-
fessionals as to whether behavioral therapy should be
considered a first line treatment for some mental ill-
nesses, and to what degree other treatments such as
medication should be employed as an adjunct, or com-
plementary, therapy. However, the general consensus
seems to be that behavioral therapy techniques can be a
powerful treatment tool for helping patients change un-
desirable behaviors.
Training & certification
Behavioral therapists are typically psychologists
(Ph.D., Psy.D., Ed.D., or M.A. degree), clinical social
workers (M.S.W., D.S.W., or L.S.W. degree), counselors
(M.A. or M.S. degree), or psychiatrists (M.D. with spe-
cialization in psychiatry). Other healthcare providers
may suggest brief behavioral interventions, but more ex-
tensive treatment should be left to individuals who are
trained in behavioral therapy techniques.
Resources
BOOKS
Mills, John. Control: A History of Behavioral Psychology. New
York: New York University Press, 1998.
PERIODICALS
Gelder, M.“The Future of Behavior Therapy.” Journal of Psy-
chotherapy Practice. 6, no. 4 (Fall 1997):285-93.
ORGANIZATIONS
The National Association of Cognitive-Behavioral Therapists.
P.O. Box 2195, Weirton, WV 26062. (800)853-1135.
Paula Ford-Martin
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Belladonna
Description
Belladonna, more commonly known as deadly night-
shade, Atropa belladonna , devil’s cherries, devil’s herb,
divale, dwale, dwayberry, great morel, naughty man’s
cherries, and poison black cherry, is a perennial herb that
has been valued for its medicinal properties for over five
centuries. Belladonna is a member of the Solanaceae
(nightshade) family, and can be identified by its bell-
shaped, purple flowers and cherry-sized green berries that
mature to a dark purple or black color. The tall, branching
plant can grow to a height of at least 5 ft (1.5 m), and is
native to Europe, North Africa, and Asia and cultivated in
North America and the United Kingdom. Belladonna has
also been introduced to a number of places, including the
United States and Ireland and now grows wild.
Belladonna leaves are large (up to 10 in [25.4 cm] in
length) and grow in pairs on either side of the plant stem.
Near the flowers or blossoms, one of each leaf pair is no-
ticeably smaller in size. Both the leaves and root have a
sharp, unpleasant odor and bitter taste. As the name
deadly nightshade suggests, the herb is highly toxic if
taken even when taken in extremely low concentrations.
One of the first widespread uses of the herb was
purely a cosmetic one. Sixteenth century Italian women
reportedly applied belladonna solutions to their eyes to
dilate the pupils and achieve a dreamy and supposedly
more desirable appearance (hence the name belladonna,
which is Italian for ‘beautiful lady’). Atropine, an alka-
loid of belladonna that blocks certain nerve impulses, is
still used by some opthamologists today to dilate the
pupils for eye exams.
General use
Belladonna has a long history of medicinal applica-
tions in healthcare. Belladonna alkaloids are anticholin-
ergic, which means that it works by blocking the certain
nerve impulses involved in the parasympathetic nervous
system, which regulates certain involuntary bodily func-
tions or reflexes, including pupil dilation, heart rate, se-
cretion of glands and organs, and the constriction of the
bronchioles in the lungs and the alimentary canal (diges-
tive tract). Belladonna relaxes the smooth muscles of the
internal organs and inhibits or dries up secretions (e.g.,
perspiration, mucous, breast milk, and saliva).
Belladonna alkaloids, the active ingredients of the
plant, include atropine and scopolamine. These alkaloids
are extracted from the leaves and root of the plant and
administered either alone or in combination with other
herbal remedies or prescription medications. However
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Belladonna plant. (Photo Researchers, Inc. Reproduced by
permission.)
even tiny doses are toxic and should only be taken by
prescription.
Belladonna alkaloids are used to treat a variety of
symptoms and conditions, including:
• Gastrointestinal disorders. Because the alkaloids relax
the smooth muscles of the gastrointestinal tract and re-
duces stomach acid secretions, it is useful in treating
colitis, diverticulitis, irritable bowel syndrome, colic,
diarrhea, and peptic ulcer.
• Asthma. By relaxing the bronchioles, belladonna alle-
viates the wheezing symptoms of an asthma attack.
• Excessive sweating. Belladonna slows gland and organ
secretion, which makes it useful in controlling condi-
tions that cause excessive sweating.
• Nighttime incontinence. Belladonna acts as a diuretic,
and can be helpful in treating excessive nighttime uri-
nation and incontinence.
• Headaches and migraines. The pain-relieving proper-
ties of atropine, a belladonna alkaloid, are useful in
treating headaches.
• Muscle pains and spasms. Belladonna is frequently
prescribed to ease severe menstrual cramps.
201
Belladonna
Belladonna
• Motion sickness. Scopolamine, an alkaloid of bel-
ladonna, is helpful in treating motion sickness and ver-
tigo.
• Parkinson’s disease. Belladonna can alleviate the exces-
sive sweating and salivation associated with the disease,
as well as controlling tremors and muscle rigidity.
• Biliary colic. Muscle spasm, or colic, of the gallbladder
and liver can be relieved through the muscle relaxing
properties of belladonna.
Homeopathic use
Belladonna is frequently prescribed homeopathic
remedy used to treat illnesses that manifest symptoms
similar to those that belladonna poisoning triggers (i.e.,
high fever, nausea, delirium, muscle spasms, flushed
skin, dilated pupils). These include the common cold,
otitis media (earache), fever, arthritis, menstrual cramps,
diverticulitis, muscle pain, sunstroke, toothache and
teething, conjunctivitis, headaches, sore throat, and
boils and abscesses. As with all homeopathic remedies,
the prescription of belladonna depends on the individ-
ual’s overall symptom picture, mood, and temperament.
When used as a homeopathic remedy, belladonna is ad-
ministered in a highly diluted form to trigger the body’s
natural healing response without risk of belladonna poi-
soning or death.
Results of a clinical trial performed at the National
Cancer Institute of Milan, Italy, have also indicated that
homeopathic remedies of belladonna can be useful in re-
lieving the discomfort, warmth, and swelling of the skin
associated with radiotherapy for breast cancer (i.e., ra-
diodermatitis).
Preparations
Belladonna leaf is harvested between May and July
and dried at temperatures no warmer than 140°F (60° C).
The roots of Atropa belladonna plants that have reached
two to four year old maturity are also harvested for
herbal preparations in early fall between mid-October
and mid-November. The roots are then cleaned and dried
at temperatures no warmer than 122°F (50°C). After dry-
ing, the leaves and roots are crushed for use in a number
of forms, including decoctions, tinctures, infusions, plas-
ters, pills, suppositories, liquid solutions or suspensions,
and powders. They can be used both alone and in combi-
nation with other herbs and medications.
It is extremely dangerous to self-prescribe bel-
ladonna, and it should always be taken under the di-
rection of a doctor or other qualified healthcare pro-
fessional. The frequency and quantity of dosage will
depend on both the patient and the illness the herb is
202
prescribed for, but the doses are always extremely
small. For example the Physicians Desk Reference
(PDR) for Herbal Medicines recommends an average
single dose of 0.05-0.10 g. Each patient’s illness is
different and some patients experience toxicity at un-
usually low doses.
For homeopathic remedies, the plant is broken apart
and juice is extracted through a pressing process. The ex-
tract is then mixed with a water/alcohol solution by a
ratio of either 1:10 or 1:100, and this process is repeated
up to 30 times to form an extremely diluted dose of the
extract. Homeopathic belladonna remedy is generally
added to pellets of sugar for easier administration. The
dilution and dosage frequency depend on the symptoms
being treated, but homeopathic remedies are typically
administered only until the patient starts to show signs of
improvement so that the body’s natural healing response
can take over.
Belladonna is available by prescription both alone
(in high concentration strength) and in combination
with other drugs. Currently available prescription
combinations include belladonna with opium (for
uterine pain), kaolin and pectin (for diarrhea), pheno-
barbital (for menopausal symptoms and migraine pro-
phylactic), other barbiturates (for insomnia and for
cramping and muscle spasms in the digestive tract), or
belladonna and opium suppositories (for severe in-
testinal cramping).
Belladonna preparations should be stored in air-tight
containers away from direct light. Under these condi-
tions, most preparations will remain potent for up to
three years.
Precautions
Ingestion of high concentrations of atropine, a po-
tent alkaloid found in belladonna, can cause severe ill-
ness and death. Atropine is fatal in doses as small as 100
mg, which equals 5-50 g of belladonna herb, depending
on the potency of the particular plant. For children, a
fatal dose is even significantly less. For this reason, bel-
ladonna should never be used unless prescribed by a
trained practitioner.
Individuals suffering from kidney disease, intestinal
blockage, glaucoma, enlarged prostate, urinary block-
age, severe ulcerative colitis, or myasthenia gravis are
advised not to take belladonna, as are those patients with
a known allergy to belladonna. Patients with any chronic
health conditions should never take belladonna without a
doctor’s prescription.
Pregnant or breastfeeding women should avoid all but
homeopathic belladonna, unless prescribed by a doctor.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Because of the sedative qualities of belladonna, in-
dividuals taking the herb should use caution when dri-
ving or operating machinery. Alcohol and other central
nervous system (CNS) depressants should also be avoid-
ed, as they may increase drowsiness and dizziness in the
patient taking belladonna.
If individuals taking homeopathic dilutions of bel-
ladonna experience worsening of their symptoms
(known as a homeopathic aggravation), they should con-
tact their healthcare professional. A homeopathic aggra-
vation can be an early indication that a remedy is work-
ing properly, but it can also be a sign that a different
remedy is called for.
Side effects
Toxic signs of belladonna include dry mouth,
drowsiness, dizziness, constipation, and nausea. Some
side effects, including pupil dilation, blurred vision,
fever (due to the inability to perspire), inability to uri-
nate, arrhythmia, and excessive dry mouth and eyes, can
also be early indications of belladonna overdose. Indi-
viduals experiencing these side effects should inform
their health care practitioner immediately.
Belladonna overdose is also indicated by a burning
throat, delirium, restlessness and mania, hallucinations,
difficulty breathing, and flushed skin that is hot and dry.
Without proper treatment, constriction of the airway can
cause suffocation. If any of these symptoms occur, indi-
viduals should seek emergency medical attention imme-
diately. Treatment of belladonna overdose is typically
gastric lavage, which involves inserting a tube down the
patient’s throat and washing out the stomach with a solu-
tion of activated charcoal or tannic acid to neutralize
the atropine. Oxygen may also be required until breath-
ing is stabilized, and barbiturates may be administered to
counteract mania and/or excitation.
Interactions
Certain medications may increase the effects of bel-
ladonna. These include central nervous system (CNS)
depressants, monoamine oxidase (MAO) inhibitors, tri-
cyclic antidepressants, quinidine, amantadine, antihista-
mines, and other anticholinergics. Other medications,
including anticoagulants (blood thinners) and corti-
cotropin (ACTH), become less effective when used with
belladonna, while some drugs, such as diarrhea medi-
cines containing kaolin and attapulgite, may decrease
the therapeutic response to belladonna when they are
taken with the herb. If you are taking these or any other
medications or herbal remedies, let your healthcare pro-
fessional know.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Alkaloids — A chemical family that contains nitro-
gen.
Allopathic — Healthcare practice that uses reme-
dies and treatments that cause different effects
than the symptoms they are intended to treat; con-
ventional medicine is usually considered allopath-
ic in nature.
Anticholinergic — A medication or other sub-
stance which blocks certain parasympathetic
nerve impulses.
Decoction — An herbal extract produced by mix-
ing an herb in cold water, bringing the mixture to
a boil, and letting it simmer to extract water. The
decoction is then strained and drunk hot or cold.
Decoctions are usually chosen over infusion when
the botanical in question is a root or bark.
Homeopathic — Remedies and treatments that
cause similar effects to the symptoms they are in-
tended to treat in an effort to stimulate the bodies
natural immune response system.
Infusion — An herbal preparation made by pouring
boiling water over an herb and letting the brew
steep for 20 minutes, then straining. Tea is made
through infusion.
Mania — Hyperelevated, or excessively excited mood.
Naturalized — Plants which are introduced in the
wild.
Prophylactic — A preventative treatment.
Radiodermatitis — Red, irritated, and inflamed
skin caused by x-rays, radiation treatment, or
other radiation exposure.
Tinctures — An alcohol liquid extract of an herb.
USP — The U.S. Pharmacopoeia. Nationally and
internationally recognized drug standards pub-
lished by the United States Pharmacopeia Con-
vention, Inc. and used as a standard by FDA and
other federal regulatory agencies.
Alcohol, a CNS depressant, can also enhance the
sedative effect of belladonna, and should be avoided dur-
ing belladonna treatment.
Individuals considering treatment with homeopathic
dilutions of belladonna should consult their healthcare
professional about possible interactions with certain
foods, beverages, prescription medications, aromatic
compounds, and other environmental elements that could
counteract the efficacy of belladonna treatment.
203
Belladonna
Beta carotene
Resources
BOOKS
Jonas, Wayne B., M.D. and Jennifer Jacobs, M.D., M.P.H.
Healing With Homeopathy. New York: Warner Books,
1996.
Medical Economics Company. PDR for Herbal Medicines.
Montvale, NJ: Medical Economics Company, 1998.
PERIODICALS
Balzarini, A. et al. “Efficacy of homeopathic treatment of skin
reactions during radiotherapy for breast cancer: a ran-
domised, double-blind clinical trial ”, British Homeopath-
ic Journal. (January 2000) 89(1): 8-12.
Sahelian, Ray and Victoria Dolby Toews. “Give Colds the
Shoulder.” Better Nutrition. (October 1999) 61(10): 40-
44.
ORGANIZATIONS
The American Botanical Council. P.O. Box 144345, Austin,
TX 78714-4345. (512)926-4900. http://www.herbalgram.
org.
Office of Dietary Supplements. National Institutes of Health.
Building 31, Room 1B25, 31 Center Drive, MSC 2086,
Bethesda, Maryland 20892-2086. (301) 435-2920. Ods@
nih.gov. http://odp.od.nih.gov/ods/.
Paula Ford-Martin
Benign prostatic hypertrophy see Prostate
enlargement
Bernard training see Auditory integration
training
Beta carotene
Description
Beta carotene is one of the most important naturally
occurring antioxidants. It is a fat-soluble pigment found
in plants (notably carrots and many colorful vegetables
and fruits) and in the sea alga Dunaleilla salina and D.
bardawil. Naturalbeta carotene supplements are derived
primarily from D. salina. Beta carotene is one of the
major dietary carotenoids and one of the most biological-
ly active of approximately 800 carotenes and more than
1 ,000 carotenoids present in food. It is responsible for the
orange or yellow colors of many fruits and vegetables. In
the human body, beta carotene is found in lipids and in fat
tissues. Sometimes beta carotene is called provitamin A
because it is more easily converted to vitamin A (retinol)
in the liver than other carotenoids. Beta carotene is consid-
ered to be a conditionally essential nutrient because it be-
comes essential when vitamin A intake is low.
204
Beta carotene consists of a chain of 40 carbon
atoms, with conjugated double bonds and a ring struc-
ture at each end of the chain. Depending on the positions
of the molecular groups attached to the carbon chain,
naturally occurring beta carotene may be:
• All -trans beta-carotene
• 9 -cis beta-carotene
• 13-cis beta-carotene, in smaller amounts
Synthetic beta carotene is primarily all -trans.
In plants and alga, beta carotene and other caroten-
oids attract light for photosynthesis and provide protec-
tion from toxic forms of oxygen. Beta carotene is a pow-
erful antioxidant because it destroys toxic free radicals,
including singlet oxygen — an oxygen atom that is miss-
ing an electron and is very damaging to human tissue if
not taken up quickly and “deactivated.”
General use
Vitamin A precursor
Vitamin A is obtained in the diet from animal prod-
ucts or is made in the liver from beta carotene and other
carotenoids. Vitamin A is essential for:
• vision and eye health
• normal cell division
• growth
• reproduction and fertility
• immune system function
• skin and mucous membrane health
In sub-Saharan Africa about three million children
under the age of five suffer from an eye disorder, caused
by vitamin-A deficiency, that can lead to blindness and
death. Although red palm oil, a traditional African food,
contains high provitamin A, its substitution by imported
cooking oils has reduced this dietary source in many
homes. Many vegetables and fruits also contain provita-
min A, but are not always consumed in adequate
amounts. Vitamin A deficiency is the leading cause of
blindness worldwide.
In the 1920s vitamin-A deficiency was linked to
stomach cancer and to precancerous conditions in the
epithelial (lining) cells of the throat and lungs. In 1977
vitamin A supplementation was shown to inhibit certain
cancers and to reduce the growth of certain tumors in at-
risk animals.
Dietary beta carotene
Carotenoids, including beta carotene, that are ob-
tained from food may have:
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Vegetable
Serving International Units (IU)
Daily Allowance (DA)
Carrot
1 whole raw, 7.5 in (1 9 cm)
20,250
41 0%
Carrot
sliced and boiled, 0.5 cup (1 1 8 ml)
19,150
380%
Carrot juice
canned, 0.5 cup (1 1 8 ml)
12,915
260%
Spinach
frozed and boiled, 0.5 cup (1 1 8 ml)
7,395
1 50%
Sweet potatoes
canned and drained, 0.5 cup (1 1 8 ml)
7,015
140%
Mango
sliced raw, 0.5 cup (1 1 8 ml)
6,425
130%
Vegetable soup
canned, ready-to-serve, 1 cup (237 ml)
5,880
1 1 5%
Canteloupe
raw, 1 cup (237 ml)
5,160
1 00%
Kale
frozen and boiled, 0.5 cup (1 1 8 ml)
4,130
80%
Spinach
raw, 1 cup (237 ml)
2,015
40%
Apricot nectar
canned, 0.5 cup (1 1 8 ml)
1,650
35%
Oatmeal
1 packet instant plain
1,510
30%
Tomato juice
canned, 6 oz (1 77 ml)
1,010
20%
Apricots
2 halves with skin packed in juice
610
10%
Red pepper
1 raw ring, 3 in (7.8 cm); 0.25 in (0.64 cm) thick
570
10%
Peas
frozen and boiled, 0.5 cup (1 1 8 ml)
535
10%
Peaches
1 medium raw fruit
525
10%
Peaches
canned halves or slices in water, 1 cup (237 ml)
470
10%
Papaya
raw cubes, 1 cup (237 ml)
400
8%
• antioxidant activity
• immune-system-enhancing activity
• activity against some cancers and precancerous conditions
• a role in preventing coronary heart disease, including
heart attack and stroke
Epidemiological studies that looked at cancer rates
and diet found that at least five daily servings of green,
orange, red, and yellow vegetables and fruits appeared to
significantly reduce the risk of stomach, lung, prostate,
breast, head, and neck cancer, and possibly slow the pro-
gression of others .In 1971 a large human study linked
cancer death rates to low levels of beta carotene in the
blood. Subsequent studies linked high blood levels of di-
etary beta carotene to lower cancer risks. However more
recent evidence links these results to a combination of
antioxidants found in fruits and vegetables, rather then to
beta carotene alone. High beta carotene levels in the
blood may be associated with a reduced risk of asthma.
Supplemental beta carotene
Supplemental beta carotene has been claimed to:
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• inhibit precancerous lesions in those at risk of oral cancer
• protect against gastric and esophageal cancers
• reduce the risk of prostate cancer
• lower the overall cancer risk
• protect against sunburn
However, there is very little evidence that supple-
mental beta carotene is an effective cancer-preventing
substance, except perhaps in those with poor nutrition
or low baseline levels of beta carotene in the blood. Ad-
ditional studies have shown that beta-carotene supple-
ments do not reduce the risk of cancer, heart disease, or
cataracts.
Yet supplemental beta carotene does appear to in-
crease the amounts of some types of immune-system
cells. Studies have shown that women with low dietary
intake or low blood levels of beta carotene are at in-
creased risk for cervical dysplasia (abnormal cell
growth) and cervical cancer. Another study found that
beta-carotene supplementation provided some protection
against the recurrence of colorectal adenoma (benign tu-
205
Beta carotene
Beta carotene
mors) in patients who neither smoked nor drank alcohol.
However in patients who used tobacco and/or alcohol the
risk of recurrence increased with beta-carotene supple-
mentation. Studies of smokers and/or those who had
been exposed to asbestos initially found an increase in
lung cancers among those receiving supplemental beta
carotene (at least 20 mg per day), particularly among
those who also consumed large quantities of alcohol.
However follow-up studies found no such increases in
lung cancer in those taking beta carotene.
The Age-Related Eye Disease Study found that a
combined supplement of beta carotene, vitamin C, vita-
min E, zinc, and copper reduced the risk of disease pro-
gression and vision loss in people with advanced macular
degeneration. The supplement did not slow disease pro-
gression in those with early-stage macular degeneration.
One study found that supplementation with a mixture
of antioxidants — beta carotene, alpha-tocopherol, and
plant sterols — lowered cholesterol levels in the blood.
Beta carotene at 25,000 international units (IU)
daily may be useful for treating psoriasis, a skin condi-
tion. Beta carotene supplements also are used to treat
acne. Two 25,000-IU supplements daily, in combination
with other supplements, sometimes are used to treat
stomach ulcers.
Preparations
Measuring beta carotene
A recommended dietary allowance (RDA) for beta
carotene has not been established and most foods are not
labeled as to vitamin A content. There are two incompat-
ible systems for quantifying beta carotene. lUs are used
most often for nutritional labeling:
• 1 IU equals 0.6 pg of all -trans beta carotene
• 3.33 IU of all-trans beta carotene, 2 jug, is equal to 1 pg
of all -trans retinol (vitamin A)
• 5,000 IU equals 3 mg of beta carotene, the RDA for vi-
tamin A
• 1 IU equals 1 .2 pg of other provitamin A carotenoids
The second system uses retinol equivalents (RE):
• 1 RE equals 1 pg of all -trans retinol
• 1 RE equals 6 pg of all -trans beta carotene
• 1 RE equals 12 pg of other provitamin A carotenoids
Dietary beta carotene
Daily values (DVs) are determined from the RDA.
They are based on a 2,000-calorie diet and usually are
expressed as a percentage of an RDA. The IUs and DVs
206
for beta carotene, per serving, in common foods are list-
ed in table 1 .
Carrots and sweet potatoes that are more orange
contain more beta carotene. New carrot cultivars that
contain more beta carotene have been developed and
high-beta-carotene sweet potatoes are being introduced
into sub-Saharan Africa to treat vitamin-A deficiency.
Other foods that contain beta carotene include:
• avocados
• broccoli
• chard
• coffee
• collard greens
• palm oil and other food colorants
• squash
• string beans
• watermelon
• yams
According to the Institute of Medicine, a daily in-
take of 3-6 mg of beta carotene will keep the blood level
within the range associated with a lower risk for chronic
diseases. The recommended daily diet of five or more
servings of fruits and vegetables provides 3-6 mg of beta
carotene (if carrots, sweet potatoes, papaya, apricots or
other very high carotenoid food is used, the RDA can be
met in a single serving). In contrast, the average Ameri-
can diet contains 1.3-2. 9 mg daily. Vegetarians may have
twice as much beta carotene in their blood as compared
to non- vegetarians, because they generally consume a lot
more greens and fruits.
Beta carotene in food is found within an oil or a ma-
trix of sugars and proteins; and, therefore, the absorption of
beta carotene by the body varies greatly. The elderly, and
those with bad digestion and liver trouble may be at risk
for poor absorption from an adequate beta carotene diet.
Animal sources of vitamin A are more easily ab-
sorbed than plant sources of beta carotene, particularly if
the vegetables and fruits are eaten raw or whole. Al-
though beta carotene can be converted to vitamin A in
the body, it has its own unique physiological functions
and beta carotene and vitamin A are not totally identical
in the health benefits they deliver. So it is good to eat
sources of both. While supplementation is helpful to
those who have trouble absorbing adequate beta
carotene, getting all or some beta carotene through food
sources rather than supplements alone is by far the best.
This is substantiated by research showing there are many
beneficial carotenoids in foods, and that they may also
work together synergistically to optimize health.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Supplemental beta carotene
Beta carotene supplements are inexpensive and
readily available over-the-counter. They are available as
pills, powders, and oils and they vary greatly in potency.
Some supplements contain a mixture of carotenoids.
There is a major problem with shelf life stability for beta
carotene, as it “oxidizes” quickly when in pure form.
When buying a supplement of it, shelf life stability or the
presence of such stabalizers as vitamin E can guarantee
biological activity of the capsule.
Supplemental intake of beta carotene probably
should not exceed 3-15 mg per day. Common prepara-
tion of supplemental beta carotene include:
• 30- or 60-mg capsules
• 5,000-, 10,000-, or 25,000-IU capsules
• 10,000- or 25,000-IU tablets
A typical dosage of beta carotene for treating cancer
is 75,000-150,000 IU daily. Absorption of beta carotene
in nutritional supplements can be 70% or more. There is
no established maximum daily intake for beta carotene.
Some common beta carotene nutritional supple-
ments include:
• A-Caro-25
• B-Caro-T
• Biotene
• Caroguard
• Caro-Plete
• Dry Beta Carotene
• Lumitene
• Marine Carotene
• Mega Carotene
• Oceanic Beta Carotene
• Superbeta Carotene
• Ultra Beta Carotene
Manufacturers often supplement food with beta
carotene. One study showed that bakery products en-
riched with beta carotene increased beta carotene levels
in the blood.
Precautions
Antioxidants such as beta carotene often work to-
gether with other antioxidants and an excess or deficien-
cy of one can inhibit the other. The Food and Nutrition
Board of the Institute of Medicine does not recommend
beta carotene supplementation except in cases of vitamin
A deficiency.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Pregnant and nursing mothers should limit their in-
take of supplemental beta carotene to 6 mg per day or less.
Side effects
Even long-term high-dosage use of supplemental
beta carotene appears to be non-toxic. Daily doses of 30
mg or more over a long period may cause carotenosis
(carotenodermia), a yellowing of the skin, which is
harmless and reversible. In contrast, very high daily
doses of vitamin A are very dangerous and damage the
liver and other organs, as well as provoke hair loss).
Interactions
Drugs and other substances that may interfere with
beta-carotene absorption include:
• Cholestyramine
• Colestipol
• mineral oil
• Olestra
• Orlistat
• pectin
The absorption of luteine, another carotenoid an-
tioxidant, may be reduced if taken in conjunction with
beta carotene.
Resources
BOOKS
American Institute for Cancer Research. Nutrition and Cancer
Prevention: New Insights into the Role of Phytochemicals.
New York: Kluwer Academic/Plenum Publishers, 2001.
Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium,
and Carotenoids. Washington: National Academy Press,
2000 .
PDR for Nutritional Supplements. Montvale, NJ: Thomson
PDR, 2001.
PERIODICALS
Baron, J. A., et al. “Neoplastic and Antineoplastic Effects of
Beta-Carotene on Colorectal Adenoma Recurrence: Re-
sults of a Randomized Trial.” Journal of the National
Cancer Institute 95 (2003): 717-22.
Bendich, Adrianne. “From 1989 to 2001: What Have We Learned
about the "Biological Actions of Beta-carotene?’” Journal of
Nutrition 134, no. 1 (January 2004): 125S-130S.
“Disheartening Study.” Better Nutrition 65, no. 9 (September
2003): 32.
Heinrich, U., et al. “Supplementation with Beta-carotene or a
Similar Amount of Mixed Carotenoids Protects Humans
from UV-induced Erythema.” Alternative Medicine Re-
view 8, no. 2 (May 2003): 202-203.
"Incidence and Mortality Following Alpha-tocopherol and
Beta-carotene Supplementation: A Postintervention Fol-
207
Beta carotene
Beta hydroxy
KEY TERMS
Alpha-tocopherol — An antioxidant derivative of
vitamin E that stabilizes cell membranes.
Antioxidant — A substance that prevents oxidation,
such as cellular damage caused by free radicals.
Carotenoid — A large class of red and yellow pig-
ments found in some plants and in animal fat.
Carotenosis (carotenodermia, carotenemia) — A
yellowish pigmentation of the skin caused by high
levels of carotene in the blood.
Cholesterol — An important sterol that is deposited
on blood vessel walls in arteriolosclerosis.
Daily value (DV) — The percentage of the RDA of a
nutrient that is present in a food or supplement.
Epithelium — Layers of cells covering internal and
external body surfaces.
Free radical — An atom or compound with an un-
paired electron; oxygen free radicals can damage
cells and cell constituents.
Immune system — The body system that protects
against foreign pathogens and abnormal cells.
International unit (IU) — A widely accepted defin-
ition that is used to quantify a given substance.
Macular degeneratio. — The progressive deteriora-
tion of the macula — the light-sensitive cells of the
central retina of the eye.
Provitamin A — A carotenoid, such as beta
carotene, that can be converted into vitamin A in
the liver.
Recommended dietary allowance (RDA) — The av-
erage daily dietary intake of a nutrient that is suffi-
cient to meet the nutritional requirements of
97-98% of healthy individuals of a given age and
gender.
Retinol equivalent (RE) — 1 pg of all -trans retinol
(vitamin A), 6 pg of all -trans beta carotene.
Vitamin A (retinol). — An essential nutrient for vi-
sion that is obtained from animal products or
made in the liver from carotenoids such as beta
carotene.
low-up.” Journal of the American Medical Association
290. no. 4 (July 23, 2003): 476-85.
Quilez, Joan, et al. ‘‘Bakery Products Enriched with Phytos-
terol esters, [Alpha] -Tocopherol and [Beta]-Carotene De-
crease Plasma LDL-Cholesterol and Maintain Plasma
[Beta]-Carotene Concentrations in Normocholesterolemic
208
Men and Women.” Journal of Nutrition 133. no. 10 (Octo-
ber 2003): 3103.
Russell, R. M., et al. “The Enigma of Beta-Carotene in Car-
cinogenesis: What Can Be Learned From Animal Stud-
ies.” Journal of Nutrition 134, no. 1 (2004): 262S-268S.
“What’s Up Doc? Getting to the Root of Carrots.” Environmen-
tal Nutrition 26, no. 9 (September 2003): 8.
“The Word: Sweet Potato.” New Scientist 179, no. 2402 (July
5, 2003): 51.
OTHER
“Beta Carotene.” Making Treatment Decisions. American Cancer
Society. 2000 [cited May 4, 2004]. <http://www.cancer.
org/docroot/ETO/content/ETO_5_3X_Beta_Carotene.asp
?sitearea=ETO>.
Beta Carotene. Mayo Clinic. May 10, 2002 [cited May 4,
2004], <http://www.mayoclinic.com/invoke.cfm7objec-
tid=DFE6CA61-7BE5-45E0-86BFD9009E27BAE2>.
Task Force Finds Little Evidence to Support Use of Vitamin
Supplements to Prevent Cancer or Heart Disease. Agency
for Healthcare Research and Quality. June 30, 2003 [cited
May 4, 2004]. <http://www.ahrq.gov/news/press/pr2003/
vitapr.htm>.
Vitamin A and Carotenoids. Office of Dietary Supplements,
National Institutes of Health. October 6, 2003 [cited May
4, 2004], <http://www.cc.nih.gov/ccc/supplements/vita.
html>.
Margaret Alic
Beta hydroxy
Description
Beta hydroxy acids are a group of acids whose skin
treatment properties are being rediscovered. Developed
long ago for acne treatment, salicylic acid, benzoic acid,
butyric acid and other less well known acids have been
recently reclassified as beta hydroxy acids (BHAs) or
beta hydroxys.
BHAs are exfoliants, which means that they cause
the top layers of the skin to exfoliate or peel. Exfoliation
leaves behind fresh skin that is also smoother and softer
than before. Beta hydroxys work by speeding up the
turnover of skin cells. They dissolve the glue that holds
dead skin cells in the top layers, allowing the fresh cells
beneath to emerge. Chemical exfoliation with beta hy-
droxys peels away a variety of such age-related skin
problems as wrinkles, acne, age spots, blemishes, and
skin unevenness. Used on a regular basis at a much
lower concentration as cleansers or acne treatments,
BHAs refresh the skin and clear away the dirt and oils
that often cause acne eruptions. In addition to cosmetic
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
applications, these chemicals also are used as treatments
for a variety of skin disorders, including psoriasis, seb-
orrhea, dandruff, and warts.
BHAs are found in many skin care products. They
are also found naturally in fresh fruit (berries, pineapple,
papaya, etc.), milk and yogurt, wintergreen leaves,
sweet birch, and some other plants.
Structurally, BHAs appear to be very similar to an-
other group of chemicals used in skin care products, the
alpha hydroxy acids or AHAs. These two groups of
chemicals have similar activities as well; both are skin
exfoliants. BHAs, however, are believed to be less irritat-
ing to the skin than AHAs. They are also more effective
in preventing acne eruptions and smoothing the skin.
General use
Skin cleansing
Many skin cleansers today contain BHAs. BHAs are
effective because they help remove excess oil from the
face. They can, however, remove oil only on the surface
and cannot affect oil production under the skin. To help
maintain healthy skin, these cleansers should be used once
or twice a week to improve skin tone and texture. BHA-
containing preparations should be left on the face for a
short time only and rinsed off with generous amounts of
water. Because the skin is more sensitive to sunlight after
the use of products containing BHAs, users should apply
sunscreens and avoid prolonged sun exposure.
Wrinkles and age spots
Wrinkles are signs of the normal aging process.
Over the years, the skin becomes thinner, drier and less
elastic as its collagen and elastin fibers gradually lose
their elasticity. To improve the appearance of the skin
and to correct minor blemishes and uneveness, some
people have chemical peels with hydroxy acids. Chemi-
cal peels have become one of the most popular methods
for removing wrinkles. This process uses concentrated
preparations of BHAs, AHAs, or combinations of both to
remove the top layer of skin. The chemical peel allows a
newer layer of skin to replace the older layer. Some fine
lines and wrinkles may also be removed.
Because of potential scarring and other severe ad-
verse reactions, chemical peels are done by a profession-
al, usually a board-certified dermatologist or a licensed
estheticist (skin care specialist).
For best results, chemical peels are often used in combi-
nation with such other anti- wrinkle treatments as collagen or
fat implants or laser surgery. For relatively young people, a
chemical peel with BHA often provides satisfactory results.
Those over 40 sometimes choose to have collagen or fat im-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
plants together with the peel. Some older patients may have
both a chemical peel and a special kind of laser surgery
called laser resurfacing. While chemical peels can remove
some fine wrinkle lines, laser resurfacing is a more powerful
tool. It can remove deeper wrinkles and skin imperfections.
Acne therapy
Acne is a skin disorder caused by excessive produc-
tion of oil under the uppermost layers of skin. When the
oil cannot pass through the hair follicles, the pores under
the skin are plugged up, trapping the oil and dead skin
cells underneath the skin. These plugged pores become
fertile breeding grounds for a type of bacterium called
Propionibacterium acnes, sometimes called the acne
bacillus, to grow inside the pore, causing irritation, in-
flammation, and in due time, pimples.
Because it is an effective cleanser, a 1% solution of
salicylic acid, which is a BHA, can enter the pores and
help to remove excess oil, dirt, and dead skin cells. It re-
duces skin breakouts by preventing the buildup of dead
skin cells associated with acne formation. Beta hydroxy
acids, including salicylic acid, are good treatments for
acne because they are relatively mild. Because they are
applied topically, they do not cause systemic side effects
as oral antibiotics sometimes do. In addition, they are es-
pecially appropriate for the treatment of acne because
they have anti-inflammatory properties. BHAs, however,
do not have the antimicrobial properties of such topical
medications as benzyl peroxide.
Psoriasis
Psoriasis is a chronic skin condition requiring life-
long treatment with topical lotions and creams, pho-
totherapy (using radiation or ultraviolet light), or med-
ications taken by mouth. Salicylic acid can be used to
treat psoriasis. Salicylic acid facilitates the removal of
scaly skin. In so doing, it helps moisturizers and other
topical medications for psoriasis work more effectively.
Warts
Salicylic acid is also an effective and mild treatment
for warts and plantar warts. Patients should wash and dry
the area around the wart thoroughly before applying the
product. Then they should apply a thin film of salicylic acid
over each wart and allow it to dry. The product should be
applied once or twice a day. Salicylic acid acts slowly and
may take as long as 12 weeks before one can see results.
Other uses
The anti-inflammatory properties of BHAs are use-
ful in treating such other skin conditions as dandruff or
seborrheic dermatitis.
209
Beta hydroxy
Beta hydroxy
Preparations
Salicylic acid is often found in many over-the-
counter skin care products such as soaps, cleansers, acne
medications, and anti-wrinkle creams. These products,
however, contain only 2% of salicylic acid. This concen-
tration is strong enough for exfoliation but not for chem-
ical peel treatment.
Chemical peel preparations contain very high con-
centrations (up to 30%) of beta hydroxy acids in combi-
nation with alpha hydroxy acids. Because of the poten-
tial for scarring and other severe adverse reactions, these
prescription-strength products are not sold to the general
public. They are available only to licensed dermatolo-
gists or estheticians.
BHAs can also be found in certain fruits and vegeta-
bles. For example, thin layers of papaya can be applied
on the face and allowed to remain for a while. Papaya
pulp helps soften the skin and decrease its unevenness. It
is most beneficial to dry, sun-damaged skin, although it
may also cause allergic reactions in some sensitive peo-
ple. Pineapple is another natural product that contains
beta hydroxy acid. Pineapple can be put into a blender or
juicer to obtain fresh juice. The juice can be applied to
the skin; again, however, it may cause allergic reactions.
Precautions
People who use skin care products containing BHAs
should be aware of the following considerations and side
effects:
• Increased sensitivity to sunlight. Exfoliated skin is very
tender and sensitive to sunlight. Studies have shown
that skin treated with these exfoliants has twice the sun
damage compared to untreated skin. Therefore, it is im-
portant to use suncreen and avoid direct exposure to the
sun when using products containing BHAs.
• Sensitization to other products. The use of salicylic
acid sometimes sensitizes the skin to other cosmetics
and causes redness and irritation. In other to avoid skin
sensitization, it is best to use only mild cleansers and
wait at least 10-30 minutes before using another cos-
metic or skin care product. Another way to avoid skin
sensitization is to use the BHA product every other day
instead of daily.
• Stinging. Salicylic acid can produce a stinging sensa-
tion when first applied. That is because it is a mild skin
irritant. Products containing salicylic acid should not
be applied on raw or abraded skin, as they may cause
redness and intense itching.
•Allergic reactions. Some salicylic acid products can
provoke hypersensitivity reactions. Any products that
210
KEY TERMS
Collagen — A fibrous tissue found in bones, con-
nective tissue, and cartilage.
Elastin — A yellow fibrous protein that is the basic
component of elastic connective tissue.
Exfoliate — To remove or peel off flakes or layers of
skin.
Plantar warts — Warts located on the sole of the
foot.
cause skin to burn, sting, redden, or break out should be
discontinued immediately.
• Blotchy skin. Sometimes BHA chemical peels cause
scarring and discoloration of some parts of the skin.
This occurs most often with the more concentrated
BHA products. Scarring and blotchy skin also tend to
occur more frequently in people with darker skin.
• Dry skin. A person with dry skin should not use BHA
cleansers too frequently (more than once a week) be-
cause they tend to dry the skin even further.
• Eye irritation. Skin care products containing salicylic
acid tend to cause the eyes to redden and water. Avoid
applying these cleansers, cream or lotion too close to
the eyes.
Side effects
Patients should stop using the product and contact
their doctors or pharmacists for advice if the following
adverse effects occur:
• dry skin
• eye irritation
• allergic reactions
• skin irritation
Interactions
Because salicylic acid tends to sensitize the skin,
allow at least 10-30 minutes to elapse between the use of
products containing salicylic acid and applying cosmet-
ics or other skin care products.
Resources
BOOKS
Sarnoff, Deborah S., and Joan Swirsky. Beauty and the Beam:
Your Complete Guide to Cosmetic Laser Surgery. New
York: Quality Medical Publishing Inc., 1998.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Tourles, Stephanie. Naturally Healthy Skin: Tips and Techniques for
a Lifetime of Radiant Skin. Vermont, RI: StoreyBooks, 1999.
PERIODICALS
Flynn, T. C. and W. P. Coleman. “Topical revitalization of body
skin." J Eur Acad Dermatol Venereol (July 2000): 280 — 4.
Kligman, D. and A. M. Kligman. “Salicylic acid peels for the
treatment of photoaging.” Dermatol Surg (March
19981:325-8.
Kockaert, M. and M. Neumann. “Systemic and topical drugs
for aging skin.” J Drugs Dermatol (August 2003):435-41.
ORGANIZATIONS
American Academy of Dermatology. P.O. Box 4014. Schaum-
burg, IL 60168-4014. (888) 462-DERM. Fax: (847) 330-
8907. <http://www.aad.org>.
Samuel Uretsky, Pharm.D.
Betaine hydrochloride
Description
The digestive process takes place as food passes
through the gastrointestinal tract, which consists of the
mouth, stomach, small intestine, and large intestine. Betaine
hydrochloride (C 5 H 12 N0 2 C1) is a source of hydrochloric
acid, a naturally occurring stomach acid that helps break up
fats and proteins for further digestion in the small intestine.
Gastric (stomach) acid also aids in the absorption of nutri-
ents through the walls of the intestines into the blood.
Gastric acid also helps protect the gastrointestinal
tract from harmful bacteria. A normal level of gastric
acid in the stomach — 100,000-1,000,000 times more
acidic than water — is sufficient to destroy bacteria, but a
low level increases the likelihood and severity of certain
bacterial and parasitic intestinal infections. One study
showed that fasting people with normal gastric acid lev-
els in the stomach had almost no bacteria in the small in-
testine, while individuals with low levels of hydrochloric
acid had some bacterial colonization in the stomach.
Betaine hydrochloride is a synthesized chemical,
and is not obtained from any plant or animal source.
Gastric acid is produced by stomach cells, and is not
available from any food source. Occasionally, betaine
(C 5 H u N0 2 )is recommended to reduce blood levels of
homocysteine, which is associated with heart disease.
This form of betaine is different from betaine hydrochlo-
ride, and is available only with a doctor’s prescription.
General use
Some research suggests that individuals with a wide
variety of chronic disorders, such as allergies, asthma,
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
and gallstones, do not produce adequate amounts of
stomach acid. Many people with rheumatoid arthritis
are deficient in stomach acid and other digestive factors.
Taking betaine hydrochloride with meals can aid in pro-
tein digestion and possibly reduce food sensitivities
through improved digestion.
Naturopaths have long held that low stomach acid is
a widespread problem that interferes with the digestion
and absorption of nutrients. Betaine hydrochloride is one
of the most common recommendations for this condi-
tion. It helps make some minerals and other nutrients
more absorbable, and may be especially helpful with nu-
tritional supplements, which are often taken in tablets or
capsules that may not be easily digested.
Based on naturopathic theories about the importance
of stomach acid, betaine hydrochloride has been recom-
mended for a wide variety of problems, including ane-
mia, asthma, atherosclerosis, diarrhea, excess Candida
yeast, food allergies, gallstones, hay fever and allergies,
inner ear infections, rheumatoid arthritis, and thyroid
conditions. Many naturopathic physicians also believe
that betaine hydrochloride can help conditions such as
ulcers, indigestion, and esophageal reflux (heartburn).
Conventional treatment for those conditions involves re-
ducing stomach acid; according to one theory, however,
lack of stomach acid leads to incomplete digestion of
proteins, which causes allergic reactions and other re-
sponses that lead to increased ulcer pain. In keeping
with this theory, some doctors might recommend animal-
derived pancreatic enzymes for patients experiencing al-
lergic reactions to food. Vegetarians may wish to take be-
taine hydrochloride as an alternative to pancreatic en-
zymes, since it is not an animal product. Individuals suf-
fering from allergies, ulcers, or heartburn should talk to
their doctors before using betaine hydrochloride.
Betaine hydrochloride may be used as a lipotropic.
Lipotropics aid in preventing the accumulation of fat in
the liver, and usually help in the detoxification of meta-
bolic wastes and toxins. They may be used to help with
weight loss.
Benefits of lipotropics
• Detoxification of the waste byproducts of protein syn-
thesis.
• Increasing resistance to disease by stimulating the thy-
mus gland.
• Stepping up production of lecithin in the liver, which
can lower cholesterol levels.
• Preventing plaque deposits in arteries.
• Preventing gallstone formation.
211
Betaine hydrochloride
Beta-methylbutyric acid
• Protecting against diabetic neuropathy, a condition in
which the cranial and spinal nerves, as well as the
nerves in the bladder and bowel, may be affected.
Betaine hydrochloride has been used as a source of
hydrochloric acid in the treatment of hypochlorhydria, a
condition in which an abnormally low amount of hy-
drochloric acid is in the stomach. It has been used in prepa-
rations for the treatment of liver disorders, hypokalaemia
(abnormally low levels of potassium in the blood), C0 2
production in double contrast radiography, and high homo-
cysteine. Betaine hydrochloride has also been used to treat
tic douloreux (a condition which involves spasmodic pain
along the course of a facial nerve), cystinuria (a hereditary
defect that results in recurrent kidney stone formation), and
vitiligo (a condition that is characterized by milky-white
patches on otherwise normal skin).
Preparations
Betaine hydrochloride (also called betaine HC1) is
typically taken in tablets or capsules of 5-10 grains (325-
650 mg)each with a meal that contains protein. Naturo-
pathic or nutritionally oriented physicians may make rec-
ommendations of such tablets based on their diagnoses.
Precautions
People with a history of ulcers, heartburn, or other
gastrointestinal symptoms should see a nutritionally ori-
ented doctor before taking betaine hydrochloride, and no
one should take more than 10 grains (650 mg) without a
physician’s recommendation. Large amounts of betaine
hydrochloride can burn the lining of the stomach. If a
burning sensation is experienced, betaine hydrochloride
should be immediately discontinued.
Side effects
Side effects are seldom seen, but betaine hydrochlo-
ride has not been through rigorous safety studies. Its safety,
especially for young children, pregnant or nursing women,
or those with severe liver or kidney disease, is not known.
Interactions
People taking nonsteroidal anti-inflammatory drugs
(NSAIDs), cortisone-like drugs, or other medications
that could cause peptic ulcers should not take betaine hy-
drochloride.
Resources
PERIODICALS
Challem, Jack. “Navigating the labyrinth: 30 things you need
to know about nutritional supplements.” Vegetarian Times
(January 1998), no. 245: 66-67 .
212
KEY TERMS
Cystinuria — Excess cystine, lysine, arginine, and
ornithine in urine due to defective transport sys-
tem of these acids in kidney and intestines.
Gastric acid — Also, stomach acid. Helps break up
fats and proteins for further digestion, aids in the
absorption of nutrients through the walls of the in-
testines into the blood, and helps protect the gas-
trointestinal tract from harmful bacteria.
Homocysteine — An amino acid in the blood, too
much of which is related to a higher risk of vascu-
lar disease.
Lipotropic — Substances that help prevent or cor-
rect excessive fat deposits in liver.
Gormley, James J. “Healthful weight loss includes L-carnitine,
chromium, and lipotropics.” Better Nutrition 58, no. 5: 40-
41.
OTHER
Personal Health Zone. “Betaine Hydrochloride.” [cited December
2000], <http://www.personalhealthzone.com/pg000106.html
/>
GNC (General Nutrition Centers), [cited December
2000]. <http://www.gnc.com/wellness/natpharm/supp/
betaine_HCl-F.htm/ >
Melissa C. McDade
Beta-methylbutyric acid
Description
Beta-methylbutryic acid, technically known as,
“beta-hydroxy beta-methylbutyric acid,” or more com-
monly known as “HMB,” is a metabolite of the amino
acid leucine. Human muscles have a particularly high
concentration of leucine, so this amino acid is often bro-
ken down/utilized during strenuous exercise. HMB is
also found in grapefruit and catfish in trace quantities. It
was first found to be of use in agriculture as an additive to
help pigs, chickens, and other farm animals gain muscle
and lose fat. It was not until a research trial conducted by
the University of Iowa at Iowa City showed positive re-
sults that it caught attention as promising for human use.
The four-week double-blind study in 1995 involved
17 exercise-trained and 23 untrained males, divided into
two groups. One group took daily capsules containing 3
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
g of HMB, and the other took placebos. Everyone ob-
served an identical weight-training regimen three times a
week. Upon the trial’s completion, the group who took
the HMB demonstrated an average 3.1% increase in lean
muscle mass, as compared with 1.9% for those who took
the placebos. Also, the HMB group lost an average of
7.3% initial body fat, against 2.2% for the placebo
group. The men who took HMB were able to average 22
pounds more with the bench press than they did at the
beginning of the study. The men who did not, averaged a
14 pound increase. Thus, when taken as a supplement,
up to 3 g a day, HMB has been shown to increase lean
muscle mass and strength in athletes who use it during
weight training. Theories suggest that HMB possibly
suppresses protein breakdown that follows exercise that
is rigorous and of long-term duration.
The patent for HMB is held jointly by Iowa State
University and Vanderbilt University, which conducted
the first studies on the compound. Experimental and Ap-
plied Sciences, Inc. (EAS)of Golden, Colorado, was
originally licensed to market it. As of 2000, dozens of
companies have it available for sale through retail stores,
and commercial websites.
General use
By the Summer Olympics in Atlanta in 1996, the
publicity of the possible benefits of HMB had spread
among athletes. Because it was not a banned substance,
demand was heavy; it continues to remain popular
among athletes as a nutritional supplement. This is true
particularly for weight trainers, but has been reported as
useful for any athlete undergoing resistance training. It is
considered a “state-of-the-art” bodybuilding supplement,
and tends to show an increase of lean mass and strength
among those who use it. Studies have also shown that
HMB might also accelerate fat loss that occurs sec-
ondary to strenuous exercise. According to Wayne Hearn
in American Medical News in August of 1996, Dr. Naji
N. Abumrad, MD, originally with the Vanderbilt team,
began to conduct studies in 1996 that explored HMB’s
“potential use as an antiwasting agent that could benefit
AIDS and cancer patients and help maintain muscle
mass in the elderly.” This research remains as ongoing.
Preparations
HMB is available in both powder and capsule form,
with capsule form being the primary method of usage. In
2000, an average price for 250 mg capsules ran approxi-
mately $35-$55 depending on retailer and volume pur-
chased. Because HMB is a food supplement and not a
drug, it is not subject to Federal Drug Administration
(FDA) standards, and therefore has no minimum require -
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Leucine — An amino acid produced by the hydrol-
ysis of proteins by pancreatic enzymes during di-
gestion, and by putrefaction of nitrogenous organ-
ic matter.
ment recommendation. Tests have suggested that
dosages from 1.5-3 g a day are required to achieve de-
sired results.
Precautions
As a food supplement found in every cell of the
human body, it has no toxic effects, according to the re-
search conducted. Because no long-term studies had
been conducted on children, or pregnant or lactating
women, the supplement could not be recommended for
these groups. Thus, these groups of people should con-
sult a physician, and use HMB with caution.
Side effects
According to Abumrad, the only side effects discov-
ered have been positive ones. Yet the benefits of lower
cholesterol and blood pressure levels found to occur with
the use of the supplement, were also associated with the
intense exercise that seems to trigger HMB’s tissue -build-
ing effects. As Hearn reported, “That stands in stark con-
trast to the side effects of unprescribed steroid use by ath-
letes and bodybuilders, which has been linked to cancer,
heart disease, kidney and liver damage, and erratic mood
swings.” Studies were ongoing to determine what other
possible benefits or disadvantages HMB would prove to
be for the long-term period of usage. Physicians were
urged to add caution to their patients regarding this sup-
plement to be alert to any unforeseen complications. In
2000, various websites offer testimony for or against
usage. Those who recommend against it do so only in of-
fering that it did not appear to be of any use, and did not
provide them with the touted benefits.
Interactions
No known adverse reactions have yet been docu-
mented when HMB is taken with other drugs or food
supplements. It has been recommended for usage with
creatine monohydrate for intense training.
Resources
PERIODICALS
Antonio, Jose, Ph.D. Let’s Live 66, no. 6 (1998).
213
Beta-methylbutyric acid
Bhakti yoga
Antonio, Jose.Ph.D. Muscle & Fitness 58, no.5 (1997).
Hearn, Wayne. American Medical News 39, no. 31 (1996).
Available at: http://web4.infotrac.galegroup.com/itw.
Lee, In- Young and J.P.N. Rosazza. Archives of Microbiology
169, no. 3 (1998). Available at: http://link.springer~ny.
com/Unk/service/joumals/00203.
Maenz, David D. and Carmen M. Engele-Schaan. Journal of
Nutrition 126, no. 2 (1996). Available at: http://web4.
infotrac.galegroup.com/itw.
Mulgannon, Terry. Men’s Fitness 13, no. 6 (1997).
OTHER
Burke, Edmund R.,Ph.D. MotherNature.com News, http://
www.MotherNature.com/.
Jane Spear
Bhakti yoga
Definition
Bhakti yoga is one of six major branches of yoga, rep-
resenting the path of self-transcending love or complete
devotion to God or the divine. A practitioner of bhakti yoga
regards God as present in every person or sentient being.
Although bhakti yoga developed within a Hindu culture, it
can be practiced by members of Western religions, as it fo-
cuses the believer’s mind and heart on God as a supreme
Person rather than an impersonal Absolute. Unlike hatha
yoga, which is the form of yoga most familiar to Ameri-
cans, bhakti yoga does not place great emphasis on breath-
ing patterns or asanas (physical postures), but rather on
acts of worship, devotion, and service.
Origins
Bhakti yoga is thought by some to be the oldest
form of yoga, with its roots in the Vedas, or ancient
scriptures of India. Some of the hymns in the Vedas are
thought to be four thousand years old. Bhakti yoga did
not emerge as a distinctive form of yoga, however, until
about 500 B.c., the time of the composition of the Bha-
gavad-Gita, a Sanskrit work containing the teachings of
Krishna, one of the most beloved of Hindu deities.
Bhakti yoga eventually became the focus of a popu-
lar devotional movement in India known as the bhakti-
marga or “road of devotion.” This movement flourished
between 800 and 1100 A.D.. Around 900, devotees of Kr-
ishna who belonged to the bhakti-marga produced a
scripture known as the Bhagav ad-Pur ana, which con-
tains Krishna’s instructions to his worshipers. In one
passage from the Bhagav ad-Pur ana, Krishna praises
214
bhakti above all other paths to bliss. He is represented as
saying, “The wise person should abandon bad company
and associate with the virtuous, for the virtuous ones
sever the mind’s attachments [to worldly concerns] by
their utterances.. O greatly blessed devotee, these
blessed ones constantly tell my story, by listening to
which people are released from sin. Those who respect-
fully listen to, esteem, and recite my story become dedi-
cated to me and attain faith and devotion to me.”
Benefits
The chief benefit of bhakti yoga, from the perspec-
tive of its practitioners, is greater love for and closeness
to God, and to other people (and all beings) as reflections
of God. Although bhakti yoga is also beneficial to mental
and physical well-being, improved health is not the pri-
mary reason most adherents choose this form of yoga.
Description
The Hindu sacred texts list nine forms of bhakti
yoga:
• Sravana. Sravana is the Sanskrit term for listening to
poems or stories about God’s virtues and mighty deeds.
Sravana bhakti cannot be practiced in isolation, howev-
er; the devotee must hear the stories from a wise
teacher, and seek the companionship of holy people.
• Kirtana. Kirtana refers to singing or chanting God’s
praises. Ram Dass has said of this form of bhakti
“When you are in love with God, the very sound of the
Name brings great joy.”
• Smarana. Smarana is remembrance of God at all times,
or keeping God in the forefront of one’s consciousness.
In Christian terms, smarana is what the French monk
Brother Lawrence (1605-1691) meant by “the practice
of the presence of God.”
• Padasevana. This form of bhakti yoga expresses love to-
ward God through service to others, especially the sick.
• Archana. Archana refers to worship of God through
such external images as icons or religious pictures, or
through internal visualizations. The purpose of archana
is to purify the heart through love of God.
• Vandana. Vandana refers to prayer and prostration
(lying face downward on the ground with arms out-
stretched). This form of bhakti yoga is intended to curb
self-absorption and self-centeredness.
• Dasya. In dasya bhakti, the devotee regards him- or
herself as God’s slave or servant, carrying out God’s
commandments, meditating on the words of God, car-
ing for the sick and the poor, and helping to clean or re-
pair sacred buildings or places.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• Sakha-bhava. This form of bhakti yoga is a cultivation
of friendship-love toward God — to love God as a mem-
ber of one's family or dearest friend, and delight in
companionship with God.
• Atma-nivedana. Atma-nivedana is complete self-offer-
ing or self- surrender to God. Unlike some other forms
of yoga, however, bhakti yoga does not teach that the
devotee completely loses his or her personal identity
through absorption into the divine. God is regarded as
infinitely greater than the human worshiper, even one at
the highest levels of spiritual attainment.
The nine types of bhakti yoga are not considered a
hierarchy in the sense that some are regarded as superior
to others in guiding people toward God. An Indian
teacher of bhakti yoga has said, “A devotee can take up
any of these paths and reach the highest state. The path
of bhakti is the easiest of all [types of yoga] and is not
very much against the nature of human inclinations. It
slowly and gradually takes the individual to the Supreme
without frustrating his [sic] human instincts.”
Preparations
The practice of bhakti yoga does not require any
special physical or emotional preparation. It is a good
idea, however, for Western readers to gather more in-
formation about a specific form of bhakti yoga that
may interest or attract them. This preparation is partic-
ularly important because the tendency of Western cul-
ture to separate intellect from feeling leads many peo-
ple to think of bhakti as sheer emotional fervor that
does not engage the mind, whereas many of the great
teachers of bhakti yoga were known for their wisdom
and mindfulness as well as intensity of devotion. Use-
ful resources for learning more about bhakti yoga in-
clude such periodicals as Yoga Journal and the various
organizations listed below.
Precautions
Bhakti yoga tends to attract persons of a strongly
emotional nature. There is some risk, however, of such
individuals remaining spiritually immature or joining
cult-like groups. The Hare Krishna movement, for exam-
ple, is an offshoot of one school of bhakti yoga, the
Gaudiya vaishnava tradition. Although some members of
the movement consider their participation meaningful,
others have left because they experienced it as repressive
and intolerant of other faiths.
Side effects
There are no known side effects associated with the
practice of bhakti yoga.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Research & general acceptance
A number of research studies have shown that such
spiritual and devotional practices as those associated
with bhakti yoga have positive effects on physical as
well as emotional health. The positive physical effects
include strengthening of the immune system, lowered
blood pressure, and improved ability to cope with chron-
ic pain. Chanting or hymn singing (kirtana) has been
shown to be particularly effective in pain management.
Several research studies published in early 2004 re-
port that all forms of yoga are becoming increasingly
popular among Americans over 40 — particularly women
and people living in urban areas — for general wellness as
well as back pain or other specific health problems. At
least 15 million adults in the United States have partici-
pated in yoga programs, according to a study conducted
at Harvard Medical School. Ninety percent of those con-
tacted by telephone in a research sample said that they
found yoga very or somewhat helpful. A survey of can-
cer patients in a supportive care program at Stanford Uni-
versity found that yoga and massage therapy were the
activities that drew the largest number of participants.
Training & certification
There are no international or nationwide licensing or
credentialing procedures for spiritual guides or teachers
of bhakti yoga. The web site of the American Yoga Asso-
ciation (AYA) does, however, include an article on “How
to Choose a Qualified Teacher.”
Resources
BOOKS
Dass, Ram. Journey of Awakening: A Meditator’s Guidebook .
New York: Bantam Books, 1978. Contains some prayers,
hymns, chants, and other suggestions for devotion drawn
from Christian and Jewish sources that can be used in the
practice of bhakti yoga.
Dossey, Larry, MD. Healing Beyond the Body: Medicine and
the Infinite Reach of the Mind . Boston: Shambhala Publi-
cations, Inc., 2001.
Feuerstein, Georg, and Stephan Bodian, eds. Living Yoga: A
Comprehensive Guide for Daily Life, Part III, “Cultivating
Love: Bhakti Yoga.” New York: Jeremy P. Tarcher/Perigee
Books, 1993.
Pelletier, Kenneth, MD> The Best Alternative Medicine, Chap-
ter 2, “Sound Mind, Sound Body.” New York: Simon &
Schuster, 2002.
Sivananda, Swami, and the Staff of the Sivananda Vedanta
Yoga Center. Yoga Mind and Body . New York: DK Pub-
lishing, 1998.
PERIODICALS
Rosenbaum, E., H. Gautier, P. Fobair, et al. “Cancer Supportive
Care, Improving the Quality of Life for Cancer Patients. A
215
Bhakti yoga
Bilberry
KEY TERMS
Asanas — Physical postures associated with the
practice of hatha yoga.
Sanskrit — The classical literary language of India.
It is considered the oldest living language of the
Indo-Aryan family.
Program Evaluation Report.” Supportive Care in Cancer
12 (May 2004): 293-301.
Saper. R. B., D. M. Eisenberg, R. B. Davis, et al. “Prevalence
and Patterns of Adult Yoga Use in the United States: Re-
sults of a National Survey.” Alternative Therapies in
Health and Medicine 10 (March-April 2004): 44-49.
Wolsko, P. M., D. M. Eisenberg. R. B. Davis, and R. S.
Phillips. “Use of Mind-Body Medical Therapies.” Journal
of General Internal Medicine 19 (January 2004): 43-50.
ORGANIZATIONS
American Yoga Association (AYA). P. O. Box 19986, Sarasota,
FL 34276. (941) 927-4977. Fax: (941) 921-9844. <http://
www.americanyogaassociation.org>.
Yoga Alliance. 122 West Lancaster Avenue, Suite 204, Reading,
PA 19607-1874. (610) 777-7793. Fax: (610) 777-0556.
<http://www.yogaalliance.org>.
Yoga Research and Education Center (YREC). P. O. Box 426,
Manton, CA 96059. (530) 474-5700. <http://www.yrec.
org>.
OTHER
Yoga.com Staff. “History of Bhakti Yoga.” [cited May 23, 2004].
<http : //w ww.yoga.com/ydc/enlighten/enlighten_document .
asp>.
Rebecca Frey, PhD
Bilberry
Description
Bilberry ( Vaccinium myrtillus ) is a European berry
shrub that is related to the blueberry, huckleberry, and
bearberry plants that grow in the United States. Bilberry
is a small, wild, perennial shrub that grows throughout
Europe and is now cultivated from the Far East to the
United States. The shrub yields large amounts of small,
darkish blue berries. Besides their medicinal use, they
are often eaten fresh or made into jams and preserves.
The leaves of the plant are used medicinally as well, but
to a lesser extent than the berries. The qualities of the
herb are sour, astringent, cold, and drying.
216
Bilberry has been used by European herbalists for
centuries. In Elizabethan times, bilberries were mixed
with honey and made into a syrup called rob that was
prescribed for diarrhea and stomach problems. The
berries were also used for infections, scurvy, and kidney
stones. The leaves of the plant were used as a folk reme-
dy for diabetes. Bilberry is most famous, though, for its
long use as a medicine for eye and vision problems. Leg-
end has it that during World War II, British and Ameri-
can pilots discovered that eating bilberry jam before
night missions greatly improved their night vision. Bil-
berries then became a staple for Air Force pilots. Since
then, extensive research in Europe has shown that bilber-
ries contain specific compounds that have beneficial ef-
fects on the eyes and circulatory system. In France, bil-
berries have been prescribed since 1945 for diabetic
retinopathy, a major cause of blindness in diabetics.
Bilberries are high in substances called flavonoids,
which are found in many fruits, vegetables, grains, beans,
peas, and are particularly abundant in citrus fruits and
berries. Flavonoids are chemicals technically known as
polyphenols. Flavonoids have antioxidant and disease-
fighting properties. Antioxidants are substances that help
cells in the body resist and repair damage. The flavonoids
found in bilberry provide the blue color of the berry. The
bilberry flavonoids are called anthocyano sides, which
were found to be the main active ingredients.
Bilberry flavonoids can increase certain enzymes
and substances in the eyes that are crucial to good vision
and eye function. Furthermore, anthocyanosides can in-
crease circulation in the blood vessels in the eyes, and
help these blood vessels repair and protect themselves.
Specifically, research has shown that anthocyanosides
help stabilize and protect a protein called collagen,
which is a basic building block of veins, arteries, capil-
laries, and connective tissue. Particularly, anthocyano-
sides seem to work favorably in the tissues found in the
retina, the back of the eye where major functions of vi-
sion take place. The retina is composed of millions of
tiny nerve cells and blood vessels, which anthocyano-
sides can help support. Bilberry is a common treatment
for many varieties of retinopathy, a disorder in which the
intricate blood and nerve vessels in the retina are dam-
aged. Retinopathy particularly affects people with dia-
betes, high blood pressure, and sickle cell anemia.
Many studies have documented bilberry’s useful-
ness as a medicinal herb. One study demonstrated that
bilberry extract used with Vitamin E prevented the pro-
gression of cataracts in 48 of 50 patients with cataract
formations. In animal studies, bilberry reduced and sta-
bilized blood sugar levels. In an Italian study, bilberry’s
flavonoids lowered cholesterol levels in the blood and
improved circulation.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
General use
Bilberry is most commonly used as a component of
treatment for various vision and eye disorders, including
glaucoma, cataracts, and macular degeneration. However,
people with glaucoma should be monitored by an eye doctor
regularly, and those with acute glaucoma should not depend
on bilberry alone to protect their vision. They can use bilber-
ry along with other emergency medical treatments. Bilberry
is included in the treatments for many types of retinopathy
and is also used for eye fatigue, poor night vision, and near-
sightedness. It can be used as a preventative measure for
glaucoma and cataracts, and to help those who require pre-
cise night vision like cab drivers and pilots. Bilberry’s circu-
lation improving and cholesterol lowering qualities make it
useful in the treatment of varicose veins and atherosclero-
sis. it is also occasionally prescribed for arthritis.
Preparations
Fresh bilberries can be eaten like blueberries, al-
though they are difficult to find outside of Europe. Two
to four ounce servings of the fresh fruit can be eaten
three times a day. One to two cups each day is a good
dose. Dried bilberries are sometimes available in herb or
organic health food stores, and two or three small hand-
fuls can be eaten per day. However, dried berries are
likely to contain only a small amount of the flavonoids.
Bilberry supplements are widely available in health
food stores. They can be purchased as capsules and liq-
uid extracts. A high-quality supplement may contain a
standardized formula of up to 25% anthocyanocides. The
dosage recommended with this percentage of active in-
gredients is 80-160 mg taken three times daily. Bilberry
supplements may be taken with food or on an empty
stomach. Bilberry jam and syrup may also be used.
For eye and circulatory problems, bilberry can be
taken with ginkgo to increase its beneficial effects. Vita-
mins A, C and E may also enhance bilberry’s healing ef-
fects in the eye. Some suggestions have been made that
other flavonoid-containing supplements, such as pine
bark extract and grape seed extract, can possibly en-
hance bilberry’s healing properties.
Precautions
Bilberry may be used as prevention and herbal sup-
port for eye conditions, but should not replace medical
care. Consumers with vision problems should be thor-
oughly and immediately examined by an ophthalmologist
(eye specialist) before any treatment or remedy is used.
Side effects
Bilberries can be taken in large doses without any
side effects. However, bilberry leaves shouldn’t be taken
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Atherosclerosis — Disease in which the arteries
and circulation are impaired from hardening and
clogging, often from high cholesterol levels.
Cataracts — Eye condition in which the lenses
harden and lose their clarity.
Glaucoma — Eye disease that can cause blindness;
characterized by excess fluid between the iris and
cornea of the eye.
Macular degeneration — Disease in which the
macula, the part of the retina responsible for pre-
cise vision, deteriorates.
in large doses or over long periods of time because they
are toxic.
Resources
BOOKS
Keville, Kathi. Herbs: An Illustrated Encyclopedia. New York:
Friedman/Fairfax, 1994.
Mayell, Mark. Off-the -Shelf Natural Health. New York: Ban-
tam, 1995.
PERIODICALS
HerbalGram (a quarterly journal of the American Botanical
Council and Herb Research Foundation) RO. Box 144345,
Austin, TX 78714-4345, (800) 373-7105. <http://www.
herbalgram.org . >
ORGANIZATIONS
Herb Research Foundation. 1007 Pearl Street, Boulder, CO
80302.
OTHER
Dietary Supplement Quality Initiative, <http://www.dsqi.org.>
Douglas Dupler
Binge eating disorder
Definition
Binge eating disorder (BED) is characterized by a
loss of control over eating behaviors. The binge eater
consumes unnaturally large amounts of food in a short
time period, but unlike a bulimic, doesn’t regularly en-
gage in any inappropriate weight-reducing behaviors
(like excessive exercise, vomiting, taking laxatives)
after the binge episodes.
217
Binge eating disorder
Binge eating disorder
Description
About three percent of women and one-tenth as
many men have duffered from either bulimia or binge
eating disorder at some time in their lives. BED typically
strikes individuals between their adolescent years and
their early 20s. Because of the nature of the disorder,
most BED patients are overweight or obese. Studies of
weight loss programs have shown that an average of
30% of individuals enrolling in these programs report
binge eating behavior. Binge eating in milder forms is
even more common, as are attempts to compensate for
the binges.
Causes & symptoms
Binge eating episodes may act as a psychological
release for excessive emotional stress. Other circum-
stances that may predispose an individual to BED in-
clude heredity and mood disorders, such as major de-
pression. BED patients are also more likely to have an
additional diagnosis of impulsive behaviors (for exam-
ple, compulsive shopping), post-traumatic stress disor-
der (PTSD), panic disorder, or personality disorders.
More than half also have a history of major depression.
In 2002, the American Psychiatric Association was con-
sidering including BED as a psychiatric diagnosis.
individuals who develop BED often come from fam-
ilies who put an unnatural emphasis on the importance of
food. For example, these families may use food as a
source of comfort in times of emotional distress. As chil-
dren, BED patients may have been taught to clean their
plates regardless of their appetite, or to be a good girl or
boy and finish all of the meal. Cultural attitudes towards
beauty and thinness may also be a factor in BED.
During binge episodes, BED patients experience a
definite sense of lost control over their eating. They eat
quickly and to the point of discomfort, even if they aren’t
hungry. They typically binge alone two or more times a
week, and often feel depressed and guilty when the
episode is over.
Diagnosis
BED is usually diagnosed and treated by a psychia-
trist and/or a psychologist, in addition to an interview
with the patient, personality and behavioral inventories,
such as the Minnesota Multiphasic Personality Inventory
(MMPI), may be administered as part of the assessment
process. One of several clinical inventories, or scales,
may also be used to assess depressive symptoms, includ-
ing the Elamilton Depression Scale (HAM-D) or Beck
Depression Inventory (BDI). These tests may be admin-
istered in an outpatient or hospital setting.
218
Treatment
Many BED individuals binge after long periods of
excessive dieting; therapy helps normalize this pattern.
The initial goal of BED treatment is to teach the patient
to gain control over his or her eating behavior by focus-
ing on eating regular meals and avoiding snacking. Cog-
nitive behavioral therapy, group therapy, or interper-
sonal psychotherapy may be used to uncover the emo-
tional motives, distorted thinking, and behavioral pat-
terns behind the binge eating. The overweight BED
patient may be placed on a moderate exercise program
and a nutritionist may be consulted to educate the patient
on healthy food choices and strategies for weight loss.
Initial treatment may focus on curbing the depression
that is a characteristic feature of BED. Recommended
herbal remedies to ease the symptoms of depression may
include damiana ( Turnera diffusa ), ginseng (Panax gin-
seng), kola ( Cola nitida), lady’s slipper ( Cypripedium cal-
ceolus), lavender ( Lavandula angustifolia), lime blossom
(Tilia x vulgaris), oats ( Avena sativa), rosemary ( Rosmar-
inus officinalis), skullcap ( Scutellaria laterifolia), St.
John’s wort ( Hypericum perforatum), valerian ( Valeri-
ana officinalis), and vervain ( Verbena officinalis).
Binge-eating episodes that appear to be triggered by
stress may be curbed by educating the patient in relaxation
exercises and techniques, including aromatherapy, breath-
ing exercises, biofeedback, music therapy, yoga, and mas-
sage. Herbs known as adaptogens may also be prescribed by
an herbalist or holistic healthcare professional. These herbs
are thought to promote adaptability to stress, and include
Siberian ginseng ( Eleutherococcus senticosus), ginseng
( Panax ginseng), wild yam ( Dioscorea villosa), borage (Bor-
ago officinalis), licorice ( Glycyrrhiza glabra), chamomile
0 Chamaemelum nobile), and nettles ( Urtica dioica). Tonics
of skullcap ( Scutellaria lateriafolia), and oats ( Avena sativa),
may also be recommended to ease anxiety.
Allopathic treatment
Treatment with antidepressants may be prescribed
for BED patients. Selective serotonin reuptake inhibitors
(such as Prozac) are usually preferred because they offer
fewer side effects. However, clinical studies don’t show
much effectiveness for use of antidepressants in treating
BED. Psychotherapy shows better results. Once the
binge eating behavior is curbed and depressive symp-
toms are controlled, the physical symptoms of the disor-
der can be addressed.
Expected results
The poor dietary habits and obesity that are sympto-
matic of BED can lead to serious health problems, such as
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Bulimia — An eating disorder characterized by
binge eating and then excessive behavior (such as
vomiting, misusing laxatives, or exercising exces-
sively) to rid the body of the food eaten.
Cognitive behavioral therapy — A therapy that fo-
cuses on changing negative behavior in order to
alter the attitudes or harmful thinking patterns that
cause the behavior.
high blood pressure, heart attacks, and diabetes, if left
unchecked. BED is a chronic condition that requires ongo-
ing medical and psychological management. To bring
long-term relief to the BED patient, it is critical to address
the underlying psychological causes behind binge eating
behaviors. It appears that up to 50% of BED patients will
stop bingeing with cognitive behavioral therapy.
Resources
BOOKS
Abraham, Suzanne and Derek Llewellyn-Jones. Eating Disor-
ders: The Facts. 4th ed. Oxford: Oxford University Press,
1997.
American Psychiatric Association. Diagnostic and Statistical
Manual of Mental Disorders, 4th ed. Washington, DC:
American Psychiatric Press, Inc., 1994.
Siegel, Michele, Judith Brisman, and Margot Weinshel. Surviv-
ing an Eating Disorder: Strategies for Family and
Friends, 2nd ed. New York: Harper Perennial, 1997.
PERIODICALS
Brewerton, Timothy D. “Binge Eating Disorder: Recognition,
Diagnosis, and Treatment.” Medscape Mental Health 2,
no. 5 (1997). http://www.medscape.com.
"Treatment of Bulimia and Binge Eating.” Harvard Mental
Health Letter (July 2002).
Tufts University. "Binge Eating Disorder Comes Out of the
Closet: Experts Say Leading Obesity Factor Has Long
Been Overlooked.” Tufts University Diet & Nutrition Let-
ter 14, no. 1 1 (January 1997): 4-5.
ORGANIZATIONS
American Psychiatric Association ( APA). Office of Public Af-
fairs. 1400 K Street NW, Washington, DC 20005. (202)
682-6119. http://www.psych.org/.
American Psychological Association (APA). Office of Public
Affairs. 750 First St. NE, Washington, DC 20002-4242.
(202) 336-5700. http://www.apa.org/.
Eating Disorders Awareness and Prevention. 603 Stewart St.,
Suite 803, Seattle, WA 98101. (800) 931-2237. http://
www.edap.org
National Eating Disorders Organization (NEDO). 6655 South
Yale Ave., Tulsa, OK 74136. (918) 481-4044.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Overeaters Anonymous World Service Office. 6075 Zenith Ct.
NE, Rio Rancho, NM 87124. (505) 891-2664. http://www.
overeatersanonymous.org/.
Paula Ford-Martin
Teresa G. Odle
Biocytin see Brewer's yeast
Biofeedback
Definition
Biofeedback, or applied psychophysiological feed-
back, is a patient-guided treatment that teaches an individ-
ual to control muscle tension, pain, body temperature, brain
waves, and other bodily functions and processes through
relaxation, visualization, and other cognitive control tech-
niques. The name biofeedback refers to the biological sig-
nals that are fed back, or returned, to the patient in order for
the patient to develop techniques of manipulating them.
Origins
In 1961, Neal Miller, an experimental psychologist,
suggested that autonomic nervous system responses (for in-
stance, heart rate, blood pressure, gastrointestinal activity,
regional blood flow) could be under voluntary control. As a
result of his experiments, he showed that such autonomic
processes were controllable. This work led to the creation
of biofeedback therapy. Willer’s work was expanded by
other researchers. Thereafter, research performed in the
1970s by UCLA researcher Dr. Barry Sterman established
that both cats and monkeys could be trained to control their
brain wave patterns. Sterman then used his research tech-
niques on human patients with epilepsy, where he was able
to reduce seizures by 60% with the use of biofeedback tech-
niques. Throughout the 1970s, other researchers published
reports of their use of biofeedback in the treatment of car-
diac arrhythmias, headaches, Raynaud’s syndrome, and
excess stomach acid, and as a tool for teaching deep relax-
ation. Since the early work of Miller and Sterman, biofeed-
back has developed into a front-line behavioral treatment
for an even wider range of disorders and symptoms.
Benefits
Biofeedback has been used to successfully treat a
number of disorders and their symptoms, including tem-
promandibular joint disorder (TMJ), chronic pain, irrita-
ble bowel syndrome (IBS), Raynaud’s syndrome,
epilepsy, attention-deficit hyperactivity disorder
219
Biofeedback
Biofeedback
A patient undergoing biofeedback therapy. (Photo Re-
searchers, Inc. Reproduced by permission.)
(ADHD), migraine headaches, anxiety, depression,
traumatic brain injury, and sleep disorders.
Illnesses that may be triggered at least in part by
stress are also targeted by biofeedback therapy. Certain
types of headaches, high blood pressure, bruxism (teeth
grinding), post-traumatic stress disorder, eating disor-
ders, substance abuse, and some anxiety disorders may
be treated successfully by teaching patients the ability to
relax and release both muscle and mental tension.
Biofeedback is often just one part of a comprehensive
treatment program for some of these disorders.
NASA has used biofeedback techniques to treat astro-
nauts who suffer from severe space sickness, during which
the autonomic nervous system is disrupted. Scientists at the
University of Tennessee have adapted these techniques to
treat individuals suffering from severe nausea and vomiting
that is also rooted in autonomic nervous system dysfunction.
Recent research also indicates that biofeedback may
be a useful tool in helping patients with urinary inconti-
nence regain bladder control. Individuals learning pelvic-
floor muscle strengthening exercises can gain better con-
trol over these muscles by using biofeedback. Sensors are
placed on the muscles to train the patient where they are
and when proper contractions are taking place.
Description
During biofeedback, special sensors are placed on
the body. These sensors measure the bodily function that
220
is causing the patient problem symptoms, such as heart
rate, blood pressure, muscle tension (EMG or elec-
tromyographic feedback), brain waves (EEC or elec-
troencophalographic feedback), respiration, and body
temperature (thermal feedback), and translates the infor-
mation into a visual and/or audible readout, such as a
paper tracing, a light display, or a series of beeps.
While the patient views the instantaneous feedback
from the biofeedback monitors, he or she begins to recog-
nize what thoughts, fears, and mental images influence his
or her physical reactions. By monitoring this relationship
between mind and body, the patient can then use these
same thoughts and mental images as subtle cues, as these
act as reminders to become deeply relaxed, instead of anx-
ious. These reminders also work to manipulate heart beat,
brain wave patterns, body temperature, and other bodily
functions. This is achieved through relaxation exercises,
mental imagery, and other cognitive therapy techniques.
As the biofeedback response takes place, patients
can actually see or hear the results of their efforts in-
stantly through the sensor readout on the biofeedback
equipment. Once these techniques are learned and the
patient is able to recognize the state of relaxation or vi-
sualization necessary to alleviate symptoms, the biofeed-
back equipment itself is no longer needed. The patient
then has a powerful, portable, and self-administered
treatment tool to deal with problem symptoms.
Biofeedback that specializes in reading and altering
brain waves is sometimes called neurofeedback. The
brain produces four distinct types of brain waves — delta,
theta, alpha, and beta — that all operate at a different fre-
quency. Delta, the slowest frequency wave, is the brain
wave pattern associated with sleep. Beta waves, which
occur in a normal, waking state, can range from 12-35
Hz. Problems begin to develop when beta wave averages
fall in the low end (underarousal) or the high end (over-
arousal) of that spectrum. Underarousal might be present
in conditions such as depression or attention-deficit dis-
order, and overarousal may be indicative of an anxiety
disorder, obsessive compulsive disorder, or excessive
stress. Beta wave neurofeedback focuses on normalizing
that beta wave pattern to an optimum value of around 14
Hz. A second type of neurofeedback, alpha-theta, focus-
es on developing the more relaxing alpha (8-13 Hz) and
theta waves (4-9 Hz) that are usually associated with
deep, meditative states, and has been used with some
success in substance abuse treatment.
Through brain wave manipulation, neurofeedback
can be useful in treating a variety of disorders that are
suspected or proven to impact brain wave patterns, such
as epilepsy, attention-deficit disorder, migraine
headaches, anxiety, depression, traumatic brain injury,
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
ELMER GREEN 1917-
A life dedicated to science has propelled Elmer
Green, Ph.D. into careers as a physicist and a biological
psychologist. Both led to his most noted work, the influ-
ence on the birth of the biofeedback movement. While
the mechanics of moving parts and machinery lured the
investigator from LaGrand, Oregon, to his work as a civil-
ian scientist with the Navy in the late 1940s, it was his
wife Alyce who caused him to ponder biophysiology and
human development. In 1953 she read a book titled The
Human Senses by Frank Geldard. It was their interests as a
couple that led to their continued education at the Uni-
versity of Chicago. In 1957 Green began work for his
Ph.D. studies in biopsychology, while Alyce studied for
her Master's degree in psychology.
Numerous opportunities, including assisting with
the development of a machine for the automated detec-
tion of brain damage, led to his position at the Men-
ninger Institute in Topeka, Kansas, in 1964. While there
he established the psychophysiology laboratory and the
Voluntary Controls Program. It was his treatment of a
colleague's wife's headaches that Green became con-
vinced that skin temperature was an autonomic nervous
system variable that was responsive to psychophysiolog-
ic self-regulation aided by thermal biofeedback. By
learning to control temperature he found that headache
control could be enhanced. Green's success attracted
support by several of the Menninger staff who also began
research and use of biofeedback therapy for headaches
and hypertension.
The 1960s proved exciting for Green as he, Alyce,
and colleague Dale Walters became involved with EEG
Biofeedback, and studied the process of meditation — a
therapy the Greens had long practiced. In April 1969,
Green and his wife organized the Council Grove Con-
ference for the study of the voluntary control of inter-
nal states. The conference served as a step toward
forming the Biofeedback Research Society, which later
became the Biofeedback Society of America, and cur-
rently the Association for Applied Psychophysiology
and Biofeedback.
Together, Elmer and Alyce Green authored numer-
ous papers, book chapters, and wrote the book, Beyond
Biofeedbaclc{'\977). They lectured throughout the United
States and around the world for more than 20 years on
multiple topics including EEG biofeedback training and
psychophysiologic control.
Green co-founded the International Society For the
Study of Subtle Energies and Energy Medicine (ISSSEEM)
in 1990 and served as its director. Alyce died in 1994 of
Alzheimer's disease. In 2000, 81 -year-old Green worked
as a professional consultant and director emeritus of the
Voluntary Controls Program at the Menninger Clinic. He
also served as the science director of the Dove Health Al-
liance in Aptos, California.
Beth A. Kapes
and sleep disorders. The equipment used for neurofeed-
back usually uses a monitor as an output device. The
monitor displays specific patterns that the patient at-
tempts to change by producing the appropriate type of
brain wave. Or, the monitor may reward the patient for
producing the appropriate brain wave by producing a
positive reinforcer, or reward. For example, children may
be rewarded with a series of successful moves in a dis-
played video game.
Depending on the type of biofeedback, individuals
may need up to 30 sessions with a trained professional to
learn the techniques required to control their symptoms
on a long-term basis. Therapists usually recommend that
their patients practice both biofeedback and relaxation
techniques on their own at home.
Preparations
Before initiating biofeedback treatment, the thera-
pist and patient will have an initial consultation to record
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
the patients medical history and treatment background
and discuss goals for therapy.
Before a neurofeedback session, an EEG is taken
from the patient to determine his or her baseline brain-
wave pattern.
Biofeedback typically is performed in a quiet and
relaxed atmosphere with comfortable seating for the pa-
tient. Depending on the type and goals of biofeedback
being performed, one or more sensors will be attached to
the patient’s body with conductive gel and/or adhesives.
These may include:
• Electromyographic (EMG) sensors. EMG sensors mea-
sure electrical activity in the muscles, specifically mus-
cle tension. In treating TMJ or bruxism, these sensors
would be placed along the muscles of the jaw. Chronic
pain might be treated by monitoring electrical energy in
other muscle groups.
• Galvanic skin response (GSR) sensors. These are elec-
trodes placed on the fingers that monitor perspiration,
221
Biofeedback
Biofeedback
or sweat gland, activity. These may also be called skin
conductance level (SCL).
• Temperature sensors. Temperature, or thermal, sensors
measure body temperature and changes in blood flow.
• Electroencephalography (EEG) sensors. These elec-
trodes are applied to the scalp to measure the electrical
activity of the brain, or brain waves.
• Heart rate sensors. A pulse monitor placed on the finger
tip can monitor pulse rate.
• Respiratory sensors. Respiratory sensors monitor oxy-
gen intake and carbon dioxide output.
Precautions
Individuals who use a pacemaker or other im-
plantable electrical devices should inform their biofeed-
back therapist before starting treatments, as certain types
of biofeedback sensors have the potential to interfere
with these devices.
Biofeedback may not be suitable for some patients.
Patients must be willing to take a very active role in the
treatment process. And because biofeedback focuses
strictly on behavioral change, those patients who wish to
gain insight into their symptoms by examining their past
might be better served by psychodynamic therapy.
Biofeedback may also be inappropriate for cogni-
tively impaired individuals, such as those patients with
organic brain disease or a traumatic brain injury, depend-
ing on their levels of functioning.
Patients with specific pain symptoms of unknown
origin should undergo a thorough medical examination
before starting biofeedback treatments to rule out any se-
rious underlying disease. Once a diagnosis has been
made, biofeedback can be used concurrently with con-
ventional treatment.
Biofeedback may only be one component of a com-
prehensive treatment plan. For illnesses and symptoms
that are manifested from an organic disease process,
such as cancer or diabetes, biofeedback should be an ad-
junct to (complementary to), and not a replacement for,
conventional medical treatment.
Side effects
There are no known side effects to properly admin-
istered biofeedback or neurofeedback sessions.
Research & general acceptance
Preliminary research published in late 1999 indicated
that neurofeedback may be a promising new tool in the
treatment of schizophrenia. Researchers reported that
222
KEY TERMS
Autonomic nervous system — The part of the ner-
vous system that controls so-called involuntary
functions, such as heart rate, salivary gland secre-
tion, respiratory function, and pupil dilation.
Bruxism — Habitual, often unconscious, grinding
of the teeth.
Epilepsy — A neurological disorder characterized
by the sudden onset of seizures.
Placebo effect — Placebo effect occurs when a
treatment or medication with no known therapeu-
tic value (a placebo) is administered to a patient,
and the patient's symptoms improve. The patient
believes and expects that the treatment is going to
work, so it does. The placebo effect is also a factor
to some degree in clinically-effective therapies, and
explains why patients respond better than others to
treatment despite similar symptoms and illnesses.
Raynaud's syndrome — A vascular, or circulatory
system, disorder which is characterized by abnor-
mally cold hands and feet. This chilling effect is
caused by constriction of the blood vessels in the
extremities, and occurs when the hands and feet
are exposed to cold weather. Emotional stress can
also trigger the cold symptoms.
Schizophrenia — Schizophrenia is a psychotic dis-
order that causes distortions in perception (delu-
sions and hallucinations), inappropriate moods
and behaviors, and disorganized or incoherent
speech and behavior.
Temporomandibular joint disorder — Inflamma-
tion, irritation, and pain of the jaw caused by im-
proper opening and closing of the temporo-
mandibular joint. Other symptoms include click-
ing of the jaw and a limited range of motion.
schizophrenic patients had used neurofeedback to simulate
brain wave patterns that antipsychotic medications produce
in the brain. Further research is needed to determine what
impact this may have on treatment for schizophrenia.
The use of biofeedback techniques to treat an array
of disorders has been extensively described in the med-
ical literature. Controlled studies for some applications
are limited, such as for the treatment of menopausal
symptoms and premenstrual disorder (PMS). There is
also some debate over the effectiveness of biofeedback
in ADHD treatment, and the lack of controlled studies on
that application. While many therapists, counselors, and
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
mental health professionals have reported great success
with treating their ADHD patients with neurofeedback
techniques, some critics attribute this positive therapeu-
tic impact to a placebo effect.
There may also be some debate among mental
health professionals as to whether biofeedback should be
considered a first line treatment for some mental illness-
es, and to what degree other treatments, such as medica-
tion, should be employed as an adjunct therapy.
Training & certification
Individuals wishing to try biofeedback should con-
tact a healthcare professional trained in biofeedback
techniques. Licensed psychologists, psychiatrists, and
physicians frequently train their patients in biofeedback
techniques, or can recommend a specialist who does. In
some cases, a licensed professional may employ a
biofeedback technician who works under their direct
guidance when treating patients. There are several na-
tional organizations for biofeedback therapists, including
the Biofeedback Certification Institute of America,
which also certifies therapists in the practice.
Resources
BOOKS
Robbins, Jim. A Symphony in the Brain: The Evolution of the
New Brain Wave Biofeedback. Boston, MA: Atlantic
Monthly Press, 2000.
PERIODICALS
Burgio, K.L. et al. “Behavioral vs. Drug Treatment for Urge
Urinary Incontinence in Older Women: A randomized
controlled trial.” Journal of the American Medical Associ-
ation 280 (Dec. 1998): 1995-2000.
Robbins, Jim. “On the Track with Neurofeedback.” Newsweek
135, no. 25 (June 2000): 76.
ORGANIZATIONS
The Association for Applied Psychotherapy and Biofeedback.
10200 W. 44th Avenue, Suite 304. Wheat Ridge, CO
80033-2840. (303) 422-8436. <http://www.aapb.org>.
Biofeedback Certification Institute of America. 10200 W. 44th Av-
enue, Suite 310, Wheat Ridge, CO 80033. (303) 420-2902.
Paula Ford-Martin
Bioflavonoids
Description
Bioflavonoids, or flavonoids, are a large class of an-
tioxidants. They are compounds abundant in the pulp
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
and rinds of citrus fruits and other foods containing vita-
min C, such as soybeans and root vegetables. Other
major sources of bioflavonoids include tea, vegetables
such as broccoli and eggplant, flaxseed, and whole
grains. Bioflavonoids are active ingredients in many
herbal remedies. These include feverfew, Tanacetum
parthenium; Ginkgo biloba; licorice root, Glycyrrhiza
glabra; St. John’s wort, Hypericum perforatum; and
Echinacea spp.
Bioflavonoids help maximize the benefits of vitamin
C by inhibiting its breakdown in the body. In 1935, Albert
Szent-Gyorgyi demonstrated that an extract he called cit-
rin, made from lemon peels, was more effective than pure
vitamin C in preventing scurvy. In 1936, Szent-Gyorgyi
found that citrin was a mixture of bioflavonoids, includ-
ing the flavone hesperidin and a flavonol glucoside.
Szent-Gyorgyi believed that bioflavonoids should be con-
sidered vitamins, but was not able to substantiate that
they were essential nutrients. Still, many researchers and
physicians believe that dietary intake of bioflavonoids is
beneficial for blood vessel health and possibly for protec-
tion against heart disease.
Bioflavonoids are categorized in a variety of ways,
sometimes with overlapping categories. Types of
bioflavonoids include flavones, isoflavonoids, flavanones
(such as catechins and naringin), and flavanols.
General use
In their natural state, bioflavonoids are usually
found in close association with vitamin C. In treating
conditions, vitamin C and bioflavonoids each enhance
the action of the other compound. Therefore, when taken
as supplements, they often should be used in combina-
tion to increase effectiveness. In general, all
bioflavonoids are potentially useful as antioxidants, an-
tivirals, and anti-inflammatories. Other health benefits of
the various bioflavonoids include:
• preventing nosebleeds, miscarriages, postpartum
bleeding, and other types of hemorrhages
• the treatment and prevention of menstrual disorders
• protection against cancer and heart disease
• anticoagulant activity (preventing blood clotting)
• reducing the occurrence of easy bruising
• decreasing the cholesterol level
• improving symptoms related to aging
• protection against infections
• counteracting the effects of pollution, pesticides, rancid
fats, and alcohol
• ability to reduce pain
223
Bioflavonoids
Bioflavonoids
• improving the circulation
• improving liver function
• improvement of vision and eye diseases
• strengthening the walls of the blood vessels
Major bioflavonoids and their actions
Rutin can be used to treat chronic venous insuffi-
ciency (condition in which blood drains inadequately
from a body part), glaucoma, hay fever, hemorrhoids,
varicose veins, poor circulation, oral herpes, cirrhosis,
stress, low serum calcium, and for cataracts. It is help-
ful in reducing weakness in the blood vessels and the re-
sultant hemorrhages. Rutin can relieve the pain from
bumps and bruises. Rutin may be taken to help reduce
serum cholesterol. It is also useful in treating rheumatic
diseases such as gout, arthritis, systemic lupus erythe-
matosus (a chronic disease marked by a rash on the face
with a variety of symptoms), and ankylosing spondyli-
tis (condition affecting ligaments in the spine, involving
the hips and shoulders). Rutin is most abundant in apri-
cots, buckwheat, cherries, prunes, rose hips, the whitish
rind of citrus fruits, and the core of green peppers.
Anthocyanins and proanthocyanidins can be used to
treat a number of eye conditions such as cataracts, night
blindness, diabetic retinopathy (progressive retina dis-
ease that is a complication of diabetes), and macular de-
generation (a hereditary condition causing loss of vi-
sion). They are also useful for strengthening the walls of
the blood vessels, and therefore may help prevent bruis-
ing, hemorrhoids, varicose veins, and spider veins. These
bioflavonoids can help to prevent osteoporosis by stabi-
lizing collagen, the major protein in bone. They can re-
duce cholesterol deposits in arteries, and prevent damage
to the artery walls. These actions reduce the possibilities
of heart disease and strokes. Anthocyanins and proantho-
cyanidins can dilate the blood vessels and prevent blood
clots. Proanthocyanidins are able to cross the blood-
brain barrier to protect the brain from damage by free
radicals and infection. Good sources of anthocyanins and
proanthocyanidins include blackberries, cranberries,
black and green tea, raspberries, grapes, eggplant, red
cabbage, elderberries, and red wine.
Hesperidin is useful in treating the complaints of
menopause and in dealing with the viruses that cause
herpes, the flu, and certain respiratory ailments. Hes-
peridin fights allergic reactions by blocking the release
of histamine. It may also help reduce edema (accumula-
tion of fluid) in the legs. Hesperidin deficiency has been
linked to weaknesses in the walls of the blood vessels,
pain and weakness in the hands and feet, and leg cramps
at night. Hesperidin is mostly found in the pulps and
rinds of citrus fruits.
224
Ellagic acid helps to inhibit cancer by neutralizing
the effect of certain carcinogens. It is particularly helpful
in reducing the effects of nitrosamines, which are found
in tobacco and processed meat products such as bacon
and hot dogs. Ellagic acid reduces the effects of the toxic
and carcinogenic factors (aflatoxins) produced by As-
pergillus flavus molds on food. Aflatoxins may cause
liver damage and cancer. Ellagic acid diminishes the ef-
fects of polycyclic hydrocarbons produced by tobacco
smoke and air pollution, as well. Sources of ellagic acid
include strawberries, grapes, apples, cranberries, black-
berries, and walnuts.
Quercetin is a good antihistamine. It can help reduce
the inflammation that results from hay fever, allergies,
bursitis, gout, arthritis, and asthma. It may lessen other
asthma symptoms. Quercetin stimulates detoxification
in the liver. It strengthens the blood vessels, and is useful
in treating atherosclerosis (plaque build-up in the arter-
ies) and high cholesterol levels. It may help inhibit tumor
formation. Quercetin can be used to treat many of the
complications of diabetes. For example, it blocks the ac-
cumulation of sorbitol, which has been linked with
nerve, eye and kidney damage in diabetics; and it regu-
lates blood sugar levels. Quercetin inhibits the growth of
Helicobacter pylori, which has been implicated in the
development of peptic ulcers. It can also help diminish
the effects of the herpes virus, the Epstein-Barr virus (a
common virus; a common cause of mononucleosis), and
the polio virus. Quercetin is found in green tea, onion-
skins, kale, red cabbage, green beans, tomatoes, pota-
toes, lettuce, strawberries, cherries, and grapes. It is also
found in smaller amounts in many other foods.
Catechins and tannins can be used to stimulate
detoxification by the liver and to strengthen the blood
vessels. They also help reduce the inflammatory re-
sponse. Catechins and tannins may help inhibit the for-
mation of tumors. In addition, catechins can be used to
inhibit the breakdown of collagen and to treat hepatitis
and arthritis. Catechins and tannins are both found in
green and black teas.
Kaempferols stimulate liver detoxification and
strengthen the blood vessels. They may also inhibit
tumor formation. Strawberries, leeks, kale, broccoli,
radishes, endives, and red beets all are good sources of
kaempferols, but kaempferols are very common and
found in many plants and foods. Naringen may slow the
progression of heart disease and visual degeneration in
diabetes. It is a potent anticoagulant that keeps the arter-
ies clear and strong to prevent strokes, heart attacks, and
the blindness of diabetes. Naringen is an active ingredi-
ent of in grapefruits. Genestein is known to be a regula-
tor of estrogen. It is good for treating disorders of men-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Antioxidants — Nutrients that protect against oxi-
dation, a chemical reaction that can damage
human cells.
Blood-brain barrier — A feature of the brain
thought to consist of walls of capillaries that pre-
vent or delay the passage of some drugs and
chemicals into the central nervous system.
Free radicals — By-products of the process of form-
ing energy in the human body. Free radicals are
atoms or groups of atoms with an odd number of
electrons. They can damage important cellular
components, and can be checked by antioxidants.
struation and menopause. Genestein is found in soy-
beans and soy products.
Preparations
Since bioflavonoids are so widely available in fruits
in high concentrations, daily servings of whole fresh fruits
and fresh fruit juices should be consumed. Highly concen-
trated liquid extracts of some fruits are also available.
Precautions
Bioflavonoids are generally safe, even at very high
doses. However, pregnant women are advised not to take
megadoses of bioflavonoids. Preliminary studies have in-
dicated that there may be a link between infant leukemia
and high doses of bioflavonoids in the mother.
Side effects
Bioflavonoids are not toxic, even at high levels.
They are water soluble, and therefore, any in excess of
what is needed by the body is excreted in the urine.
Interactions
Bioflavonoids are usually found in close association
with vitamin C, and they enhance its effect. There are no
known drug interactions.
Resources
BOOKS
The Editors of Time-Life Books. The Drug &Natural Medicine
Advisor. Alexandria, Virginia: Time-Life Custom Publish-
ing, 1997.
Griffith, H., M.D. Vitamins, Minerals, & Supplements: The
Complete Guide. Arizona: Fisher Books, 1998.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Ronzio, Robert A. The Encyclopedia of Nutrition and Good
Health. New York: Facts on File, 1997.
Winter. Ruth, M.S. A Consumer’s Guide to Medicines in Food
New York: Random House, 1995.
OTHER
"All About Bioflavonoids.” MotherNature.com. http://www.
mothernature.com/articles/bioflavonoids/articlel.stm
(January 17, 2001).
Passwater. Richard A., Ph.D. “Bioflavonoids, ‘Vitamin P' and
Inflammation: An Interview with Dr. Miklos Gabor.” http://
www.nutritionfocus.com/nutrition_library/gabor_interview.
html (January 17, 2001).
Wolinsky, Howard. “Large Doses of Bioflavonoids Linked to
Leukemia in Children Pregnant Women Should Avoid
Megadoses, Researchers Say.” WehMD Medical News .
April 18, 2000. http://my.webmd.com/content/article/
1728.56735 (January 17, 2001).
Patience Paradox
Biological dentistry see Holistic dentistry
Biota
Description
Biota is the common name for Biota orientalis. It is
used in Chinese healing and called bai zi ren. In English
biota is sometimes called oriental arborvitae.
Biota is a slow-growing tree native to China. It
grows to a height of about 45 ft (15 m) in moist, well-
drained soils throughout East Asia. It tolerates air pollu-
tion well and will grow in cities. When cultivated, biota
produces an abundant seed crop. The leaves and seeds
are used in healing. A yellow dye can be made from the
young branches. Many varieties of biota are used for or-
namental landscaping.
Biota is an herb that is sometimes confused with
Thuja occidentalis. Thuja is a North American tree in the
cedar family that is called American arborvitae. The
leaves of thuja are sometimes used by Western herbalists,
but are used in very different ways from I). orientalis.
General use
Biota is one of the less important of the 50 funda-
mental herbs of Chinese herbalism. In Chinese herbal-
ism, biota is said to have a neutral nature and a sweet,
acid taste. It is associated primarily with the heart and di-
gestive system and is often a component of shen tonics.
Biota seeds are used as a sedative, to help disperse
anxiety and fear, and to reduce insomnia. Other uses are
225
Biota
Biotin
to treat heart palpitations, nervous disorders, night
sweats, and constipation. Biota is said to be especially
helpful for treating constipation in the elderly due to its
oily nature.
Biota leaves, either fresh or dried, are used to treat a
variety of conditions including:
• stopping various kinds of bleeding
• bacterial infection
• fever
• cough
• bronchitis
• asthma
• premature baldness
• skin infections
• mumps
• arthritis pain
• dysentery caused by bacteria
• constipation
Biota is an herb that has not received much attention
from scientists. There are very few chemical analyses or
laboratory studies done on biota leaves or seeds in either
Asia or the United States. Virtually all health claims for
this herb are based on its use in traditional Chinese
medicine and observations of herbalists rather than con-
trolled scientific studies.
Preparations
Biota seeds are prepared by boiling, and extracts are
made of the leaves. Commercially most biota is sold as
capsules. Most often biota is used as part of a formula or
tonic. It is a component of formulas that tend to stimulate
the heart and relieve stress, fatigue, and forgetfulness.
Biota is one ingredient of the cerebral tonic pills
called bu nao wan. These pills are used to improve con-
centration and treat conditions such as Alzheimer disease.
They are also given to combat restlessness and agitation.
Another common formula that contains biota is gin-
seng and zizyphus (tian wang bu xin dan). This formula
treats insomnia and disturbed sleep, nightmares, anxiety,
restlessness, forgetfulness, heart palpitations, and hard,
dry bowel movements. It is available in both tea and cap-
sule form. Dosage varies considerably depending on the
formula and the condition being treated.
Precautions
Some herbal practitioners recommend that biota not
be taken by pregnant women.
226
KEY TERMS
Shen — Shen is one of the five body energies. It in-
fluences mental, spiritual, and creative energy. Shen
tonics address deficiencies in this type of energy.
Side effects
No undesirable side effects have been reported.
Interactions
Biota and other Chinese herbs are often used togeth-
er with no reported interactions. Since biota has been
used almost exclusively in Chinese medicine, there are no
studies of its interactions with Western pharmaceuticals.
Resources
BOOKS
Molony, David. Complete Guide to Chinese Herbal Medicine.
New York: Berkeley Books, 1998.
Teegaurden. Ron. The Ancient Wisdom of the Chinese Tonic
Herbs. New York: Warner Books, 1998.
ORGANIZATIONS
American Association of Oriental Medicine. 433 Front Street,
Catasauqua, PA 18032. (610) 266-2433.
Tish Davidson
Biotin
Description
Biotin is a member of the B complex family, but is
not actually a vitamin. It is a coenzyme that works with
them. Also known as vitamin H and coenzyme R, it was
first isolated and described in 1936. It is water soluble
and very unstable; it can be destroyed by heat, cooking,
exposure to light, soaking, and prolonged contact with
water, baking soda, or any other alkaline element. The
body obtains biotin from food and can also synthesize
this nutrient from bacteria in the gut.
General use
Biotin is utilized by every cell in the body and con-
tributes to the health of skin, hair, nerves, bone marrow,
sex glands, and sebaceous glands. Apart from being a
vital cofactor to several enzymes, biotin is essential in
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
carbohydrate metabolism and the synthesis of fatty
acids. It is also involved in the transformation of amino
acids into protein. Biotin plays a role in cell growth and
division through its role in the manufacture of DNA and
RNA, the genetic components of cells.
Adequate biotin is required for healthy nails and
hair, and biotin deficiency is known to be a factor in
balding and the premature graying of hair. It has been
claimed that, as part of an orthomolecular regime, it can
reverse the graying of hair. When PABA and biotin are
taken together in adequate amounts they can restore hair
color. Biotin supplements will also effectively treat
weak, splitting nails.
Biotin can be a valuable tool to combat yeast infec-
tions, which are notoriously difficult to fight. In their
book The Yeast Syndrome , John Parks Trowbridge and
Morton Walker describe how adequate levels of biotin
can prevent Candida albicans from developing from its
yeast-like state into fungal form, in which it sends out
mycelium that further invade body organs.
Seborrheic dermatitis, or Leiner’s disease, which is
a non-itchy, red scaling rash affecting infants during the
first three months of life, is also treated with biotin and
other B complex vitamins.
Biotin has been used in conjunction with other nu-
trients as part of weight loss programs, as it aids in the
digestion and breakdown of fats.
High doses of biotin are sometimes used by the allo-
pathic medical profession to treat diabetes since it en-
hances sensitivity to insulin and effectively increases
levels of enzymes involved in glucose metabolism. In
2002, one company started clinical trials testing a combi-
nation of chromium picolinate and biotin for treatment
of type 2 diabetes. Biotin is also used to treat peripheral
neuropathy, a complication of diabetes, and patients
with Duchenne muscular dystrophy, who suffer from
metabolic deficiencies.
Biotin can be found in beans, breads, brewer’s
yeast, cauliflower, chocolate, egg yolks, fish, kidney,
legumes, liver, meat, molasses, dairy products, nuts, oat-
meal, oysters, peanut butter, poultry, wheat germ, and
whole grains.
Preparations
The recommended daily allowance for adults in the
United States is 30 meg. Daily requirements are estimat-
ed at 30 meg for adults and 35 meg for women who are
nursing. Supplementation ranges from 100-600 meg per
day, and can be obtained in the form of brewer’s yeast,
which contains biotin as part of the B complex, or as an
individual biotin supplement.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Precautions
The body needs biotin on a daily basis since it is not
stored to any great extent. Biotin requirements increase
during pregnancy and lactation. In 2002, an investigation
outlined the need for supplemental biotin during pregnan-
cy. Nearly 50 % of pregnant women appear to be defi-
cient in biotin, which could result in birth defects (at least
according to animal studies). Researchers suggest that bi-
otin be included in prenatal multivitamin formulas.
Those taking antibiotics should supplement their
diets with biotin. Certain individuals are at risk for bi-
otin deficiency, including infants fed biotin-deficient for-
mula or with inherited deficiency disorders, patients who
are fed intravenously, and anyone who habitually eats a
lot of raw egg whites, because they contain a protein
called avidin, which prevents the absorption of biotin.
Mild deficiency
Because it is synthesized in the gut, deficiency
symptoms of biotin are rare. However they may include
weakness, lethargy, grayish skin color, eczema (which
may include a scaly red rash around the nose, mouth and
other orifices), hair loss, cradle cap in infants, muscle
aches, impaired ability to digest fats, nausea, depres-
sion, loss of appetite, insomnia, high cholesterol levels,
eye inflammations, sensitivity to touch, anemia, and tin-
gling in the hands and feet.
Extreme deficiency
Symptoms of extreme biotin deficiency include ele-
vation of cholesterol levels, heart problems, and paraly-
sis. When extreme deficiency is a problem, the liver may
not be able to detoxify the body efficiently, and depres-
sion may develop into hallucinations. Infants may exhib-
it developmental delay and lack of muscle tone.
Biotin deficiency could result in a loss of immune
function, since animal experiments have shown that bi-
otin deficiency resulted in a decrease in white blood-cell
function. Because biotin is essential to the body’s meta-
bolic functions, any deficiency could result in impaired
metabolism as well.
Overdose
There have been no reports of effects of overdose of
biotin, even at very high doses, primarily because any
excess is excreted in the urine.
Side effects
There are no side effects associated with biotin sup-
plementation.
227
Biotin
Bipolar disorder
KEY TERMS
Coenzyme — A non-protein organic compound
that plays an essential role in the action of particu-
lar enzymes.
Lactobacillus — A bacteria present in the gut of
healthy people.
Mycelium — Fine thread-like tendrils sent out by a
fungus to seek nutrition, capable of invading body
organs.
Peripheral neuropathy — Weakness and numbness
of the nerves in the fingers and toes, which may
progress up the limb — often a complication of di-
abetes.
Interactions
Biotin works in conjunction with all the B vitamins,
which are synergistic, meaning they work best when all
are available in adequate amounts.
Raw egg white contains the protein avidin, which
prevents absorption of biotin.
Sulfa drugs, estrogen, and alcohol all increase the
amount of biotin needed in the body. In addition, anti-
convulsant drugs may lead to biotin deficiency. Long
term use of antibiotics may prevent the synthesis of bi-
otin in the gut by killing off the bacteria which help the
body produce biotin. Supplements of lactobacillus may
help the body make sufficient amounts of biotin after
long term antibiotic use.
Resources
BOOKS
Kenton, Leslie. The Joy of Beauty. Great Britain: Century Pub-
lishing Co Ltd., 1983.
Trowbridge, John Parks, and Morton Walker. The Yeast Syn-
drome. New York: Bantam Books, 1986.
PERIODICALS
“Biotin Deficiency in Pregnancy. (Nutrition and Pregnancy).”
Nutrition Research Newsletter (April 2002): 9—11.
Gaby, Alan R. “Biotin Needed During Pregnancy.” Townsend
Letter for Doctors and Patients (June 2002): 31.
“Nutrition 21 to Test Chromium/Biotin Combo in Diabetes.”
Nutraceuticals International (May 2002).
OTHER
“Vitamins, etc.” [cited August 1, 2000] <http://www.book-
man.com.au/vitamins/biotin. html> .
Patricia Skinner
Teresa G. Odle
228
Bipolar disorder
Definition
Bipolar, or manic-depressive disorder, is a mood
disorder that causes radical emotional changes and mood
swings, from manic highs to depressive lows. The major-
ity of bipolar individuals experience alternating episodes
of mania and depression.
Description
In the United States alone, bipolar disorder afflicts
approximately 2.3 million people, and nearly 20% of this
population will attempt suicide without effective treat-
ment intervention. The average age at onset of bipolar
disorder is from adolescence through the early twenties.
However, because of the complexity of the disorder, a
correct diagnosis can be delayed for several years or
more. In a survey of bipolar patients conducted by the
National Depressive and Manic Depressive Association
(NDMDA), one-half of respondents reported visiting
three or more professionals before receiving a correct di-
agnosis, and over one-third reported a wait of 10 years or
more before they were correctly diagnosed.
The Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition ( DSM-IV ), the diagnostic stan-
dard for mental health professionals in the United States,
defines four separate categories of bipolar disorder:
bipolar I, bipolar II, cyclothymia, and bipolar not-other-
wise-specified (NOS).
Bipolar I disorder is characterized by manic
episodes, the “high” of the manic-depressive cycle. A
bipolar patient experiencing mania often has feelings of
self-importance, elation, talkativeness, increased sociabil-
ity, and a desire to embark on goal-oriented activities,
coupled with the characteristics of irritability, impatience,
impulsiveness, hyperactivity, and a decreased need for
sleep. Usually this manic period is followed by a period
of depression, although a few bipolar I individuals may
not experience a major depressive episode. Mixed states,
where both manic or hypomanic symptoms and depres-
sive symptoms occur at the same time, also occur fre-
quently with bipolar I patients (for example, depression
with racing thoughts of mania). Also, dysphoric mania is
common (mania characterized by anger and irritability).
Bipolar II disorder is characterized by major depres-
sive episodes alternating with episodes of hypomania, a
milder form of mania. Bipolar depression may be difficult
to distinguish from a unipolar major depressive episode.
Patients with bipolar depression tend to have extremely
low energy, retarded mental and physical processes, and
more profound fatigue (for example, hypersomnia; a
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
sleep disorder marked by a need for excessive sleep or
sleepiness when awake) than unipolar depressives.
Cyclothymia refers to the cycling of hypomanic
episodes with depression that does not reach major de-
pressive proportions. One-third of patients with cy-
clothymia will develop bipolar I or 11 disorder later in life.
A phenomenon known as rapid cycling occurs in up
to 20% of bipolar I and II patients. In rapid cycling,
manic and depressive episodes must alternate frequently,
at least four times in 12 months, to meet the diagnostic
definition. In some cases of “ultra-rapid cycling,” the pa-
tient may bounce between manic and depressive states
several times within a 24-hour period. This condition is
very hard to distinguish from mixed states.
Bipolar NOS is a category for bipolar states that do not
clearly fit into the bipolar I, II, or cyclothymia diagnoses.
Causes & symptoms
The source of bipolar disorder has not been clearly
defined. Because two-thirds of bipolar patients have a
family history of affective or emotional disorders, re-
searchers have searched for a genetic link to the disorder.
Several studies have uncovered a number of possible ge-
netic connections to the predisposition for bipolar disor-
der. Recent studies emphasize a hereditary connection
and early research links several chromosomes, one par-
ticularly related to bipolar II, to development of the dis-
order. A 2003 study found that schizophrenia and bipo-
lar disorder could have similar genetic causes that arise
from certain problems with genes associated with myelin
development in the central nervous system. (Myelin is a
white, fat-like substance that forms a sort of layer or
sheath around nerve fibers.)
Another possible biological cause under investiga-
tion is the presence of an excessive calcium build-up in
the cells of bipolar patients. Also, dopamine and other
neurochemical transmitters appear to be implicated in
bipolar disorder and these are under intense investigation.
Over one-half of patients diagnosed with bipolar
disorder have a history of substance abuse. There is a
high rate of association between cocaine abuse and bipo-
lar disorder. Some studies have shown up to 30% of
abusers meeting the criteria for bipolar disorder. The
emotional and physical highs and lows of cocaine use
correspond to the manic depression of the bipolar pa-
tient, making the disorder difficult to diagnose.
For some bipolar patients, manic and depressive
episodes coincide with seasonal changes. Depressive
episodes are typical during winter and fall, and manic
episodes are more probable in the spring and summer
months.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Symptoms of bipolar depressive episodes include
low energy levels, feelings of despair, difficulty concen-
trating, extreme fatigue, and psychomotor retardation
(slowed mental and physical capabilities). Manic
episodes are characterized by feelings of euphoria, lack
of inhibitions, racing thoughts, diminished need for
sleep, talkativeness, risk taking, and irritability. In ex-
treme cases, mania can induce hallucinations and other
psychotic symptoms such as grandiose illusions.
Diagnosis
Bipolar disorder usually is diagnosed and treated by
a psychiatrist and/or a psychologist with medical assis-
tance. In addition to an interview, several clinical inven-
tories or scales may be used to assess the patient’s men-
tal status and determine the presence of bipolar symp-
toms. These include the Millon Clinical Multiaxial In-
ventory III (MCMI-III), Minnesota Multiphasic
Personality Inventory II (MMPI-2), the Internal State
Scale (ISS), the Self-Report Manic Inventory (SRMI),
and the Young Mania Rating Scale (YMRS). The tests
are verbal and/or written and are administered in both
hospital and outpatient settings.
Psychologists and psychiatrists typically use the cri-
teria listed in the Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition (DSM-IV) as a guide-
line for diagnosis of bipolar disorder and other mental
illnesses. DSM-IV describes a manic episode as an ab-
normally elevated or irritable mood lasting a period of at
least one week that is distinguished by at least three of
the mania symptoms: inflated self-esteem, decreased
need for sleep, talkativeness, racing thoughts, dis-
tractibility, increase in goal-directed activity, or exces-
sive involvement in pleasurable activities that have a
high potential for painful consequences. If the mood of
the patient is irritable and not elevated, four of the symp-
toms are required.
Although many clinicians find the criteria too rigid,
a hypomanic diagnosis requires a duration of at least
four days with at least three of the symptoms indicated
for manic episodes (four if mood is irritable and not ele-
vated). DSM-IV notes that unlike manic episodes, hypo-
manic episodes do not cause a marked impairment in so-
cial or occupational functioning, do not require hospital-
ization, and do not have psychotic features. In addition,
because hypomanic episodes are characterized by high
energy and goal directed activities and often result in a
positive outcome, or are perceived in a positive manner
by the patient, bipolar II disorder can go undiagnosed.
In late 2001, a study reported at an international
psychiatric conference that impulsivity remains a key
229
Bipolar disorder
Bipolar disorder
distinguishing characteristic for bipolar disorder, at least
when patients are in manic phases.
Bipolar symptoms often present differently in chil-
dren and adolescents. Manic episodes in these age groups
typically are characterized by more psychotic features
than in adults, which may lead to a misdiagnosis of schiz-
ophrenia. Children and adolescents also tend toward irri-
tability and aggressiveness instead of elation. Further,
symptoms tend to be chronic, or ongoing, rather than
acute, or episodic. Bipolar children are easily distracted,
impulsive, and hyperactive, which can lead to a misdiag-
nosis of attention-deficit hyperactivity disorder
(ADHD). Furthermore, their aggression often leads to vio-
lence, which may be misdiagnosed as a conduct disorder.
Substance abuse, thyroid disease, and use of pre-
scription or over-the-counter medication can mask or
mimic the presence of bipolar disorder. In cases of sub-
stance abuse, the patient must ordinarily undergo a peri-
od of detoxification and abstinence before a mood dis-
order is diagnosed and treatment begins.
Treatment
Alternative treatments for bipolar disorder generally
are considered to be complementary treatments to con-
ventional therapies. General recommendations for con-
trolling bipolar symptoms include maintaining a calm
environment, avoiding overstimulation, getting plenty of
rest, regular exercise, and proper diet. Psychotherapy
and counseling are generally recommended treatments
for the disease, whether treated alternatively or allopathi-
cally. Psychotherapy, such as cognitive-behavioral thera-
py, can be a useful tool in helping patients and their fam-
ilies adjust to the disorder and in reducing the risk of sui-
cide. Also, educational counseling is recommended for
the patient and family. In fact, a 2003 report revealed that
people on medication for bipolar disorder have better re-
sults if they also participate in family-focused therapy.
Chinese herbs also may help to soften mood swings.
Traditional Chinese medicine (TCM) remedies are pre-
scribed based on the patient’s overall constitution and the
presentation of symptoms. These remedies can stabilize
moods, not just treat swings in mood. A TCM practitioner
might recommend a mixture called the Iron Filings Com-
bination (which includes the Chinese herbs asparagus,
ophiopogon, fritillaria, arisaema, orange peel, polygala,
acorns, forsythia, hoelen, fu-shen, scrophularia, uncaria
stem, salvia, and iron filings) to treat certain types of
mania in the bipolar patient. There are other formulas for
depression. A trained practitioner should guide all of these
remedies. Compliance can be better with natural remedies
if they work. These remedies do not flatten moods and
people in manic states do not like to be suppressed.
230
Acupuncture can be used for treatment to help
maintain a more even temperament.
Biofeedback is effective in helping some patients
control symptoms such as irritability, poor self control,
racing thoughts, and sleep problems. A diet low in vana-
dium (a mineral found in meats and other foods) and
high in vitamin C may be helpful in reducing depression.
In 2003, a report stated that rhythm therapy, or sim-
ply taking steps to go to bed and wake up at consistent
times each day, helps some people with bipolar disorder
maintain mood stability, especially when faced with psy-
chosocial stress.
Recommended herbal remedies to ease depressive
episodes may include damiana ( Turnera diffusa), gin-
seng ( Panax ginseng), kola (Cola nitida), lady’s slipper
(Cypripedium calceolus), lavender (Lavandula angusti-
folia), lime blossom (Tilia x vulgaris), oats (Avena
sativa), rosemary ( Rosmarinus officinalis), skullcap
(Scutellaria laterifolia), St. John’s wort (Hypericum
perforatum), valerian (Valeriana officinalis), and ver-
vain ( Verbena officinalis).
Allopathic treatment
Allopathic treatment of bipolar disorder is usually
by means of medication. A combination of mood stabi-
lizing agents with antidepressants, antipsychotics, and
anticonvulsants is used to regulate manic and depressive
episodes.
Mood stabilizing agents such as lithium, carba-
mazepine, and valproate are prescribed to regulate the
manic highs and lows of bipolar disorder:
• Lithium (Cibalith-S, Eskalith, Lithane, Lithobid,
Lithonate, Lithotabs) is one of the oldest and most fre-
quently prescribed drugs available for the treatment of
bipolar mania and depression. Lithium has also been
shown to be effective in regulating bipolar depression, but
is not recommended for mixed mania. Possible side ef-
fects of the drug include weight gain, thirst, nausea and
hand tremors. Prolonged lithium use may also cause hy-
perthyroidism (a disease of the thryoid that is marked by
heart palpitations, nervousness, the presence of goiter,
sweating, and a wide array of other symptoms).
• Carbamazepine (Tegretol, Atretol) is an anticonvulsant
drug usually prescribed in conjunction with other mood
stabilizing agents. The drug is often used to treat bipo-
lar patients who have not responded well to lithium
therapy. Blurred vision and abnormal eye movement
are two possible side effects of carbamazepine therapy.
• Valproate (divalproex sodium, or Depakote; valproic
acid, or Depakene) is one of the few drugs available that
has been proven effective in treating rapid cycling bipo-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
lar and mixed states patients. Valproate is prescribed
alone or in combination with carbamazepine and/or
lithium. Stomach cramps, indigestion, diarrhea, hair
loss, appetite loss, nausea, and unusual weight loss or
gain are some of the common side effects of valproate.
Because antidepressants may stimulate manic
episodes in some bipolar patients, their use is typically
short-term. Selective serotonin reuptake inhibitors
(SSRIs) or, less often, monoamine oxidase inhibitors
(MAOIs) are prescribed for episodes of bipolar depres-
sion. Tricyclic antidepressants used to treat unipolar de-
pression may trigger rapid cycling in bipolar patients and
are, therefore, not a preferred treatment option for bipo-
lar depression.
Electroconvulsive therapy (ECT), has a high success
rate for treating both unipolar and bipolar depression,
and mania. However, because of the convenience of drug
treatment and the stigma sometimes attached to ECT
therapy, ECT usually is employed after all pharmaceuti-
cal treatment options have been explored. ECT is given
under anesthesia and patients are given a muscle relaxant
medication to prevent convulsions. The treatment con-
sists of a series of electrical pulses that move into the
brain through electrodes on the patient’s head. Although
the exact mechanisms behind the success of ECT thera-
py are not known, it is believed that this electrical cur-
rent alters the electrochemical processes of the brain,
consequently relieving depression. In bipolar patients,
ECT often is used in conjunction with drug therapy.
Long-acting benzodiazepines such as clonazepam
(Klonapin) and alprazolam (Xanax) are used for rapid
treatment of manic symptoms to calm and sedate pa-
tients until mania or hypomania have waned and mood
stabilizing agents can take effect. Neuroleptics such as
chlorpromazine (Thorazine) and haloperidol (Haldol)
also are used to control mania while a mood stabilizer
such as lithium or valproate takes effect. Clozapine
(Clozaril) is an atypical antipsychotic medication used to
control manic episodes in patients who have not re-
sponded to typical mood stabilizing agents. The drug
also has been a useful prophylactic, or preventative treat-
ment, in some bipolar patients.
The treatment rTMS, or repeated transcranial mag-
netic stimulation, is a relatively new and still experimen-
tal treatment for the depressive phase of bipolar disorder.
In rTMS, a large magnet is placed on the patient’s head
and magnetic fields of different frequency are generated
to stimulate the left front cortex of the brain. Unlike
ECT, rTMS requires no anesthesia and does not induce
seizures.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Expected results
While most patients will show some positive re-
sponse to treatment, response varies widely, from full re-
covery to a complete lack of response to all treatments,
alternative or allopathic. Drug therapies frequently need
adjustment to achieve the maximum benefit for the pa-
tient. Bipolar disorder is a chronic recurrent illness in
over 90% of those afflicted, and one that requires life-
long observation and treatment after diagnosis. Patients
with untreated or inadequately treated bipolar disorder
have a suicide rate of 15-25% and a nine-year decrease
in life expectancy. With proper treatment, the life ex-
pectancy of the bipolar patient will increase by nearly
seven years and work productivity increases by 10 years.
Prevention
The ongoing medical management of bipolar disor-
der is critical to preventing relapse, or recurrence, of
manic episodes. Even in carefully controlled treatment
programs, bipolar patients may experience recurring
episodes of the disorder. Patient education in the form of
psychotherapy or self-help groups is crucial for training
bipolar patients to recognize signs of mania and depres-
sion and to take an active part in their treatment program.
Resources
BOOKS
American Psychiatric Association. Diagnostic and Statistical
Manual of Mental Disorders. 4th ed. Washington, DC:
American Psychiatric Press, Inc., 1994.
Whybrow, Peter C. A Mood Apart. New York: Harper Collins,
1997.
PERIODICALS
Biederman, Joseph A. "Is There a Childhood Form of Bipolar
Disorder?” Harvard Mental Health Letter. 13, no. 9
(March 1997): 8.
Bowden, Charles L. “Choosing the Appropriate Therapy for
Bipolar Disorder.” Medscape Mental Health. 2, no. 8
(1997). http://www.medscape.com.
Bowden, Charles L. “Update on Bipolar Disorder: Epidemiolo-
gy, Etiology, Diagnosis, and Prognosis.” Medscape Men-
tal Health. 2, no. 6 (1997). http://www.medscape.com.
"Family-focused Therapy May Reduce Relapse Rate." Health
& Medicine Week (September 29, 2003): 70.
Francis, A., J.P Docherty, and D.A. Kahn. "The Expert Con-
sensus Guideline Series: Treatment of Bipolar Disorder.”
Journal of Clinical Psychiatry. 57, supplement 12A (No-
vember 1996): 1-89.
Sherman, Carl. “Progress in Bipolar Genetics slow, but promis-
ing.” Clinical Psychiatry News. 29, no. 12 (December
2001): 4.
Sherman, Carl. “Impulsivity a Key Characteristic of Bipolar
Disorder.” Clinical Psychiatry News. 29, no. 1 1 (Novem-
ber 2001): 35.
231
Bipolar disorder
Bites and stings
KEY TERMS
Affective disorder — An emotional disorder involv-
ing abnormal highs and/or lows in mood. Now
termed mood disorder.
Anticonvulsant medication — A drug used to pre-
vent convulsions or seizures; often prescribed in
the treatment of epilepsy. Several anticonvulsant
medications have been found effective in the
treatment of bipolar disorder.
Antipsychotic medication — A drug used to treat
psychotic symptoms, such as delusions or halluci-
nations, in which patients are unable to distin-
guish fantasy from reality.
Benzodiazpines — A group of tranquilizers having
sedative, hypnotic, antianxiety, amnestic, anticon-
vulsant, and muscle relaxant effects.
DSM-IV — Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition (DSM-IV). This
reference book, published by the American Psy-
chiatric Association, is the diagnostic standard for
most mental health professionals in the United
States.
ECT — Electroconvulsive therapy sometimes is
used to treat depression or mania when pharma-
ceutical treatment fails.
Hypomania — A milder form of mania that is char-
acteristic of bipolar II disorder.
Mania — An elevated or euphoric mood or irritable
state that is characteristic of bipolar I disorder.
Mixed mania/mixed state — A mental state in
which symptoms of both depression and mania
occur simultaneously.
Neurotransmitter — A chemical in the brain that
transmits messages between neurons, or nerve
cells. Changes in the levels of certain neurotrans-
mitters, such as serotonin, norepinephrine, and
dopamine, are thought to be related to bipolar
disorder.
Psychomotor retardation — Slowed mental and
physical processes characteristic of a bipolar de-
pressive episode.
“Schizophrenia and Bipolar Disorder Could Have Similar Ge-
netic Causes.” Genomics & Genetics Weekly (September
26, 2003): 85.
Spete, Heidi. “Rhythm Therapy Can Stabilize Bipolar Disorder
Patients.” Clinical Psychiatry News. (July 2003): 55.
232
ORGANIZATIONS
American Psychiatric Association (APA). Office of Public Af-
fairs. 1400 K Street NW, Washington. DC 20005. (202)
682-6119. http://www.psych.org/.
National Alliance for the Mentally 111 (NAMI). 200 North
Glebe Road, Suite 1015, Arlington, VA 22203-3754. (800)
950-6264. http://www.nami.org.
National Depressive and Manic-Depressive Association
(NDMDA). 730 N. Franklin St., Suite 501, Chicago, IL
60610. (800) 826-3632. http://www.ndmda.org.
National Institute of Mental Health (NIMH). 5600 Fishers
Lane, Rm. 7C-02, Bethesda, MD 20857. (301) 443-4513.
http://www.nimh.nih.gov/.
Paula Ford-Martin
Teresa G. Odle
Birth see Childbirth
Bites and stings
Definition
A bite is an injury caused by an animal, such as a
mammal or insect, that breaks the skin. A sting is a punc-
ture wound made by insects or marine animals. There is
often a danger of infection from toxins or venom with
bites and stings.
Description
In the United States, dogs surpass all other mammals
in the number of bites inflicted on humans. Children face
a greater risk than adults, and children under 10 years old
are more liable than anyone to suffer serious bites to the
face, neck, and head. Cat bites are far less common than
dog bites, but they carry a higher risk of infection. Bites
from wild animals should be of especial concern due to
the risk of rabies. More than 70,000 human-to-human
bites a year are reported in the United States. Human
bites are more infectious than those of any other animal.
The most common invertebrates responsible for
bites and stings include lice, bedbugs, fleas, mosquitoes,
black flies, fire ants, chiggers, ticks, centipedes, scorpi-
ons, spiders, bees, and wasps. Black widows and brown
recluse spiders are the two most common poisonous spi-
ders in the United States. The bites of most other spiders
in North America cause only minor reactions. Ticks at-
tach themselves to the skin and feed on the blood of ani-
mals. Most are relatively harmless, but some carry dis-
eases such as Rocky Mountain spotted fever and Lyme
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Bites and stings
KEY TERMS
Affective disorder — An emotional disorder involv-
ing abnormal highs and/or lows in mood. Now
termed mood disorder.
Anticonvulsant medication — A drug used to pre-
vent convulsions or seizures; often prescribed in
the treatment of epilepsy. Several anticonvulsant
medications have been found effective in the
treatment of bipolar disorder.
Antipsychotic medication — A drug used to treat
psychotic symptoms, such as delusions or halluci-
nations, in which patients are unable to distin-
guish fantasy from reality.
Benzodiazpines — A group of tranquilizers having
sedative, hypnotic, antianxiety, amnestic, anticon-
vulsant, and muscle relaxant effects.
DSM-IV — Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition (DSM-IV). This
reference book, published by the American Psy-
chiatric Association, is the diagnostic standard for
most mental health professionals in the United
States.
ECT — Electroconvulsive therapy sometimes is
used to treat depression or mania when pharma-
ceutical treatment fails.
Hypomania — A milder form of mania that is char-
acteristic of bipolar II disorder.
Mania — An elevated or euphoric mood or irritable
state that is characteristic of bipolar I disorder.
Mixed mania/mixed state — A mental state in
which symptoms of both depression and mania
occur simultaneously.
Neurotransmitter — A chemical in the brain that
transmits messages between neurons, or nerve
cells. Changes in the levels of certain neurotrans-
mitters, such as serotonin, norepinephrine, and
dopamine, are thought to be related to bipolar
disorder.
Psychomotor retardation — Slowed mental and
physical processes characteristic of a bipolar de-
pressive episode.
“Schizophrenia and Bipolar Disorder Could Have Similar Ge-
netic Causes.” Genomics & Genetics Weekly (September
26, 2003): 85.
Spete, Heidi. “Rhythm Therapy Can Stabilize Bipolar Disorder
Patients.” Clinical Psychiatry News. (July 2003): 55.
232
ORGANIZATIONS
American Psychiatric Association (APA). Office of Public Af-
fairs. 1400 K Street NW, Washington. DC 20005. (202)
682-6119. http://www.psych.org/.
National Alliance for the Mentally 111 (NAMI). 200 North
Glebe Road, Suite 1015, Arlington, VA 22203-3754. (800)
950-6264. http://www.nami.org.
National Depressive and Manic-Depressive Association
(NDMDA). 730 N. Franklin St., Suite 501, Chicago, IL
60610. (800) 826-3632. http://www.ndmda.org.
National Institute of Mental Health (NIMH). 5600 Fishers
Lane, Rm. 7C-02, Bethesda, MD 20857. (301) 443-4513.
http://www.nimh.nih.gov/.
Paula Ford-Martin
Teresa G. Odle
Birth see Childbirth
Bites and stings
Definition
A bite is an injury caused by an animal, such as a
mammal or insect, that breaks the skin. A sting is a punc-
ture wound made by insects or marine animals. There is
often a danger of infection from toxins or venom with
bites and stings.
Description
In the United States, dogs surpass all other mammals
in the number of bites inflicted on humans. Children face
a greater risk than adults, and children under 10 years old
are more liable than anyone to suffer serious bites to the
face, neck, and head. Cat bites are far less common than
dog bites, but they carry a higher risk of infection. Bites
from wild animals should be of especial concern due to
the risk of rabies. More than 70,000 human-to-human
bites a year are reported in the United States. Human
bites are more infectious than those of any other animal.
The most common invertebrates responsible for
bites and stings include lice, bedbugs, fleas, mosquitoes,
black flies, fire ants, chiggers, ticks, centipedes, scorpi-
ons, spiders, bees, and wasps. Black widows and brown
recluse spiders are the two most common poisonous spi-
ders in the United States. The bites of most other spiders
in North America cause only minor reactions. Ticks at-
tach themselves to the skin and feed on the blood of ani-
mals. Most are relatively harmless, but some carry dis-
eases such as Rocky Mountain spotted fever and Lyme
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
disease. Now, people worry about the danger or West
Nile virus from mosquito bites. Bees and wasps will
sting to defend their nests or if they are disturbed. Fifty
or more people a year die in the United States after being
stung by bees, wasps, or fire ants. Almost all of those
deaths are the result of allergic reactions.
The poisonous snakes of the United States are divid-
ed into two families, pit vipers (which include rat-
tlesnakes, copperheads, and cottonmouths, also called
water moccasins) and the coral snake family. Pit vipers
are responsible for about 99% of the poisonous snakebites
in the United States. Each year about 8,000 people in the
United States fall victim to a venomous snakebite. How-
ever, only about 15 of those people die. Most deaths are
due to rattlesnake bites. In comparison, coral snakes are
responsible for about 25 bites a year in the United States.
Jellyfish, stingrays, sea urchins, sea anemones, bar-
racudas, and coral pose a threat to those who live or va-
cation in coastal communities. The majority of stings re-
ceived from marine animals happen in saltwater and are
rarely life-threatening.
Causes & symptoms
The typical animal bite results in a laceration, tear,
puncture, or crush injury. Cat bites are mostly found on the
arms and hands, with deep puncture wounds that can reach
to muscles, tendons, and bones. Human bites result from
fights, sexual activity, and seizures. They may also be due
to spousal or child abuse. Children often bite other chil-
dren, but those bites are hardly ever severe. Human bites
are capable of transmitting a wide range of dangerous dis-
eases, including hepatitis B, syphilis, and tuberculosis.
People do not always feel a spider bite. In most
cases, spider bites produce only minor symptoms. The
first, and possibly only, evidence of a bite may be a mild
swelling of the injured area and puncture marks or blis-
ters. The affected area may be painful, itchy, or discol-
ored. With more serious bites, there may be severe mus-
cle cramps and rigidity of the abdominal muscles shortly
after being bitten. Other possible symptoms include ex-
cessive sweating, nausea, vomiting, headaches, fever,
chills, edema, and dizziness, as well as problems with
breathing, vision, and speech. In addition, a brown spi-
der’s bite can lead to necrotic arachnidism, in which the
tissue around the bite dies. This can produce an open
sore that that can take years to heal completely. The
symptoms of bee and wasp stings include pain, redness,
swelling, and itchiness at the area of the sting. Multiple
stings can have much more severe consequences. The
danger signs of a severe allergic reaction, called anaphy-
lactic shock, need immediate medical attention. They in-
clude nausea, chest pain, abdominal cramps, diarrhea,
and difficulty swallowing or breathing.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
*
A close-up view of lacerations on the shin of an adult
woman, inflicted by a Rottweiler dog. (Custom Medical Stock
Photo. Reproduced by permission.)
Venomous pit viper bites usually begin to swell with-
in 10 minutes and sometimes are painful. Other symptoms
include edema at the wound site, skin blisters and discol-
oration, weakness, sweating, nausea, faintness, dizziness,
bruising, and tender lymph nodes. Severe poisoning can
lead to tingling sensations, muscle contractions, an elevat-
ed heart rate, rapid breathing, large drops in body temper-
ature and blood pressure, vomiting of blood, and coma.
Coral snake bites are painful, and the effects of the venom
may include tingling at the wound site, weakness, nausea,
vomiting, excessive salivation, and irrational behavior.
Nerves can become paralyzed, causing double vision, dif-
ficulty swallowing and speaking, and respiratory prob-
lems. Poisonous snakes often introduce little or no venom
into the victim’s body when they bite. The symptoms of
these bites are not so severe. However, there is still a dan-
ger that the wounds can become infected by harmful mi-
croorganisms from the snake’s mouth.
Jellyfish venom is delivered by barbs located on
their tentacles. These barbs can penetrate the skin of
people who brush up against them, even if the jellyfish is
dead or the tentacle is severed from the body. Painful and
itchy red lesions arise instantly on contact. The pain can
continue up to 48 hours. Severe cases may lead to skin
necrosis, muscle spasms and cramps, vomiting, nausea,
diarrhea, headaches, excessive sweating, and other
symptoms. In rare cases, jellyfish venom may cause car-
diorespiratory failure.
Tail spines are the delivery mechanism for stingray
venom. Stingray venom produces immediate, excruciating
pain that lasts several hours. They cause deep puncture
wounds, which may become infected if pieces of the spines
become embedded in them. Sometimes the victim suffers a
severe reaction, including vomiting, diarrhea, hemorrhag-
ing, a drop in blood pressure, and cardiac arrhythmia.
233
Bites and stings
Bites and stings
Signs of infection in a bite or sting site include red-
ness, pain, swelling, warmth, and a discharge filled with
pus. An inflammation of the connective tissue, called
cellulitis, may also result. Sometimes systemic, and pos-
sibly life-threatening, infections develop, especially
among those who are immunosuppressed.
Diagnosis
Most bites and stings are minor and do not need to be
formally diagnosed. When required, though, diagnosis re-
lies on a physical examination of the victim, information
about the circumstances of the injury, and a look at the an-
imal that caused the injury, if possible. It is especially im-
portant to retrieve the live animal or carcass of dogs, wild
animals, snakes, and spiders for assessment. Information
about tetanus immunization history and possible allergies
to venom is important. A physical exam may be required
to assess damage caused by deep puncture wounds or se-
vere crush injuries. Chest x rays and electrocardiography
may be required to assess severe symptoms. Laboratory
tests for identifying the microorganisms may be ordered if
there is an infection. Blood and urine tests also may be
taken. Testing the blood for hepatitis B and other diseases
is always necessary after a human bite, for example. Med-
ical professionals should also look for indications of
spousal or child abuse in cases of human bites.
Treatment
Some bites and stings, such as those from venomous
snakes, require immediate medical attention, as do a host
of others. So often, it is best to check with a medical/
emergency practitioner first. Also, once a patient begins
treating a bite or sting with an alternative method, if
signs of infection or severe allergic reaction appear, he or
she should seek immediate medical help.
Homeopathic remedies can be useful for relieving
the pain and swelling of bites and stings. If there is a pos-
sible allergic reaction, these remedies can be used while
awaiting emergency care. Aconitum can be helpful, espe-
cially if the person feels fearful or panicked after being
stung. Aconitum should be used while symptoms are in-
tense, and then can be followed a by another remedy, as
indicated. Apis mellifica is especially useful for bee
stings, and it can help to reduce the allergic reaction. Car-
bolicum acidum can also be used to treat an allergic reac-
tion, especially when the person feels sick and weak and
has trouble breathing. Cantharis, Ledum palustre, Hyper-
icum, and Urtica mens are other useful remedies that
may be indicated. A 6c or 12c dose of the chosen remedy
can be taken every 15 minutes for up to four doses.
Neem, an Ayurvedan remedy, can be used to soothe
minor bites and stings as well as to keep insects away. A
234
thick paste can be made from neem powder blended with
warm water. It can then be applied to the affected area
twice daily. To prevent insect bites altogether, neem oil
can be rubbed on exposed skin as a repellant. Another
Ayurvedic remedy for soothing insect bites uses the herb
cilantro. One cup of the fresh leaves should be mixed
with 1/3 cup of water in a blender and strained. The juice
should be stored in the refrigerator, and 2 tbsp can be
taken three times per day. The pulp should be saved and
applied directly to affected areas once or twice daily.
A compress made from meat tenderizer that contains
either papain or bromelain breaks down the venom of bites
and stings. This is because most venom is protein-based.
The meat tenderizer functions by breaking down such pro-
teins, which neutralizes the venom. A thick paste can be
made using warm water or rubbing alcohol and powdered
meat tenderizer and then applied directly to the affected
areas for relief. Powdered bromelain or papain can also be
used. The typical home’s kitchen or medicine cabinet holds
quick soothers for bee and wasp stings. Bicarbonate of soda
or ammonia can soothe a bee sting and vinegar or lemon
juice have been shown to help soothe wasp stings.
Allopathic treatment
Minor animal bites can be treated at home. The
wound should be washed with soap and water. Applying
pressure to the injured area with a clean towel or sterile
bandage can stop bleeding. Antibiotic ointment and a
sterile dressing can be applied to the wound if necessary.
Alternately, to minimize swelling and infection, ice can
be applied to the wound. Bites that do not stop bleeding
after 15 minutes with pressure should be seen by a med-
ical professional. Medical attention may also be required
if there are signs of infection. People who have been bit-
ten by a cat or by a human should always see a doctor.
The same is true for snake bites; bites that are deep or
gaping; bites to the head, hands, or feet; and bites that
may be in conjunction with broken bones, damaged
nerves, or any other major injury. If an unfamiliar animal
bites, especially for no apparent reason, rabies may be
suspected. A physician should be consulted. Dogs, rac-
coons, skunks, bats, coyotes, foxes, and ground hogs
often carry rabies. In cases of suspected rabies, the victim
will be given several injections with rabies vaccine. Dia-
betics, AIDS patients, cancer patients, people who have
not had a tetanus shot in five years, and anyone else who
has increased susceptibility to infection should also seek
medical treatment for all bites and serious sting wounds.
Medical treatment may require the removal of dead
and damaged tissue. Any patient whose tetanus shots are
not up-to-date should receive a booster shot. Some wounds
are left open and allowed to heal on their own, while others
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
may require stitches. Antibiotics are usually limited to pa-
tients whose injuries or other health problems make them
likely candidates for infection. Cat bites and human bites,
however, are usually treated with antibiotics. The patient
may also require immunization against hepatitis B and
other diseases. A follow-up visit could be required.
An ice pack should be applied to the area of a spider
bite as soon as it is discovered. Treatment for a serious
spider bite may involve the administering of muscle re-
laxants, antihistamines, antibiotics, pain medication, and
possibly a tetanus shot. Areas of necrosis may need de-
bridement and skin grafts. An antivenin is available, but
it is not necessary in most cases, and could possibly
cause unpleasant side effects.
Most stings can be treated at home. A stinger can be
scraped off the skin with a blade, fingernail, credit card, or
stiff piece of paper. Tweezers are not recommended, since
they may actually push more venom into the wound. The
area should then be cleaned and covered with ice. Aspirin
and other painkillers, antihistamines, and calamine lotion
are good for reducing symptoms. People who experience
an allergic reaction, or who are at risk for one, should seek
immediate medical attention. People who are allergic
should carry emergency kits containing epinephrine to
counter anaphylactic shock at all times. Ticks can be care-
fully removed at home using tweezers. It is important to be
sure that the head of the tick is not left embedded in the
skin. If symptoms such as fever, rash or pain develop after
a tick bite, a physician should be consulted immediately.
Although most snakes are not poisonous, any snakebite
should immediately be examined at a hospital. If there is
time, the victim should wash the wound site with soap and
water, and then keep the injured area still and at a level
lower than the heart. The injured person should not have
anything to eat or drink, especially alcohol, until an evalua-
tion and treatment is obtained. There is controversy about
the use of tourniquets as well as sucking out venom. These
should only be done when help is far away and by someone
familiar with first aid techniques. Minor rattlesnake bites
can be successfully treated without antivenin, as can the
bites of copperhead and water moccasins. However, coral
snake and the more dangerous rattlesnake bites require an-
tivenin. Other treatment measures include antibiotics to pre-
vent infection and a tetanus booster shot.
When dealing with bites or stings of marine animals,
the victim should be kept still. Gloves should be worn
when removing stingers. The area should be washed with
saltwater and then soaked in very hot water for 30-90
minutes to neutralize the venom. Vinegar and other sub-
stances are used to neutralize jellyfish barbs, which are
then scraped off. A doctor will usually examine stingray
wounds to ensure that no pieces of the spines remain.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Antivenin — Antibodies taken from the serum of
horses that can be used to neutralize the venom of
snakes and insects.
Compress — A cloth used to apply heat, cold, or
medications to the skin.
Debridement — The surgical removal of dead tis-
sue.
Edema — An accumulation of excess fluid in the
tissues of the body, often due to inflammation or
injury.
Electrocardiography — A procedure for measuring
heart activity.
Hemorrhaging — Heavy or uncontrollable bleed-
ing.
Necrosis — The death of tissue in response to in-
jury or disease.
Tetanus — A potentially fatal infection of the cen-
tral nervous system, found in wounds.
Anesthetic ointments, antihistamine creams, and steroid
lotions are sometimes beneficial. If the bites or stings are
severe, they may require emergency care.
Expected results
Most bites and stings require little intervention, and
clear up in a few hours or days. Those most at risk of se-
vere problems with bites and stings are very young chil-
dren, the elderly, those who are immunosuppressed, and
people who are allergic to venom. Serious bites and
stings require prompt treatment to ensure a favorable
outcome. Infected bites may require hospitalization and
can be fatal if neglected. In some cases, medication and
surgery may be necessary. Some snakebites may result in
amputation, permanent deformity, or loss of function in
the injured area. People who are allergic to stings may
experience a severe, and occasionally fatal, reaction.
Prevention
Insect repellant can help prevent insect bites and
stings. Those with concentrated amounts of DEET stay
effective longer. Sweet-scented fragrances should be
avoided. Wearing white or khaki-colored clothing, in-
cluding socks and long pants, helps protects the skin from
bites or stings. Care and attention should always be used
when going into wilderness areas. Posted warnings in
swimming areas should be heeded. Unfamiliar animals
235
Bites and stings
Bitter melon
should not be touched. Dead or dying animals should be
avoided, as they may still be able to cause injury. When
threatened by a dog, a person should remain still. If an at-
tack seems unavoidable, lying face down with the hands
and forearms covering sensitive areas may be the best
protection. A rabies vaccine may be taken preventively if
there is a high risk of exposure due to work or travel.
Resources
BOOKS
The Burton Goldberg Group. Alternative Medicine: The Defin-
itive Guide. Washington: Future Medicine Publishing,
1993.
Bennett, J. Claude and Fred Plum, eds. Cecil Textbook of Medi-
cine. Philadelphia: W.B. Saunders, 1996.
PERIODICALS
Kuritzky, Louis. “Comparative Efficacy of Insect Repellents
Against Mosquito Bites.” Primary Care Reports (Septem-
ber 2, 2002):S20.
PERIODICALS
“Pain Relief for Stings can be Found in the Kitchen Cabinet.”
Contemporary Pediatrics (August 2002): 129 — 13 1.
PERIODICALS
Peterson, Lyle, and Anthony A. Martin. “West Nile Virus: A
Primer for the Clinician.” Annals of Internal Medicine
(August 6, 2002): 173-177.
OTHER
“Common First Aid Procedures: Bites and Stings.” Columbia
University College of Physicians & Surgeons Complete
Home Medical Guide, http://cpmcnet.columbia.edu/texts/
guide/hmgl4_0004.html#14.6 (January 17, 2001).
Bitter melon fruits. (Eastword Publications. Reproduced by
permission.)
genus, Momordica, is derived from the Latin word for
bite, as the seeds of the fruit are serrated and appear as if
they have been chewed or bitten.
Patience Paradox
Teresa G. Odle
Bitter melon
Description
Bitter melon ( Momordica charantia) is a tropical
plant that grows in Asia, Africa, the Caribbean, and
South America. It is also known as balsam pear. This an-
nual of the Cucurbitaceae family is a thin, climbing vine
with long, stalked leaves that flowers in July or August.
The plant bears a long, cucumber-shaped fruit that hangs
like a pendulum, with small bumps all over it. The plant,
which is green when it is young and yellowish-orange
when it is ripe, fruits around September or October. All
parts of the plant — the seeds, leaves and vines — are used
for medicinal purposes, but the actual fruit of the bitter
melon is most commonly used. The name of the plant’s
General use
Bitter melon is used both as a medicine and as a
food. It is often added to dishes, for all parts of the plant,
as its name suggests, taste very bitter and add an astrin-
gent or sour quality to foods. Bitter melon contains a
protein, MAP30, that was patented by American scien-
tists in 1996. These scientists stated that MAP30 is effec-
tive against tumors, AIDS, and other viruses. The plant
has been used around the world, from native healers in
the Amazon to Ayurvedic doctors in India, to treat dia-
betes as it is a natural hypoglycemic. In India, the plant
is also used in treating hemorrhoids, abdominal discom-
fort, fever, warm infections, and skin diseases.
Diabetes
Bitter melon has been used to treat diabetes melli-
tus. The plant contains at least three known compounds
that significantly lower the body’s blood sugar level. The
plant’s phytochemical composition is a combination of
steroidal saponins, charantin, peptides, and alkaloids that
236
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
contribute to bitter melon’s hypoglycemic effects. In the
Amazon, the juice of the fruit is used, either alone or in
conjunction with a leaf decoction, to treat diabetes. In
India, where the plant is called kalara, the leaves are
ground up, the juice is extracted, and the extract taken
early in the morning for 15 days.
Human immunodeficiency virus (HIV)
The alpha- and beta-momorchardin proteins con-
tained in bitter melon have an inhibiting effect on human
immunodefiency virus (HIV) infection, according to a
test-tube study published in the Journal of Naturopathic
Medicine. Bitter melon can be used alone for the treat-
ment of HIV, but it has also been used in combination
with other AIDS treatments.
Herpes
True to its antiviral properties, the MAP30 found in
bitter melon can also be used by patients with herpes. In
a 1982 study of the effects of bitter melon on the herpes
simplex virus- 1 (HSV-1), MAP30 inhibited the repro-
duction of the virus, as well as reducing its ability to
form plaques (patches of irritated skin).
Psoriasis
Bitter melon inhibits the activity of guanylate cy-
clase, an enzyme that is involved in psoriasis.
Skin conditions
Practitioners of Ayurvedic medicine have used bit-
ter melon as a treatment for skin diseases, especially sca-
bies. The juice is extracted from the leaf and applied ex-
ternally to the affected area. In traditional Chinese
medicine, bitter melon is used to treat dry coughs, bron-
chitis, and throat problems. The seeds are used topically
for skin swellings caused by sprains and fractures, and
for sores that are slow to heal.
Preparations
Patients who do not mind the extremely bitter taste
can eat a small melon. Otherwise, up to 50 ml of fresh
bitter melon juice can be taken once a day. Patients who
do not want the bitterness of the fresh fruit or fresh fruit
juice can take a fresh fruit tincture in 5 ml doses two or
three times per day.
Precautions
Bitter melon is an abortifacient, so it should not be
taken by women who are pregnant or nursing. It is also a
medicinal herb that should not be given to small children
and infants due to its hypoglycemic effects. Bitter melon
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Abortifacient — A substance that induces abor-
tions.
Charantin — A compound with hypoglycemic ef-
fects that can be extracted from bitter melon with
alcohol.
Emmenagogue — A type of medication that brings
on or increases a woman's menstrual flow.
Hypoglycemia — An abnormally low level of glu-
cose in the blood.
Scabies — A skin disease caused by an itch mite
that burrows into the skin.
is also an emmenagogue, which means that it brings on
or increases menstrual flow in women.
Side effects
If too much bitter melon juice is taken, it can cause
mild abdominal pain or diarrhea.
Interactions
Although bitter melon is commonly used for patients
with diabetes, it should be taken with caution. Bitter
melon should not be used by diabetic patients who are
currently taking such prescription medications as chlor-
propamine, glyburide, or phenformin, as well as insulin,
for their condition. Bitter melon can increase the effects
of these drugs and lead to severe hypoglycemia. Patients
with diabetes should always take bitter melon under the
supervision of a medical or herbal professional.
Resources
ORGANIZATIONS
American Association of Naturopathic Physicians. P. O. Box
20386. Seattle, WA 98112.
American Foundation of Traditional Chinese Medicine
(AFTCM). 505 Beach Street. San Francisco, CA 94133.
(415) 776-0502. Fax: (415) 392-7003. aftcm@earthlink.net.
Katherine Y. Kim
Bitters
Description
Bitters are herbs and herbal preparations that have a
characteristically sharp effect on the palate. The name
237
Bitters
Bitters
derives from the Middle English verb bitan,, which
means “to bite.” In the Ayurvedic medical tradition of
India, other such groupings of herbs include astringent
(e.g. cucumber), salty, pungent (e.g. horseradish or gin-
ger), sweet, and sour. Both traditional Chinese and Indi-
an Ayurvedic medicine regard the action of bitters as
drying. Bitters are also antibacterial, cleansing, detoxify-
ing, germicidal, parasiticidal, stimulating, and tonifying.
While the Chinese and Ayurvedic systems of medi-
cine were familiar with bitters as far back as 5,000 years,
two more recent paths of historical rediscovery and de-
velopment have contributed substantially to promoting
the benefits of bitters. Chronologically, the first of these
involves one of the fathers of Western medicine, also re-
garded as “the father of chemistry,” the Swiss physician
Paracelsus, (1493-1541). Paracelsus is credited with the
beginnings of a formula still in use. His development of
the formula may have benefited from Marco Polo’s trav-
els to China, the opening of the trading route from China
known as The Silk Road, and the distribution of com-
merce through the Venetian trading empire.
A quarter of a century later, the Swedish naturalist
and healer, Jonathan Samst, resurrected his family’s tra-
ditional formula called elixir ad longam vitam (elixir for
a long life), traceable to the formula of Paracelsus. This
mainly European development also branched out to in-
clude monasteries, such as the Benedictines, and several
European families involved in trade, organized as “Hous-
es.” As a result, several Italian, French, and German orig-
inal bitter herb beverages are commercially available.
The second discovery tradition begins with a Ger-
man medical doctor, Johann Gottlieb Benjamin Siegert,
who in 1820 left Germany to join the South American
revolutionary, Simon Bolivar, in winning independence
from Spain. Siegert was appointed surgeon general at the
military hospital in a trading port town at the mouth of
the Orinoco River. The name of this port town, Angostu-
ra, is likely familiar to bartenders and gin drinkers. Dr.
Siegert, scientifically seeking a more effective means of
treating the many wounded who also suffered from fever
and internal stomach disorders, spent more than four
years researching the properties and qualities of local
plants and herbs that might be useful to his cause. In
1824, Dr. Siegert, with his privately developed formula
called Amargo Aromatico (aromatic bitter) used by his
patients, family and friends, unwittingly initiated what is
today The House of Angostur. This is an industry located
on 20 acres in Trinidad, with worldwide distribution.
Bitters include, but are not limited to:
• gentian root ( Gentiana spp.)
• aloe (Aloe vera syn. A. barbadensis)
238
• wormwood (Artemisia absinthium) from which ab-
sinthe was made
• dandelion root (Taraxacum officinale)
• angelica root (Angelica archangelica)
• senna leaves (Cassia senna)
• zedoary root (Curcuma zedoaria)
• myrhh (Commiphora molmol)
• cinchona bark (Cinchona spp.)
• turmeric (Curcuma longa syn. C. domestica )
• shitetta (Swertia chirata syn. Ophelia chirata)
• saffron (Crocus sativa)
Other plants may possess the principals and actions
of bitters, but are primarily listed in another category.
For example, goldenseal (Hydrastis canadensis) con-
tains the bitter berberine compounds, but is primarily
categorized as an astringent.
Chemically, the bitter herbs frequently contain volatile
oils with anti-inflammatory qualities. Volatile oils evapo-
rate quickly, and have distinctive aromas, forming the
chemical basis of aromatherapy. Three well-known foods
with bitter principles that demonstrate the aromatic charac-
teristic in bitters are coffee, chocolate, and stout beer. Al-
though purveyors and consumers may mask the bitter taste
with milk, sugar, or other additives, the bitter action of
stimulation of the digestive system remains, and is appreci-
ated by many. In addition to volatile oils, the bitters contain
a wide variety of active chemical components, including:
• furocoumarins, also in celery, which stimulate gastric
juice secretion and relax the muscles
• complex sugars (complex carbohydrates), which have
antiviral and anti-inflammatory effects
• furanosesquiterpenes (a fat in edible oils), with possi-
ble antiseptic activity
• anthraquinones, which have an irritant laxative effect
• alkaloids (in chocolate, mildly) with antispasmodic, an-
tibacterial, and pain relieving effects
• other vitamins, minerals, and compounds, some that
have demonstrated anticancer effects
General use
For several hundred to several thousand years, the
chief medicinal and culinary use of bitter herbs has been
to stimulate digestion and improve elimination. This is
clearly demonstrated with coffee, chocolate, and stout
beer. Nerve endings in the tongue, reacting to the bitter
flavor, increase the flow of saliva and trigger a wave-like
action of rhythmic contractions throughout the smooth
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Alkaloids — A group of plant substances that are
basic rather than acidic. They are considered to
have strong chemical and pharmacological ac-
tions, such as combining with fatty acids to form
soap, or combining with acids to form chemical
salts used in medicine; may be used in anticancer
therapies.
Anthraquinones — A group of plant substances
known to produce an irritant laxative effect.
Astringent — Having the characteristic of drawing
together or tightening.
Biliary duct disease — Disease of the anatomic duct
from the liver, which joins the duct from the gall
bladder to form the common bile duct before en-
tering the small intestine.
Crohn's disease — An inflammatory small intestine
disease named after the gastroenterologist, Burrill
B. Crohn, characterized by symptoms of cramping,
especially after meals, and chronic diarrhea of
loose, liquid, frequent stools.
Complex sugars — A category of carbohydrate
compounds within plants, found to have antiviral
and anti-inflammatory effects; they have a more
complex structure than the sweet, simple dietary
sugars.
Choline and inositol — Two of the vitamins in the B
vitamin complex.
Elixir — Similar to a liquid extract, sweetened, and
with added aromatic principals, said to be one of
the most common forms of liquid herbal medi-
cines for oral consumption.
Extract, or herbal extract — An herbal remedy in
which water or alcohol is used to dissolve the
medicinally desired components from plant mate-
rials. Prepared extracts may be solid or liquid.
Furocoumarins — A kind of compound found in
certain foods and plants including celery, limes,
and angelica root, known to effect the skin and the
immune system; may increase the risk of skin can-
cer. One source reports that studies with celery
lead researchers to conclude that the risk for devel-
oping skin cancer is small. Caution, however, is
advised, especially with continuous use and signif-
icant exposure to sunlight. Fungi were occasional-
ly noted to increase the furocoumarin content of
foods.
Furanosesquiterpenes — A sub-class of compounds
known as terpenes in the oils of plants and foods
that do not contain an alcohol portion. These com-
pounds tend to be found in volatile oils, and are
related to the aroma of volatile and essential oils.
Germicidal — Known to kill germs.
Glutathione — Formed from three amino acids
(protein building blocks), glutathione is an antioxi-
dant involved in cellular respiration, protection of
red blood cells, and the detoxification by the liver
of foreign substances.
Irritable bowel syndrome (IBS) — Conditions of the
large intestine, which may involve diarrhea and
constipation, or alternating bouts of one or the
other.
Methionine — A sulfur containing essential amino
acids.
N-acetylcysteine (NAC) — A compound amino
acid and antioxidant that protects the liver, sup-
ports the immune system, and helps break up mu-
cous.
Parasiticidal — Known to kill or eliminate parasites.
Peristalsis — A wave-like action of rhythmic con-
tractions throughout the smooth muscles of the di-
gestive tract, from esophagus to rectum.
Volatile oils — One of the primary chemical char-
acteristics of bitter herbs, these are oils are known
for their anti-inflammatory qualities, quick evapo-
ration, and distinctive aromas.
muscles of the digestive tract, from esophagus to rectum.
This wave-like action, known as peristalsis, is the means
by which food and its non-digestable remainder is
moved through the body. The taste of bitters also initi-
ates the flowing of stomach, liver, and pancreatic secre-
tions. Bitters, therefore, are known to improve nutrient
digestion and absorption. They are regarded as appropri-
ate accompaniments to fatty or heavy meals, which oth-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
erwise tend to be digested sluggishly. Bitters are said to
tonify and strengthen the digestive system, which may
make them useful in the treatment of digestive organs in-
cluding the stomach, liver, pancreas, and bowels, under
the guidance of a healthcare professional.
Bitters also promote circulation. Many anecdotes at-
test to their usefulness in treating the pain of arthritis and
rheumatism, animal bites, colic, constipation, and hem-
239
Bitters
Bitters
orrhoids. Their aromatic principals make bitters useful in
arousal from fainting. Antiseptic characteristics help in
reducing fever, cleansing wounds, and the promotion of
proper healing. This antiseptic action is a reason why
hops ( Humulus lupulus ) was used in beer making as a
preservative, prior to pasteurization. It is reported that the
amount of hops, and therefore the amount of bitterness, is
what distinguishes beer from ale and stout (the most bit-
ter). The stimulant action of bitter herbs on the liver, ac-
cording to one source, makes bitters a first aid remedy for
hangover. Its purported remarkable effects on gin drink-
ing seem to have contributed to the popularity of Dr.
Siegert’s Aromatic Bitter in England, and amongst royal-
ty when he first took his product to London in 1862.
Preparations
A number of preparations of bitters are commercial-
ly available. Many brand name bitter aperitif (before din-
ner) and digestif (after dinner) alcoholic beverages and
liqueurs have been in use since the mid- 1800s. Bitter
tonics and extracts, usually in an alcohol base, are avail-
able for internal and external use. For internal use, it is
recommended that extracts be added to water. Externally,
they may be applied on cotton wool as a compress. Ref-
erences to external application also suggest first applying
calendula ( Calendula officinalis) ointment or oil, moist-
ening the cotton wool with the bitter herb tonic, and cov-
ering with plastic wrap. The ointment or oil prevents
drying of the affected area, and the plastic keeps the area
warm.
Encapsulations of bitter herbs are now available,
which allow consumers to avoid the bitter taste. Howev-
er, the capsules may be less effective since arousal of the
tongue is an initiating physiologic factor in stimulating
the digestive system.
Sources recommend that users read label warnings
carefully, follow the manufacturer’s dosing suggestions,
and pay attention to adverse effects, if any, that occur
within several hours of taking the bitters.
Precautions
The chief, and almost universal precaution noted
with the use of bitter herbal products, is that they are not
to be taken internally by children and pregnant or nurs-
ing women. Another widely found precaution is avoid-
ance of bitters by persons who have diseases of the gall
bladder or the biliary ducts, irritable bowel syndrome
(IBS), Crohn’s disease, or other digestive disorders.
Some precautions also exist for avoidance if one has kid-
ney disease. Since bitters are known to be drying, cau-
tion is also advised regarding dehydration, and avoid-
240
ance of the simultaneous use or overuse of alcohol prod-
ucts, which are also known to be drying.
Side effects
In general, bitters may cause dehydration in children,
and uterine bleeding and miscarriage in women. Individ-
ual ingredients may also produce undesirable side effects.
For example, angelica root may cause hormonal imbal-
ances in children. It may also cause skin sensitivities, es-
pecially for persons with psoriasis, when used with pro-
longed exposure to sunlight. Senna may cause severe ab-
dominal cramping. Both angelica root and senna are the
herbs found in a noted bitter herb tonic. One source ad-
vises the universal precaution of paying particular atten-
tion to dizziness, nausea, or skin rashes, especially if
they occur within several hours of taking a product.
To limit or avoid side effects, sources recommend fol-
lowing the directions of the manufacturer, one’s health-
care professional provider, and general health guidelines.
Interactions
The following interactions pertain to the use of bit-
ter herb formulas.
Herb-alternative drug favorable interactions
Formulas using dandelion root and leaf as part of the
treatment for liver or gall bladder disease, are reported to
be facilitated by supplements that contain methionine,
choline and inositol, and N-acetylcysteine (NAC). Assis-
tance from a healthcare professional is recommended.
Formulas using dandelion root and leaf as part of
the treatment for kidney disease, are reported to be facili-
tated by supplements. Assistance from a healthcare pro-
fessional is recommended.
Herb-drug unfavorable interactions
Formulas using any of the berberine compound
herbs such as goldenseal, Oregon grape root ( Berberis
aquifolium), or barberry (, Berberis vulgaris), for exam-
ple, are reported to be contraindicated with the use of
tetracycline antibiotics.
Formulas using dandelion root or leaf are reported
to be contraindicated with potassium sparing diuretics,
such as amiloride.
Formulas using sedatives such as hops are generally
contraindicated with antidepressants, smoking cessation
prescriptions, or sedatives, and are specifically con-
traindicated with bupropion and buspirone.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Herb-food unfavorable interactions
No specific unfavorable interactions have been
found. However, precautions exist against potential inter-
actions between bitter herb formulas and nonprescrip-
tion, over the counter (OTC) drugs containing caffeine
or an alcohol base. Sources recommend following all
label advisories.
Resources
BOOKS
Meletis, Chris D., N.D. Natural Health Magazine, Complete
Guide to Safe Herbs. New York: D.K. Publishing, Inc.,
2002 .
White, Linda B., and Steven Foster. The Herbal Drugstore. Ro-
dale Press, 2000.
OTHER
Angostura, Ltd. "The Story of Angostura Bitters." [cited April
26, 2004]. <http://www.angostura.com/test/iTash/history.
shtmlx
Blumenthal, Mark. “A Matter of Taste; Herbal Bitters Can
Help Sweeten Up Your Life.” EastWest 19 (1989) [cited
April 26, 2004], <http://galenet.galegroup.com/servlet/
HWRC>.
Claff, Chester E. A., Jr., Ph.D., “Translator’s Guide to Organic
Chemical Nomenclature.” Translation Journal, Science
and Technology May 3, 2003 [cited April 26, 2004].
<http ://accurapid. com/journal/ 1 5 org .htm> .
“Furocoumarins.” Committee on Toxicity of Chemicals in
Food, Consumer Products and the Environment. Furo-
coumarins, Toxicity, [cited April 29, 2004]. <http://www.
archive.official-documents.co.uk/document/doh/toxicity/
chap-lc.htm>.
“Herbal Bitters.” RemedyFind 2000-2003 [cited April 26,
2004], <http://remedyfind.com/rem.asp?ID=242>.
“The Long Elixir of Life.” Swedish Bitters [cited April 26,
2004]. <http://www.SwedishBitters.com>.
“Swedish bitters, ancient herbal remedy, revived.” Better Nutri-
tion for Today’s Living 57 (1995) [cited April 26, 2004].
<http://galenet.galegroup.com/servlet/HWRC>.
Katy Nelson, N.D.
Black cohosh
Description
Black cohosh ( Cimicufuga racemosa) is a member
of the Ranunculaceae family. Its nicknames of squaw-
root and snakeroot denote its Algonquian heritage and
differentiate it from the common snake root plant ( Aris -
tolochia serpentaria). It should also not be confused
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Black cohosh plants. (© PlantaPhile, Germany. Reproduced
by permission.)
241
Black cohosh
Black cohosh
with blue cohosh (Caulophyllum thalictroides): their
only similarity is that both are roots.
Black cohosh grows from a gnarled black root,
hence its name; it has a smooth stem and big multiple
leaves with jagged edges. In summer, white flowers de-
velop from what are called racemes. These flowers emit
a stinky odor. The plant, which can grow to 9 ft (1 m)
tall, is a native North American plant found on hills and
in forests located at high levels. It is found from On-
tario, Canada to Maine to the southern states of Georgia
and Missouri.
Black cohosh contains several components, as out-
lined by James F. Balch, MD and Phyllis A. Balch, CNC
in their book Prescription for Nutritional Healing, Sec-
ond Edition:
• actaeine
• cimicifugin
• estrogenic substances
• isoferulic acid
• oleic acid
• palmitic acid
• pantothenic acid
• phosphorus
• racemosin
• tannins
• triterpenes
• vitamin A
General use
Black cohosh has a history of usage for women’s
health problems, dating back to the Algonquian natives
living in the Ohio Valley. However, according to Michael
Castleman in The Healing Herbs, the Algonquians also
boiled the roots in water and drank the concoction for fa-
tigue, arthritis, sore throat, and a typical occurrence of
that time, rattlesnake bites. The Eclectic doctors of the
1800s also recommended black cohosh for what they
called “hysterical” diseases, i.e. female reproductive dis-
eases as well as fevers, rashes, sleeplessness and malar-
ia. A popular patent medicine company of the same era,
the Lydia E. Pinkham’s Vegetable Compound, sold a po-
tion containing black cohosh for menstrual complaints.
Today, black cohosh is still used for gynecological
problems from menstruation to menopause, with sever-
al studies over the past 40 years backing up this pattern
of usage. Michael T. Murray, ND, a well-known natural
medicine author, outlines some of this research regarding
menopause in his paper Hormone Replacement Therapy
242
vs. Black Cohosh in Menopause. Growing numbers of
menopausal women are turning to black cohosh rather
than allopathic treatment to manage their symptoms. A
2002 study of menopausal women in the San Francisco
Bay area found that women taking black cohosh and
other herbal remedies for their symptoms reported high-
er satisfaction with their treatment than women receiving
conventional allopathic therapy.
The most famous research was a 1982 open study in
which 629 women took 80 mg of black cohosh over a
period of six to eight weeks. Over 80% of the women ex-
perienced relief from several menopausal symptoms —
hot flashes, perspiration, headaches, vertigo, heart palpi-
tations, irritability, sleep disturbances and depression. A
later random study focused on 60 women under 40 years
of age who had hysterectomies, with one ovary remain-
ing. The women were either given black cohosh or hor-
mone replacement therapy (HRT) of estrogen or estro-
gen-progestin combinations. Although the HRT met with
better results, the study concluded that black cohosh was
a favorable natural alternative for post hysterectomy.
A 1998 German clinical study showed that black co-
hosh has good therapeutic results in treating symptoms
of menopause and also that black cohosh did not show
any hormone-like activity as previously thought. A sec-
ond German study, published in 2002, reported that
black cohosh has antiestrogenic effects.
Because the collective results of a number of studies
show synthetic hormone replacement therapy, which con-
tains estrogen, increases breast cancer risk by 1-30%,
black cohosh is being considered as an alternative. A 1998
study at the University of Bridgeport in Connecticut re-
viewed eight previous studies of black cohosh as treatment
for menopausal symptoms. This study stated that black co-
hosh is a safe alternative to estrogen replacement therapy
(ERT) for women where ERT is contraindicated or de-
clined. Some contraindicated conditions from ERT include
a history of estrogen-dependent cancer, unidentified uterine
bleeding, liver disease, gallbladder disease, endometriosis,
uterine fibroids and fibrocystic breast disease.
In a 1999 in vitro study at the New York College of
Osteopathic Medicine, several herbs, including black co-
hosh, hops, and vitex, were shown to inhibit the growth
of T-47D cells. The study concluded that these herbs
may be useful in preventing breast cancer.
A 1999-2000 study at Cedars-Sinai Hospital in Los
Angeles, California, focused on the efficacy and safety
of several traditional phytomedicines, including black
cohosh root extract, to treat women’s gynecological con-
ditions, such as PMS and menopause. This study con-
cluded that both dong quai and black cohosh are safe to
use to relieve menopausal symptoms, but only black co-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Eclectics — Ninteenth century herbal scientists in
the United States who founded the Reformed Med-
ical School. Their outlook was based on herbal
medicines of Europe, Asia and native Indian.
Efficacy — The power to bring about intended re-
sults.
Extract — A concentrated form of the herb made by
pressing the herb with a hydraulic press, soaking it
in water or alcohol, then letting the excess water or
alcohol evaporate.
German Commission E — The world standard to
regulate herbal products.
Hypertension — Another name for high blood pres-
sure, which occurs when blood pressure is above
140/90. Called the silent disease, it often has no
symptoms, but if left untreated, can lead to stroke
or a heart attack.
Hysterectomy — Removal of the uterus by surgery
either to remove tumors, treat cancer or precancer-
ous conditions. Surgery is performed through the
abdominal wall or through the vagina.
Menopause — Literally means cessation of the
menses. Average age of occurrence in women is
51 , although it can occur earlier or later.
Menstruation — A monthly occurrence of blood
and uterine material discharge from a woman's
vagina while she is in her reproductive years.
Oleic acid — Oily acid found in most vegetable and
animal oils and fats. Used to make ointments.
Progesterone — Female hormone that prepares the
uterus for the fertilized egg. Progesterone is nor-
mally produced in the ovaries, except when a
woman is pregnant, then it is produced in the pla-
centa. The adrenal glands also produce small
amounts of progesterone.
Tannins — Phenolic compounds that occur natural-
ly in plants. Tannins help form proteins, alkaloids
and glucosides from a solution. Tannins are found
in tea and coffee.
Tincture — Herbs preserved usually in alcohol. The
concentration of the herb is usually low, on a
strength ratio of 1:10 or 1 :5 .
hosh showed efficacy. The study stated that information
regarding safety for use during pregnancy and lactation
is still small in amount and suggested pharmacists study
scientific literature to help decide the value of recom-
mending these herbs for use.
A 1999 national survey of 500 midwives belonging to
the American College of Nurse-Midwives and 48 nurse-
midwife education programs was undertaken by the West
Virginia University School of Medicine. The purpose was
to determine if colleges were educating their students in
the use of herbs to stimulate labor. Of the 172 surveys re-
turned, 90 used herbal preparations and 82 did not. Herbal
usage was broken down as: black cohosh (45%), evening
primrose oil (60%), blue cohosh (64%), and castor oil
(93%). Those who used these herbs did so because they
are natural, and those who refrained from using them cited
the lack of sufficient research about the safety.
Black cohosh can sometimes bring relief from tinni-
tus (ringing in the ears) as James A. Duke, Ph.D. relates in
The Green Pharmacy. He refers to a professional flutist
who suffered this condition for many years and a black co-
hosh tincture caused his tinnitus to decrease considerably.
Black cohosh can also decrease blood pressure by
“opening the blood vessels in the limbs (peripheral va-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
sodilation)” according to a study referred to by Michael
Castleman in The Healing Herbs. A person with hyper-
tension should first consult a physician.
Other possible benefits of black cohosh are to alleviate
muscle spasms, reduce neuralgia pain, and relieve
bronchial infections by stopping the compulsion to cough.
Black cohosh has also been recommend as a glandular tonic.
Preparations
Black cohosh may be taken in capsule, extract, tea,
or tincture.
To make a tea, boil 1/2 tsp powdered black cohosh
root for each cup (250 ml) of water for 30 minutes. After
it cools, it can be sipped with lemon and honey to mask
its bitter taste.
One teaspoon of black cohosh tincture can be taken
on a daily basis. Ten to 30 drops of extract mixed in
water can be taken daily. Two to five capsules (40
mg/capsule) may be taken daily. The German Commis-
sion E recommends taking two 20-mg capsules daily,
one in the morning and one at night. These tablets are
available under the name Remifemin, a black cohosh ex-
tract. A 2002 German study found that these standard
243
Black cohosh
Black cohosh
dosages are effective for most women and that there is
no therapeutic benefit from higher dosages.
Precautions
Black cohosh should not be used during pregnancy
except at the time of birth. It should also not be taken by
those with a chronic disease, or women taking birth con-
trol pills or HRT. Children under 12 years and adults
over 62, should start with lower dosages.
The German Commission E recommends taking
black cohosh for six months at a time only. However, re-
cent studies with animals show no toxicity problems. It
is always best to first consult a health care practitioner.
Side effects
An overdose (over 900 rng/day) could cause dizzi-
ness, nausea and vomiting, diarrhea, pain in the ab-
domen, headaches, joint pains, and a lowered heart rate.
These conditions could also appear sometimes when tak-
ing low dosages of black cohosh. Large dosages can also
cause poisoning symptoms.
Interactions
Women taking black cohosh should not take it to-
gether with birth control pills; HRT; such sedatives as di-
azapam; or blood pressure medications.
Resources
BOOKS
Balch, James F., MD. and Phyllis A. Balch. CNC. Prescription
for Nutritional Healing, second edition. Avery Publishing
Group, 1997.
Castleman, Michael. The Heeding Herbs. Rodale Press, 1991.
Duke, James A., PhD. The Green Pharmacy. Rodale Press,
1997.
Heinerman, John. Heinerman’s Encyclopedia of Healing,
Herbs Spices. Prentice Hall, 1996.
Landis, Robin, with Karta Pukh Singh Khalsa. Herbal Defence.
Warner Books, Inc. 1997.
Mindle, Earl. Earl Mindell’s Herb Bible. Simon & Schuster, 1992.
Murray, Michael. ND. Encyclopedia of Nutritional Supplements.
Prima Publishing, 1996.
Murray, Michael, ND. The Healing Power of Herbs, second
edition. Prima Publishing, 1995.
Rothenberg, Mikel, MD, and Charles Chapman. Dictionary of Med-
ical Terms, third edition. Barron's Educational Series, 1994.
PERIODICALS
Kam, I. W., C. E. Dennehy, and C. Tsourounis. "Dietary Sup-
plement Use Among Menopausal Women Attending a San
Francisco Health Conference.” Menopause 9 (January-
February 2002): 72-78.
244
Liske, E., W. Hanggi, H. H. Henneicke-von Zepelin, et al.
“Physiological Investigation of a Unique Extract of Black
Cohosh ( Cimicifugae racemosae rhizoma ): A 6-month
Clinical Study Demonstrates No Systemic Estrogenic Ef-
fect.” Journal of Women’s Health and Gender-Based Med-
icine 1 1 (March 2002): 163-174.
Stengler, Angela, ND and Mark Stengler, ND. “Black Cohosh.”
Natural Factors Research Information (September 10,
1998).
Tyler, Varro E., PhD, ScD. “Honest Herbalist: Five Herbs That
Ease Menopause.” Prevention Magazine (March 1999).
Zierau, O., C. Bodinet, S. Kolba, et al. “Antiestrogenic Activities of
Cimicifuga racemosa Extracts.” Journal of Steroid Biochem-
istry and Molecular Biology 80 (January 2002): 125-130.
OTHER
Hardy, M. L. Herbs of special interest to women [Abstract].
Cedars-Sinai Integrative Medicine Medical Group,
Cedars-Sinai Hospital, Los Angeles, CA. 2000.
Lieberman, S. A review of the effectiveness of Cimicifuga race-
mosa (black cohosh) for the symptoms of menopause [Ab-
stract]. University of Bridgeport, Connecticut, USA. 1998.
McFarlin B.L, M.H. Gibson, J. O’Rear, and P. Harman. A na-
tional survey of herbal preparation use by nurse-midwives
for labor stimulation. Review of the literature and recom-
mendations for practice [Abstract]. West Virginia Univer-
sity School of Medicine, Department of Obstetrics and
Gynecology, Morgantown, 1999.
Sharon Crawford
Rebecca J. Frey, PhD
Black cumin seed extract
Description
Black cumin seed (Nigella sativa ) is an annual herba-
ceous plant and a member of the Ranunculaceae (butter-
cup) family. The fruit of the plant, the black seeds, ac-
counts for its name. Black cumin seed (also called black
seed) should not be confused with the herb, cumin ( Cu -
munum cyminum, which is found in many grocery stores.
Considered native to the Mediterranean region,
black cumin seed is cultivated in North Africa, Asia, and
southeastern Europe. The largest producers of black
cumin seed are Egypt, India, Pakistan, Iran, Iraq, and
Turkey. Other species, such as Turkish black cumin
( Nigella damascened), are not used medicinally; and one
type, Nigella garidella , is even poisonous.
Playfully referred to as “Love in the Mist,” the black
cumin seed plant has leaves that grow in pairs. The lower
leaves are short and supported by slender stems, while
the upper leaves generally grow to approximately 4 inch-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
es (10 cm) in length. The stalk of the plant, with its
bluish white flower petals, can grow up to 18 inches (46
cm) in height while its fruit matures. At first, the seeds
(the fruit of the plant) are held in a capsule in the center
of the flower. The capsule opens upon maturity, reveal-
ing lightly colored seeds. It is only upon their exposure
to air that the seeds become black.
Most often, the extract is produced by a process re-
ferred to as cold pressing. Temperatures no higher than
140-176°F (60-80°C) are applied to the seeds to help re-
lease the oil and preserve its benefits.
Rich with compounds such as nigellone and thymo-
quinone, black cumin seed is thought to contain over 100
ingredients; many remain unknown. However, experts
agree that the most important compounds contained in
the extract are the fatty acids and nutrients. Some com-
ponents of black cumin seed extract are as follows:
• myristic acid
• palmitic acid
• palmitoleic acid
• stearic acid
• oleic acid
• linoleic acid (omega-6)
• linolenic acid (omega-3)
• arachidonic acid
• protein
• thiamin
• riboflavin
• pyridoxine
• niacin
• folacin
• calcium
• iron
• copper
• zinc
• phosphorous
General use
Black cumin seed has been used for centuries to
treat respiratory and digestive problems, parasites, and
inflammation. In ancient times, it was a remedy for a va-
riety of health conditions including, colds, infections,
headaches, and toothaches. The pharoahs’ personal doc-
tors are reported to have offered black cumin seed as a
digestive aid after large meals. In fact, the extract was
found in the tomb of King Tutankhamun, presumably to
protect him in the afterlife.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Black cumin was also used as a remedy for skin dis-
eases, dry skin, dandruff, and wounds.
At one time, black cumin seed was highly valued in
Europe, but by the eighteenth century it had lost popular-
ity, and was primarily used as a garden decoration. How-
ever, black cumin seed extract has regained popularity,
and is now more widely used as a remedy in Europe and
North America.
Many herbalists in current times embrace the heal-
ing properties of black cumin seed extract. For example,
the extract is sometimes used externally to treat such
skin care problems as psoriasis, eczema, and dry skin,
and internally to treat stomach problems, respiratory ail-
ments, and allergies, as well as to improve circulation
and the immune system. In recent years, the extract has
been the subject of immune system research.
One reason that is often given for the medicinal
value of black cumin seed extract is its richness in
polyunsaturated fatty acids, which help to produce
prostaglandin El. Prostaglandin El has many functions
in the body, particularly in relation to the immune sys-
tem, sugar metabolism, skin infections, and blood clots.
It is also believed to protect the stomach lining.
Experts point out that the medicinal value may be
provided by a unique and mysterious synergy (combined
action) between the multitude of compounds present in
the seeds. In addition, the extract, which is more concen-
trated than the seeds alone, is said to have greater heal-
ing power. A study at Cairo University in Eqypt showed
a boost in antibacterial activity when the extract was
used in combination with antibiotics such as strepto-
mycin and gentamicin. In the same study, it showed ad-
ditional antibacterial function in combination with ery-
thromycin, tobramycin, doxycycline, and ampicillin, to
kill E. Coli and the pathogenic yeast, Candida albicans.
In addition, the study showed that the extract destroyed
non-fatal subcutaneous staphylococcal infection in mice.
In 2003, one study noted the antifungal activity of
black cumin seed extract against Candida albicans. In the
study, mice were injected with Candida albicans , produc-
ing colonies of the organism in their liver, spleen, and
kidneys. The researchers found that treatment with black
cumin seed extract 24 hours after inoculation inhibited
growth of the Candida albicans. With continued treat-
ment, the extract significantly decreased the amount of
Candida albicans found in the kidneys, liver, and spleen.
Aside from verifying its antibacterial and antifungal
properties, researchers in recent years have tested the
anti-inflammatory and analgesic effects of black cumin
seed extract. In 1995, a group of scientists from the De-
partment of Pharmacy at King’s College in London
found that the extract contains these properties, and is an
245
Black cumin seed extract
Black cumin seed extract
antioxidant as well. They believe the anti-inflammatory
and antioxidant abilities may be linked to ingredients
such as thymoquinone and unsaturated fatty acids. Ulti-
mately, the researchers concluded that black cumin seed
extract is a justified treatment for rheumatism and related
inflammatory diseases.
In 2001, a study performed at the Department of
Pharmacology at King Faisal University in Saudi Arabia,
reported anti-inflammatory and analgesic activity from
the use of black cumin seed extract in animals. Paw
edema (swelling) was reduced, as was reaction time in
response to extreme heat. A 2003 study confirmed the
analgesic effects of the extract. Studies in this area are
likely to continue well into the future.
Researchers have also investigated and verified the
extract's antihistamine activity, focusing on nigellone, an
ingredient in black cumin seed extract. One 1993 study
found that nigellone acted as an inhibitory agent on hista-
mine (a substance involved in an allergic response, caus-
ing widening of blood vessels and tightening of bronchial
passages) by inhibiting protein kinase C, known to initi-
ate histamine release. In 2003, another study concluded
that black seed oil is an effective treatment for allergies.
Preparations
There are many applications made with black cumin
seed extract. It can be found in teas, cough syrups,
wound salves, compresses, massage oils, and other prod-
ucts. Black seed honey, soap, shampoo, and creams are
all available commercially.
The extract has a strong flavor, which is improved
by mixing it with honey. Herbal teas also help dilute its
strength. As with any product used for medicinal purpos-
es, it is important to read and follow the label instruc-
tions and warnings.
Although black cumin seed extract is not normally
associated with severe skin irritation, a skin patch test
should be conducted before using it for the first time. A
small amount of diluted extract is placed on the inside of
one elbow and covered with a bandage. After 24 hours,
any redness or irritation is indicative of a negative reac-
tion. This test should be done before a person proceeds
with more extensive use.
Black cumin seed extract, in these dosages, is used
as a remedy for the following conditions:
• Headache. A few drops of the diluted extract are
rubbed on the patient's forehead. Some patients may
also find it helpful to take 1/2 teaspoon of the extract
after breakfast, lunch, and dinner.
• Cough. The dose is 1/2 teaspoon of diluted black cumin
seed extract in the morning. A dry cough may require
246
one teaspoon of the extract twice a day, mixed with one
cup of coffee or hot tea. The extract can be rubbed on
the chest and back for additional relief.
• Common cold. One teaspoon of the extract is mixed
with hot lemon tea and honey two or three times a day.
• Diarrhea. One teaspoon of extract is mixed with one
cup of yogurt twice a day.
Precautions
Black cumin seed extract is not to be used during
pregnancy.
Its safety in young children has not been established.
Patients with liver or kidney disease are advised not to
use this product unless a physician directs them to do so.
Black cumin seed extract is said to lower blood
sugar levels; therefore, a diabetic patient is advised to
consult with a physician before using.
Side effects
In general, if used as directed, black cumin seed ex-
tract is not associated with serious side effects. However,
it has been reported that black cumin seed extract has a
very low degree of toxicity, and may cause significant
negative effects on liver and kidney function. A recom-
mended daily allowance (RDA) has not been established
for the extract, so it is wise to consult with a physician
before beginning any internal treatment.
Interactions
There does not appear to be a list of serious interac-
tions associated with the use of black cumin seed extract;
however, it is recommended that anyone taking prescrip-
tion drugs seek the opinion of a physician and/or phar-
macist before using black cumin seed extract in combi-
nation with the prescribed treatment.
Resources
BOOKS
Luetjohann, S. The Healng Power of Black Cumin. Twin Trees,
WI: Lotus Light Publications, 1998.
Schleicher. P., and M. Saleh The Magical Egyptian Herb for
Allergies. Asthma, and Immune Disorders. Rochester, VT:
Healing Arts Press, 2000.
PERIODICALS
Albert-Matesz, R. “One of life's tiny treasures.” The Herb
Companion October 2003; 16: 16-25. 1998.
Ali, B. H., and G. Blunden. “Pharmacological and toxicologi-
cal properties of Nigella sativa.” Phytotherapy Research.
(April 2003): 299-305.
Al-Ghamdi, M.S. “The anti-inflammatory, analgesic, and an-
tipyretic activity of Nigella sativa.” Journal of Ethnophar-
macology. (June 2001): 45-48.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Prostaglandins — Fatty acid derivatives that are
present in many tissues of the body, and affect all
organs.
Hypertension — High blood pressure, which oc-
curs when the reading is above 140/90. Called the
silent disease, it often has no symptoms, but if left
untreated, can lead to stroke or a heart attack.
Hysterectomy — Removal of the uterus by surgery
either to remove tumors, treat cancer or precan-
cerous conditions. Surgery is performed through
the abdominal wall or through the vagina.
Al-Naggar, T. B., M. P. Gomez-Serranillos, M. E. Carretero,
and A. M. Villar. “Neuropharmacological activity of
Nigella sativa L Extracts." Journal of Etlmopharmacolo-
gy. (September 2003): 63-68.
Chakravarty, N. “Inhibition of histamine release from mast
cells by nigellone.” Annals Allergy. (March 1993):
237^12.
Hanafy, M. S., and M. E. Hatem. “Studies on the antimicrobial
activity of Nigella sativa seed (black cumin).” Journal of
Ethnopharmacology. (September 1991): 275-8.
Kalus, U., A. Pruss, J. Bystron, A. Smekalova, J. J. Lichius,
and H. Kiesewetter. "Effect of Nigella sativa (black seed)
on subjective feeling in patients with allergic diseases.”
Phytotherapy Research. (December 2003): 1209-14.
Khan, M. A., M. K. Ashfaq, H. S. Zuberi, M. S. Mahmood, and
A. H. Gilani. “The in vivo antifungal activity of the aque-
ous extract from Nigella sativa seeds.” Phytotherapy Re-
search (February 2003): 183-6.
OTHER
Blackseedusa.com. “Frequently asked questions.” [cited May
14, 2004]. <http://blackseedusa.com>.
Peles, U. “Prostaglandin.” [cited May 14, 2004], <http://www.
peles.com/injection.html>.
Wagner. H. "Black seed oil.” [cited May 14, 2004]. <http://
w w w.amazingherbs . com> .
Lee Ann Paradise
Black currant seed oil
Description
The black currant (Rihes nigrum ), is a deciduous
shrub of the Saxifragaceae family. Though all parts of the
shrub are used — berries, bark, leaves, and seeds — it is the
oil of the seed that is used most commonly today. Black
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
currant seed oil is rich in essential fatty acids, which
promote and maintain the body’s vital functions. Essen-
tial fatty acids provide energy, regulate body temperature
and metabolism, protect tissues, and insulate nerves. Ap-
proximately 17% of black currant seed oil consists of an
omega-6 fatty acid, gamma-linolenic acid (GLA). Anoth-
er 13% consists of an omega-3 fatty acid, alpha-linolenic
acid. Evening primrose oil is primarily used for its es-
sential fatty acid content, but it contains only about 8%
gamma-linolenic acid, half of what is found in black cur-
rant seed oil. Because both omega-6 and omega-3 acids
are needed in our diets, a supplement of black currant
seed oil is beneficial. These essential fatty acids are bro-
ken down by the body into prostaglandins, the body’s
regulating substances that block pain and govern many
other physical functions, especially in proper functioning
of the circulatory system.
General use
Because black currant seed oil is so high in gamma-
linolenic acid, which makes prostaglandins, it is a highly
effective anti-inflammatory herb. The oil is best used for
chronic inflammatory conditions, cramps, and aches. It
also boosts the immune system, and helps women with
their menstrual cycles and menopause, while also easing
discomforts associated with premenstrual syndrome.
Black currant seed oil is also used to treat skin disorders.
Rheumatoid arthritis
As an anti-inflammatory agent, black currant seed
oil works well in rheumatoid arthritis patients by de-
creasing morning stiffness in their joints. The British
Journal of Rheumatology has noted that black currant
seed oil may be so effective in rheumatoid arthritis pa-
tients because of a “reduction in the secretion of the in-
flammatory cytokines 11-1 and TNF-alpha.” Cytokines
are a source of inflammation. By preventing their pro-
duction, black currant seed oil offers some relief.
Cardiovascular disorders
Black currant seed oil is beneficial to patients with
cardiovascular problems, as prostaglandins counteract
the constriction of blood vessels. Two Canadian studies
have also showed that omega-6 fatty acids lower blood
pressure.
Women ’s health problems
Because prostaglandins regulate the menstrual cycle,
black currant seed oil is helpful for women before and
during menstruation. Gamma-linolenic acid produces
anti-inflammatory prostaglandins, as opposed to inflam-
247
Black currant seed oil
Black haw
KEY TERMS
Prostaglandins — A class of fatty acids found in the
body that regulate the contraction of smooth mus-
cle, inflammation, body temperature, and many
other functions.
matory prostaglandins, thus lessening the severity of pre-
menstrual cramps. Gamma-linolenic acid has also been
shown to alleviate the symptoms of depression and breast
tenderness associated with PMS. Menopausal women
have also found black currant seed oil to be helpful.
Skin disorders
The anti-inflammatory properties of black currant
seed oil are also effective against skin irritations when
taken orally. A study at the Skin Study Center in
Philadelphia showed that black currant seed oil also
helps with dry skin disorders, as the gamma-linolenic
acid protects against the water loss that contributes to
itching and other symptoms associated with dry skin.
Preparations
Black currant seed oil is available in capsule form.
When it is taken as a supplement, one to three 500-mg
capsules should be taken daily, unless a physician rec-
ommends otherwise. The capsules usually contain black
currant seed oil, vegetable glycerine and gelatin.
Precautions
There are no known precautions to observe when
taking black currant seed oil.
Side effects
Apart from possible allergic reactions, there are no
major side effects with black currant seed oil.
Interactions
There are no known interactions between black cur-
rant seed oil and standard pharmaceutical preparations.
Resources
OTHER
Grieve, M. A Modern Herbal. 1931. Botanical.com. [cited Janu-
ary 17, 2001], <http://www.botanical.com>
HealthQuest. 1998-1999. [cited January 17, 200 1 ] .<http://
www.hquest.com>
Katherine Y. Kim
248
Black haw
Description
Black haw ( Viburnum prunifolium ), is a shrub or
small tree with serrated oval leaves. Its white flowers and
dark berries occur in clusters. The stem bark of black haw
is approved for use in foods in the United States. It is na-
tive to the woodlands of temperate and subtropical parts of
North America, Europe, and Asia. Its other names are stag-
bush and American sloe. Black haw belongs to the same
genus as the guelder rose Viburnum op ulus which is also
known as cramp bark. The two are sometimes used inter-
changeably and have similar properties, but black haw is
more specific in its effects on the uterus. The actions of
black haw are described as antispasmodic, sedative, astrin-
gent, muscle relaxant, cardiotonic, uterine relaxant, and
anti-inflammatory.
General use
Black haw has been used traditionally for problems
related to the female reproductive tract. It acts as a gener-
al antispasmodic that may relax skeletal muscle as well,
but is particularly effective on the uterus. As such, it is a
potential agent to be included in the treatment of threat-
ened miscarriage, menstrual cramps, false labor, and the
afterpains of childbirth. The antispasmodic properties of
black haw are also reportedly useful for colic, bladder
spasms, cramping pain in the bile ducts, diarrhea, and
heavy bleeding during menopause. Black haw may also
have some ability to lower high blood pressure.
The most common use of black haw is as an anti-
spasmodic for menstrual pain. To relax the uterus and re-
lieve menstrual cramping, the most commonly recom-
mended dose is 5 mL (ltsp) of the tincture in water,
taken three to five times daily as needed. Tinctures of
black haw are generally prepared by placing an ounce of
fresh herb in an ounce of 50% alcohol, and steeping the
mixture for six weeks. Alcohol may extract certain
chemical components of the herb more or less strongly
than water does, so tinctures may exert different levels of
activity than teas (generally the least strong preparations)
or infusions. Tinctures and other preparations of black
haw are commercially available from some herbalists or
health food stores.
Black haw is sometimes used to prevent chronic
miscarriage. It has been similarly utilized for the condi-
tion of irritable uterus occurring in late pregnancy. The
reported nervine (nerve-calming) effect of black haw
may be useful in addition to its spasmolytic properties.
One recommended dose for these indications is 1-2 cups
of tea per day as soon as pregnancy is diagnosed. Alter-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
natively, the patient may take 0.5 cup per day of an infu-
sion of black haw. A tea can be prepared with 1 tsp of
dried herb in 1 cup of boiling water, steeped for up to 20
minutes. An infusion is prepared by putting 1 oz of black
haw in a pint jar, filling the jar with boiling water, and
steeping for eight hours. This preparation is thought to
act as a uterine relaxant but will not prevent a miscar-
riage due to abnormalities in the fetus or placenta.
Women should consult a health care practitioner knowl-
edgeable about herbal use in pregnancy before using
black haw or any other herbal remedy when pregnant.
For afterpains following childbirth, 1 oz of black
haw or cramp bark can be combined with 0.5 oz of blue
cohosh root and 0.25 oz of dried hops flowers. The mix-
ture of herbs is steeped in a quart of boiling water for
eight hours to make an infusion for the relief of uterine
pain. This combination is also said to aid milk produc-
tion and encourage sleep. Small amounts of the infusion
are taken as needed.
One of the historical uses of black haw was for the
relief of asthma. Evidence from contemporary clinical
studies does not support this use, although black haw’s
activity as a smooth muscle relaxant could theoretically
relieve bronchoconstriction. On the other hand, some
components of black haw, particularly the salicylates,
have the potential to trigger an asthmatic reaction in sen-
sitive individuals. Asthma is a serious condition that
should be monitored and managed by a health care
provider. Conventional medications are available that are
generally safe and proven effective to control asthma.
Preparations
The bark of the branches and roots of the plant con-
tain the pharmacologically active ingredients of black
haw. These components include salicyclic acid, salicin,
oxalic acid, tannins, and scopoletin. The latter ingredient
is probably the uterine relaxant. The salicylate con-
stituents would contribute to black haw’s anti-inflamma-
tory effects. The root bark should be harvested only in
the fall. Bark from the branches may be used either in
spring or fall.
Fresh plant material from the shrub may be grown
or purchased to make teas, tinctures, or infusions. Some
of these remedies are described above. These prepara-
tions may also be commercially available from profes-
sional herbalists or specialty stores.
Precautions
People who are allergic to aspirin could theoretical-
ly have a reaction to black haw, as one of its components
is a salicylate (compound related to aspirin). Bleeding
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Astringent — A substance that causes soft tissue to
contract or constrict. Black haw has some astrin-
gent properties.
Infusion — The most potent form of extraction of a
herb into water. Infusions are steeped for a longer
period of time than teas.
Nervine — A substance that has a quieting effect
on the nervous system.
Spasmolytic — A substance or medication that re-
lieves cramping.
Tincture — The extraction of a herb into an alcohol
solution for either internal or external use.
time may also be prolonged as a result in patients who
take high chronic doses of black haw. Patients with a his-
tory of kidney stones should not use this herb, as the ox-
alic acid it contains could increase the risk of a recur-
rence of the disorder.
Some sources say that black haw should not be used
in pregnancy. Women should consult a health care practi-
tioner experienced in the use of natural remedies for ad-
vice on the use of black haw for the prevention of mis-
carriage or other possible indications for pregnancy.
Side effects
This species of Viburnum has not been well-studied
in regard to its efficacy, side effects, or safety, although it
has centuries of traditional use in humans.
Interactions
There are no identified interactions of black haw
with foods, other herbs, or standard medications.
Resources
BOOKS
Chevallier, Andrew. The Encyclopedia of Medicinal Plants.
New York: DK Publishing, Inc., 1996.
Jellin, J.M.. F. Batz, and K. Hitchens. Pharmacist’ s Letter/Pre-
scriber's Letter Natural Medicines Comprehensive Data-
base. Stockton, CA: Therapeutic Research Faculty, 1999.
Ody, Penelope. The Complete Medicinal Herbal. New York:
DK Publishing, Inc., 1993.
Weed, Susun. Wise Woman Herbal for the Childbearing Year.
Woodstock, NY: Ash Tree Publishing, 1986.
Judith Turner
249
Black haw
Black walnut
Black walnut
Description
Black walnut ( Juglans nigra), is a short-trunked for-
est tree with a spreading crown that can grow to 100 ft
(30 m). It is native to Eastern North America, where it is
found from New Brunswick south to Georgia and as far
west as Kansas and Minnesota. Although chiefly valued
for its decorative fine-grained wood, the tree’s bark, root,
leaves, and nuts all have medicinal properties. These
qualities are similar to those of the closely related
Juglans regia (better known as English walnut), the tree
most commonly used by commercial walnut growers.
General use
The main active ingredients of black walnut are tan-
nins such as galloyglucose and ellagitannins, and juglone
(5-hydroxy-alphanapthaquinone). Walnut shells are very
rich in vitamin C, and betacarotene, Bj, B 2 , and B 6 are
found in the leaves.
Herbalists use external applications of the plant for a
variety of skin complaints including ringworm, jock itch,
athlete’s foot, psoriasis, blisters, eczema, scabbing pru-
ritus, varicose ulcers, and even syphilis sores. The oil is a
traditional hair tonic. Black walnut preparations have also
been used for eye infections and irritations of the eyelid.
Internally, black walnut extracts are taken for ailments
such as gout, rheumatism, glandular disturbances, worms,
and parasites. It is also used to stimulate the appetite and as
a laxative. Some authors consider it a blood purifier. There
is evidence dating back to the 1960s showing that chemical
components in the nut may help reduce blood pressure.
An April 2000 report in the Annals of Internal Medi-
cine raised hope that walnuts might help reduce harmful
LDL cholesterol. In a study conducted by a researcher at
the Hospital Clinic Provincial in Barcelona, it was report-
ed that substituting 8-11 walnuts a day for olive oil and
other fatty foods in the cholesterol-lowering Mediter-
ranean diet significantly improved the diet’s effective-
ness. In fact, the average reduction of LDL cholesterol in
walnut dieters was twice that of participants using the tra-
ditional Mediterranean diet. However, the walnuts were
added to a diet already known to be healthy, so the find-
ings do not necessarily imply that addition of the nuts to a
less nutritious diet would have a similar effect.
The ancient Doctrine of Signatures stated that hints
to the healing properties of plants could be found in their
physical appearance. In accordance with this belief, wal-
nuts, with their convoluted surface, have long been
thought useful in treating brain disorders. Discorides, the
ancient Greek author of De materia medica which has
250
Black walnut branches and fruit. (Photo Researchers, Inc.
Reproduced by permission.)
been the foremost textbook of pharmacology for 16 cen-
turies, considered walnuts to have an excitatory effect on
the head. This effect has been attributed to the plant’s
high levels of serotonin.
In East Asia, dried black walnut is used to treat
cough, asthma, and bronchitis. In chronic bronchitis
and asthma in older patients, it is given two or three times
a day for as long as two months. This is said to improve
appetite and sleep patterns. East Asian practitioners also
employ the plant in kidney stone remedies to ease pain.
The plant has dental applications. Homeopaths use a
tincture of black walnut leaves to treat cutting wisdom
teeth. In Pakistan, walnut bark is used in toothpaste.
Preparations
Black walnut extract can be bought at health food
stores as a liquid or in capsules. Amateur herbalists can
also prepare their own black walnut teas or salves. One
traditional herbalist quoted in the 1989 book Herbal
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Medicine Past and Present said, “I take a double handful
of hulls in boiling water to make a tea. Then I add hog
lard and boil again to reduce it to a salve.”
The following formula for English walnut leaves is
from the 1 994 book Herbal Drugs and Phytopharma-
ceuticals: “Making the tea: 1.5 g [1.67 tsp] of the finely
chopped [leaves are] put into cold water, heated to boil-
ing, and after three to five minutes passed through a tea
strainer, Internally as an adjuvant .. for skin conditions, a
cupful of the tea is drunk one to three times a day. For
dressings and lotions, a decoction of 5 g [5.6 tsp] drug in
200 ml [3.8 oz (US)] water is used.”
Another source recommends an extract produced by
boiling black walnut bark in water for 10 or 15 minutes.
According to folklore, drinking a mixture of walnut
kernel ash and red wine prevents loss of hair, but also tints it
blonde. Another traditional preparation was to gargle with
juice from unripened green walnut husks mixed with honey.
Black walnut leaves should be collected, free of
leafstalk, early in the summer. The nuts are considered
mature four-and-a-half to five months after flowering,
and are harvested in the fall. Commercial growers use
trunk and limb shakers to remove walnuts when the
green, fleshy shucks begin to split and the inner nut is a
light tan color. They then use forced-air dryers to reduce
the moisture content to 8%.
Precautions
Directions and dosages should be carefully followed,
as black walnut contains juglone, a powerful and toxic
substance that prevents many plants from growing within
the tree’s root zone, extending as much as 80 ft (24 m)
from a mature black walnut trunk. Juglone is especially
strong in the roots, but is also found in the leaves, bark,
and wood. Use of black walnut sawdust or wood chips as
bedding material for horses has caused laminitis. In high
doses, juglone is a kidney and liver toxin. Pollen from
black walnut trees (usually shed in May) is a common
cause of allergies in hypersensitive persons.
In their 1996 book Botanical Medicine: A European
Professional Perspective, Dan Kenner and Yves Requena
warn that black walnut should not be used against a
cough involving fever.
Juglone can stain the skin yellow, brown, or black.
This effect is so pronounced that black walnut oil is used
to stain furniture and in artist’s pigments.
Side effects
Acknowledging the previous precautions, black wal-
nut generally has no adverse side effects when properly
administered in appropriate doses. However, users are
advised to consult a health professional before using it.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Laminitis — A veterinary term for inflammation in
the foot of a horse.
LDL cholesterol — Low-density lipoprotein choles-
terol. A blood lipid that increases risk of coronary
artery disease.
Mediterranean diet — A low-cholesterol diet that
emphasizes vegetables and fish, and limits con-
sumption of red meat and eggs.
Serotonin — A chemical compound that acts as a
neurotransmitter, conveying information within
the nervous system. Insufficient serotonin is be-
lieved to be a cause of depression. Too much sero-
tonin may be responsible for migraines or nausea.
Tannin — An acidic substance often found in
plants. Tannins are used for numerous medical
purposes and are used to tan leather, color fabrics
and ink. They are also used to contribute to the
color and flavors of tea.
Interactions
Although interactions are unlikely, it is advisable to
see a health professional before using black walnut ex-
tracts or capsules.
Resources
BOOKS
D’ Amelio, Frank Sr. Botanicals: A Phytocosmetic Desk Refer-
ence. CRC Press, 1999.
Gruenewald, Joerg, Thomas Brendler, and Christof Jaenicke,
eds. Physicians' Desk Reference for Herbal Medicines.
Medical Economics Company, Inc., 1998.
Kenner, Dan and Yves Requena. Botanical Medicine: A European
Professional Perspective. Paradigm Publications, 1996.
PERIODICALS
Zambon, Daniel, et al. “Substituting Walnuts for Monounsatu-
rated Fat Improves the Serum Lipid Profile of Hypercho-
lesterolemic Men and Women.” Annals of Internal Medi-
cine (April 2000) 132: 533-537.
David Helwig
Bladder cancer
Definition
Bladder cancer is a disease in which the cells lining
the urinary bladder lose the ability to regulate their
251
Bladder cancer
Bladder cancer
An immunofluorescent light micrograph of cells cultured from
squamous carcinoma of the bladder. (Photograph by Nancy
Kedersha, Photo Researchers, Inc. Reproduced by permission.)
growth and start dividing uncontrollably. This abnormal
growth results in a mass of cells that form a tumor.
Description
Bladder cancer attacks the urinary bladder, a hollow,
muscular organ that stores the urine received from the kid-
neys until it is excreted out of the body. Bladder cancer is
the fifth most common cancer in the United States, and the
development of new cases is on the rise. The disease is al-
most three times more common among men than women,
and the risk of the disease increases with age. Most cases
of bladder cancer are found in people in their 60s.
Causes & symptoms
Smoking is considered one of the greatest risk fac-
tors for bladder cancer. The risk is probably due to the
fact that cancer-promoting substances found in tobacco
tend to collect in the urine, and then become concentrat-
ed in the bladder while awaiting excretion. Other chemi-
cals, including aniline dyes, beta-napthylamine, benza-
dine salts, and mixtures of aromatic hydrocarbons also
are believed to be cancer-causing agents. These chemi-
cals are widely used in the rubber, leather, textile, chemi-
cal, plastics, petroleum, wood, and paint industries. It
may take up to 50 years after the original chemical expo-
sure for bladder cancer to develop. In 2003, studies
showed that hormone replacement therapy (HRT), a
treatment used by many postmenopausal women, signifi-
cantly increased the risk of bladder and other cancers.
Frequent urinary tract infections, kidney and blad-
der stones, and other conditions that cause long-term ir-
ritation to the bladder may increase the risk of bladder
cancer. If there is a past history of tumors in the bladder,
there is a strong possibility of their recurrence.
252
One of the first warning signals of bladder cancer is
blood in the urine. Sometimes, there is enough blood to
change the color of the urine to a yellow-red or a dark
red. However, during the early stages of bladder cancer
there are often no observable symptoms of the disease. A
change in bladder habits such as painful urination, in-
creased frequency of urination and increased urgency in
the need to urinate, are all symptoms of bladder cancer;
but they are also common symptoms of less serious dis-
eases of the urinary tract and prostate glands.
Diagnosis
There are several tests to find out whether bladder
cancer is present. As a first step, a complete medical histo-
ry will be taken to check for any risk factors. A thorough
physical examination will be conducted to assess all the
signs and symptoms. Laboratory testing of a urine sample
helps rule out the presence of a bacterial infection.
More in-depth tests are used to make a definite diag-
nosis. The intravenous pyelogram (1VP) is an x-ray ex-
amination that is performed after a dye is injected into
the blood stream. It clearly outlines the kidneys, ureters,
bladder, and urethra to detect abnormalities in the lining
of these organs.
In a procedure known as a cystoscopy, a thin hollow
lighted tube is introduced into the bladder. If any suspi-
cious looking masses are seen, a small piece of the tissue
can be removed using a pair of biopsy forceps. The tis-
sue is then examined microscopically to verify if cancer
is present. Imaging tests such as chest x rays, computed
tomography (CT) scans, and magnetic resonance imag-
ing (MRI) may be done to determine if the cancer has
spread to other organs.
Treatment
Most alternative treatments for cancer should be
used in addition to allopathic treatment. A well-devel-
oped treatment plan for cancer should be discussed with
an oncologist or other physician.
Studies indicate that garlic may be used to stop the
spread of bladder cancer. It also can help reduce the
body wasting and fatigue that may accompany cancer, as
well as reducing the side effects of radiation and
chemotherapy. The equivalent of one to two cloves per
day is recommended.
European mistletoe ( Viscum album L.), is recom-
mended to stimulate the immune system and to kill can-
cer cells. It also has been reported to reduce tumor size.
The most widely available mistletoe extract is sold under
the name of Iscador. Iscador is available in Europe only,
especially Switzerland. A three-month supply can be
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
purchased and brought back to the United States. Mistle-
toe often is taken in injectable form and should be ad-
ministered under a physician's supervision.
High doses of multivitamins have been reported to
be useful in decreasing the possibility of the recurrence
of bladder cancer. Treatment should be monitored by a
qualified healthcare practitioner.
Other complementary and alternative treatments in-
clude guided imagery, local and general hyperthermia,
and Chinese herbs. These herbs have been shown effec-
tive in controlled trials, particularly as a complement to
chemotherapy.
Allopathic treatment
Treatment for bladder cancer depends on the stage
of the tumor. The standard modes of treatment available
for bladder cancer are surgery, immunotherapy, radiation
therapy, and chemotherapy. Surgery is considered an op-
tion only when the disease is in its early stages. If the
tumor is small and has not spread to the inner layers of
the bladder, surgery can be done without cutting open
the abdomen. A cystoscope is introduced into the bladder
through the urethra, and the tumor is removed through it.
A high-energy laser beam or other cautery instrument
may be introduced through the cystoscope to burn away
any remaining cancer.
If cancer has invaded deep into the walls of the blad-
der, surgery will be done through an incision in the ab-
domen. Part or all of the bladder and surrounding organs
such as the prostate or the uterus, ovaries, and fallopian
tubes may have to be removed. If the entire urinary blad-
der is removed, an alternate place must be created for the
urine to be stored before it is excreted. To do this, the
ureters are connected to a surgically created opening in
the skin, called a stoma. This procedure is called a
urostomy. A procedure can create a new bladder (called a
neo-bladder) using the patient’s intestine.
Radiation therapy uses high-energy rays to kill can-
cer cells. It generally is used after surgery to destroy any
cancer cells that have not been removed during surgery.
In addition, if the tumor is large or it is in a location that
makes surgery difficult, radiation may be used before
surgery to shrink the tumor. Radiation sometimes is used
together with chemotherapy in place of surgery. Radia-
tion therapy is used to ease pain, bleeding, and block-
ages in cases of advanced bladder cancer.
Chemotherapy uses drugs to destroy cancer cells.
Generally a combination of drugs is more effective than
any single drug in treating bladder cancer. Medications
are introduced into the bloodstream by injecting them
into a vein in the arm or orally in pill form. Anticancer
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
drugs may also be introduced directly into the bladder to
treat superficial tumors. Chemotherapy may be given
following surgery to kill any remaining cancer cells. A
2003 report stated that giving patients with bladder can-
cer chemotherapy followed by surgery may improve
their outcomes. In the study of 307 patients, those with
this combination of therapy lived two years longer than
those treated with surgery only.
Immunotherapy, or biological therapy, uses the
body’s own immune system to fight the disease. In the
case of early-stage bladder cancer, bacille Calmette-
Guerin (BCG), a weakened strain of tuberculosis, may
be placed directly into the bladder. As the immune sys-
tem rallies to fight off the tuberculosis, it also attacks and
kills cancer cells. This therapy has been shown to be ef-
fective in controlling superficial bladder cancer.
New treatments are continuously being investigated.
Scientists have made great strides in gene mapping and re-
search in the twenty-first century. In 2003, a type of gene
therapy was being tested on patients with bladder cancer
with success, but further enhancements were needed.
Expected results
If cancer is detected early and is limited to the inner
lining of the bladder, it responds well to treatment. Most
bladder cancers are first seen at this stage. At least 90%
of patients survive five years or more after an initial di-
agnosis. However, if the disease has spread to nearby tis-
sues, the survival rates drop to 49%, and if the cancer
metastasizes to distant organs only about 6% of patients
will survive five years or more.
Bladder cancer has a very high rate of recurrence.
Even after tumors are totally removed, there is a high
chance that new tumors will develop. Therefore, those
who have had bladder cancer should have frequent and
thorough follow-up care.
Prevention
Those who have a history of bladder cancer, who
have been regularly exposed to cancer-causing chemicals,
or who have had conditions that cause long-term irritation
to the bladder, should undergo regular screening tests for
bladder cancer. This will ensure that the disease can be
detected in the early stages and treated appropriately.
Avoiding risk factors whenever possible is the best
alternative, particularly tobacco. Appropriate safety pre-
cautions should be maintained when working with can-
cer-causing chemicals. Working with such chemicals
should probably be avoided altogether. Women may
want to discuss the risks vs. benefits of hormone replace-
ment therapy with their physicians.
253
Bladder cancer
Bladder infection
KEY TERMS
Cautery instrument — A device that uses heat ap-
plied to the tissues to destroy damaged or dis-
eased areas.
Cystoscope — An instrument used to view and in-
troduce treatments into the urinary tract.
Metastasize — The spread of cancer to an area
away from where it started originally.
Oncologist — A doctor who specializes in treating
cancer.
Tumor — An uncontrolled growth of tissue, which
may be cancerous.
Ureters — The tubes that carry urine from the kid-
ney into the bladder for storage.
Since stress and irritation of the bladder may con-
tribute to bladder cancer, the health of the bladder and
urinary tract should be carefully maintained. Caffeine,
which is found in coffee, tea, colas, and chocolate, is
thought to be a factor for cancer of the lower urinary
tract, including the bladder, and should be avoided. It
also is important to have a good fluid intake to flush the
urinary tract of possible toxins. Six to eight glasses or
more of water and fluids such as plain herbal teas and di-
luted fruit or vegetable juices should be consumed daily.
A dropperful (25-30 drops) of a tincture of burdock seed,
Artium lappa, will help flush the entire urinary tract, re-
lieve bladder irritation and inflammation, and strengthen
the bladder.
Resources
BOOKS
Berkow, MD, Robert, editor-in-chief, et al. The Merck Manual
of Medical Information, Home Edition. New York: Pocket
Books, 1997.
The Burton Goldberg Group. Alternative Medicine: The Defin-
itive Guide. Washington: Future Medicine Publishing,
1995.
Murphy, Gerald P. Lois B. Morris, and Dianne Lange. In-
formed Decisions: The Complete Book of Cancer Diagno-
sis, Treatment and Recovery. New York: Viking, 1997.
Weed, Susan. Healing Wise. New York: Ash Tree Publishing,
1989.
PERIODICALS
Grossman, H. Barton, et al. “Neoadjuvant Chemotherapy Plus
Cystectomy Compared With Cystectomy Alone for Local-
ly Advanced Bladder Cancer.” The New England Journal
of Medicine (August 28, 2003): 859.
254
“HRT Increases Risk of Gallbladder, Breast, Endometrial, and
Bladder Cancer." Women's Health Weekly (July 17, 2003):
31.
“Intravesical Gene Therapy Appears Safe for Those With Local
Bladder Cancer.” Cancer Weekly (July 8, 2003): 144.
OTHER
AltemativeMedicine.com. http://www.alternativemedicine.com
(January 17, 2001).
Lycos Health with WebMD. 1996-2000. http://webmd.lycos.
com/content/dmk/dmk_article_58401 (January 17, 2001).
“Mistletoe Summary.” May 4, 1999. The University of Texas
Center for Alternative Medicine Research. http://www.
sph.uth.tmc.edu/utcam/summary/mistletoe.htm (January
17, 2001).
Patience Paradox
Teresa G. Odle
Bladder infection
Definition
Bladder infection, also called cystitis, refers to in-
fection and inflammation of the urinary bladder. Urethri-
tis is an inflammation of the urethra, which is the pas-
sageway that connects the bladder with the exterior of
the body. Sometimes cystitis and urethritis are referred to
collectively as a lower urinary tract infection, or UTI. In-
fection of the upper urinary tract involves the spread of
bacteria to the kidney and is called pyelonephritis.
Description
The frequency of bladder infections in humans
varies significantly according to age and sex. The
male/female ratio of UTIs in children younger than 12
months is 4: 1 because of the high rate of birth defects in
the urinary tract of male infants. In adults, the male/fe-
male ratio of UTIs is 1:50. After age 50, however, the in-
cidence among males increases due to prostate disorders.
UTIs are common in females. It is estimated that
50% of adult women experience at least one episode of
dysuria (painful urination); half of these patients have a
bacterial UTI. Between 2-5% of women’s visits to pri-
mary care doctors are for UTI symptoms. About 90% of
UTIs in women are uncomplicated but recurrent.
UTIs are uncommon in younger and middle-aged
men, but may occur as complications of bacterial infec-
tions of the kidney or prostate gland.
In children, bladder infection is often caused by
congenital (present at birth) abnormalities of the urinary
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
tract. Vesicoureteral reflux is a condition in which the
child cannot completely empty the bladder. It allows
urine to remain in or flow backward (reflux) into the par-
tially empty bladder.
Causes & symptoms
The causes of bladder infection vary according to
gender because of the differences in anatomical structure
of the urinary tract.
Females
Most bladder infections in women are so-called as-
cending infections, which means that they are caused by
microbes traveling upward through the urethra to the
bladder. The relative shortness of the female urethra
(1.2-2 in [3-5 cm] in length) makes it easy for bacteria to
gain entry to the bladder and multiply. The most com-
mon bacteria associated with UTIs in women include Es-
cherichia coli (about 80% of cases), Staphylococcus
saprophyticus , Klebsiella, Enterobacter , and Proteus
species. Risk factors for UTIs in women include:
• Sexual intercourse. The risk of infection increases if
the woman has multiple partners.
• Use of a diaphragm for contraception.
• An abnormally short urethra.
• Diabetes or chronic dehydration.
• The absence of a specific enzyme (fucosyltransferase)
in vaginal secretions. The lack of this enzyme makes it
easier for the vagina to harbor bacteria that cause UTIs.
• Inadequate personal hygiene. Bacteria from fecal mat-
ter or vaginal discharge can enter the female urethra be-
cause its opening is very close to the vagina and anus.
• History of previous UTIs. About 80% of women with
bladder infection develop recurrences within two years.
The early symptoms of bladder infection in women
are dysuria (pain on urination), urgency (sudden strong
desire to urinate), and increased frequency of urination.
About 50% of female patients experience fever, pain in
the lower back or flanks, nausea and vomiting, or shak-
ing chills. These symptoms indicate pyelonephritis, or
spread of the infection to the upper urinary tract.
Males
Most UTIs in adult males are complications of kid-
ney or prostate infections. They usually are associated
with a tumor or kidney stones that block the flow of
urine and often are persistent infections caused by drug-
resistant organisms. UTIs in men are most likely to be
caused by E. coli or another gram-positive bacterium. 5.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
This illustration depicts the cycle of recurrence of urinary
tract infections. The lower tract (urethra and bladder) is rela-
tively resistant to infection. The kidneys are more vulnera-
ble. (Custom Medical Stock Photo. Reproduced by permission.)
saprophyticus , which is the second most common cause
of UTIs in women, rarely causes infections in men. The
symptoms of bladder infection and pyelonephritis in
men are the same as in women. Risk factors for UTIs in
men include:
• Lack of circumcision. The foreskin can harbor bacteria
that cause UTIs.
• Urinary catheterization. The longer the period of
catheterization, the higher the risk of UTIs.
Hemorrhagic cystitis
Hemorrhagic cystitis, which is marked by large
quantities of blood in the urine, is caused by an acute
bacterial or viral infection of the bladder. In some cases,
hemorrhagic cystitis is a side effect of therapy or treat-
ment with cyclophosphamide. Hemorrhagic cystitis in
children is associated with adenovirus type 11. In some
255
Bladder infection
Bladder infection
cases, hematuria results from athletic training, particu-
larly in runners.
Diagnosis
When bladder infection is suspected, the doctor will
first examine the patient’s abdomen and lower back, to
evaluate pain and unusual enlargements of the kidneys or
swelling of the bladder. In small children, the doctor will
check for fever, abdominal masses, and a swollen bladder.
The next step in diagnosis is collection of a urine
sample. The procedure differs somewhat for women and
men. Laboratory testing of urine samples can now be
performed with dipsticks that indicate immune system
responses to infection, as well as with microscopic
analysis of samples. Normal human urine is sterile. The
presence of bacteria or pus in the urine usually indicates
infection. The presence of blood in the urine (hematuria)
may indicate acute UTIs, kidney disease, kidney stones,
inflammation of the prostate (in men), endometriosis (in
women), or cancer of the urinary tract.
Females
Female patients sometimes require a pelvic exami-
nation as part of the procedure to diagnose bladder infec-
tions. The patient lies on an obstetrical table with feet in
the stirrups. The may take a vaginal culture smear. The
patient often is asked to provide a urine sample. A mid-
stream urine sample of 200 ml is collected to test for
bladder infection. Often, just a “clean catch,” or mid-
stream sample, is needed, without a pelvic exam.
A high bacterial count in the urine sample indicates
urethritis. A count of more than 100,000 (10 5 bacteria
CFU/ml, or colony-forming units per milliliter) in the
midstream sample indicates a bladder or kidney infec-
tion. A colony is a large number of microorganisms that
grow from a single cell. Bacterial count can be given in
CFU or colony forming units.
Males
In male patients, the doctor will cleanse the opening
to the urethra with an antiseptic before collecting the
urine sample. The first 10 ml of urine are collected sepa-
rately. The patient then voids a midstream sample of 200
ml. Following the second sample, the doctor will mas-
sage the patient’s prostate and collect several drops of
prostatic fluid. The patient then voids a third urine speci-
men for prostatic culture.
A high bacterial count in the first urine specimen or
the prostatic specimen indicates urethritis or prostate in-
fections respectively. A bacterial count greater than
100,000 bacteria CFU/ml in the midstream sample sug-
256
gests a bladder or kidney infection. Children may need to
be catheterized (a sterile procedure), in which case a cul-
ture of 1,000 bactera CFU/ml is indicative of infection.
Other tests
Women with recurrent UTIs can be given ultrasound
tests of the kidneys and bladder together with a voiding
cystourethrogram to test for structural abnormalities. (A
cystourethrogram is an x-ray test in which an iodine dye
is used to better view the urinary bladder and urethra.)
Voiding cystourethrograms are also used to evaluate chil-
dren with UTIs. In some cases, computed tomography
scans (CT scans) can be used to evaluate patients for
possible cancers or other masses in the urinary tract.
Treatment
Diet
Dietary changes which may help to control and pre-
vent bladder infection include:
• Drinking 8-12 glasses of water daily helps to wash out
bacteria (although this may also dilute antibacterial fac-
tors in the urine).
•Acidifying the urine by eating few alkaline foods
(dairy, soda, and citrus).
• Following a diet rich in grains, vegetables, and acidify-
ing juices.
• Eliminating foods that irritate the bladder (coffee, black
tea, alcohol, and chocolate).
• Eliminating high sugar foods (sweet vegetables, fruits,
sugar, and honey).
• Drinking unsweetened cranberry juice to acidify the
urine and provide hippuric acid. Cranberry capsules
can substitute for the juice.
• Ingesting at least one clove of garlic (or up to 1 ,200 mg
garlic as a tablet) daily for its anti-infective properties.
Herbals and Chinese medicine
Herbals that possess antibacterial, antioxidant,
demulcent, astringent, antiviral, antispasmodic, and/or
diuretic properties are useful in treating bladder infec-
tion. Herb tinctures have a more rapid effect than teas.
Useful herbals include bearberry ( Arctostaphylos uva-
ursi), buchu ( Barosma betulina), cornsilk (Zea mays),
cinnamon, cedar, pipsissewa ( Chimaphilia ), Oregon
grape root {Berberis aquifolia), goldenseal (Hydrastis
canadensis ), marsh mallow root (Althea officinalis),
kava, and birch. A tincture recipe for bladder infection is
as follows:
• cornsilk, 2 parts
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• bearberry, 2 parts
• Viburnum prunifolium, 1 part
• Valeriana officinalis , 1 part
The patient should take the 5 ml of the tincture three
times daily. An infusion of Archillea millefolium should
be drunk frequently. The patient can take 1.5-3 g of the
Chinese patent medicine Qing Lin Wan (Green Unicorn
Pill) twice daily.
Supplements
The antioxidant vitamins A, C, and E may be benefi-
cial in treating bladder infection. The patient should take
400-600 IU of vitamin E and 300 mg vitamin B 6 daily.
Ascorbic acid is irritating to the bladder so vitamin C
should be taken in the form of calcium ascorbate, about
6,000-20,000 per day. Magnesium may be helpful in treat-
ing renal disease. Zinc may boost the immune system.
Homeopathic medicine also can be effective in treat-
ing bladder infection. Choosing the correct remedy
(based on the patient’s symptoms) is always key to the
success of homeopathic treatment. Homeopathic reme-
dies for bladder infection include Spanish fly
(Cantharis), sarsaparilla, stavesacre ( Staphysagria ), and
Oregon grape ( Berberis aquifolium). The correct homeo-
pathic treatment is effective within 12 hours. Acupunc-
ture also can be helpful in treating acute and chronic
cases of bladder infection.
Allopathic treatment
Medications
Uncomplicated cystitis is treated with antibiotics.
These include penicillin, ampicillin, and amoxicillin;
sulfisoxazole or sulfamethoxazole; trimethoprim; nitro-
furantoin; cephalosporins; or fluoroquinolones. Treat-
ment for women is short-term; most patients respond
within three days. In 2003, reports showed that pre-
sumed, uncomplicated UTIs in women could often be
treated over the telephone when the patient reported her
symptoms to a nurse who had a series of prepared ques-
tions. Men typically do not respond as well and require
seven to 10 days of oral antibiotics for uncomplicated
UTIs. Patients of either sex may be given phenazopyri-
dine or flavoxate to relieve painful urination. Trimetho-
prim and nitrofurantoin are preferred for treating recur-
rent UTIs in women.
Over 50% of older men with UTIs also suffer from
infection of the prostate gland. Some antibiotics, includ-
ing amoxicillin and the cephalosporins, do not affect the
prostate gland. Fluoroquinolone antibiotics or trimetho-
prim are the drugs of choice for these patients.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Surgery
A minority of women with complicated UTIs may
require surgical treatment to prevent recurrent infections.
Surgery is also used to treat reflux problems (movement
of the urine backwards) or other structural abnormalities
in children and anatomical abnormalities in adult males.
Expected outcome
In many cases, alternative medicines can resolve
bladder infections quickly. It is important to see a doctor
if symptoms do not subside after a few days or worsen.
The prognosis for recovery from uncomplicated bladder
infection is excellent. However, complicated UTIs in
males are difficult to treat because they often involve
bacteria that are resistant to commonly used antibiotics.
Prevention
Researchers are trying to develop a vaccine for
UTIs. In 2003, a study of women with frequent infec-
tions showed that a vaccine administered by a vaginal
suppository headed off bladder infections in many of the
study volunteers. The vaccine was still not available on
the market, however. The following measures may be
taken to prevent bladder infection:
• drinking large amounts of fluid
• reducing intake of sugar
• voiding frequently and as soon as the need arises
Women with two or more UTIs within a six-month
period are sometimes given prophylactic antibiotic treat-
ment, usually nitrofurantoin or trimethoprim for three to
six months. In some cases the patient is advised to take
an antibiotic tablet following sexual intercourse.
Other preventive measures for women include:
• voiding frequently, particularly after intercourse
• proper cleansing of the area around the urethra (wipe
front to back)
• acupuncture
The primary preventive measure specifically for
males is prompt treatment of prostate infections. Chronic
prostatitis may go unnoticed but can trigger recurrent
UTIs. In addition, males who require temporary
catheterization following surgery can be given antibi-
otics to lower the risk of UTIs.
Resources
BOOKS
Anderson, E. Everett. “Dysuria, Pyuria, and Hematuria.” In
Current Diagnosis 9. Edited by Rex B. Conn, et.al.
Philadelphia: W. B. Saunders Company, 1997.
257
Bladder infection
Blessed thistle
KEY TERMS
Bacteriuria — The presence of bacteria in the urine.
Dysuria — Painful or difficult urination.
Hematuria — The presence of blood in the urine.
Pyelonephritis — Infection of the kidney.
Urethritis — Inflammation of the urethra, the passage
through which urine is eliminated from the body.
Donovan, James F., and Richard D. Williams. “Urology.” In Cur-
rent Surgical Diagnosis & Treatment. Edited by Lawrence
W. Way. Stamford, CT: Appleton & Lange, 1994.
King, Lowell R. “Bacterial Infections of the Urinary Tract in
Girls.” In Conn’s Current Therapy. Edited by Robert E.
Rakel. Philadelphia: W. B. Saunders Company, 1998.
Mata, John A. "Bacterial Infections of the Urinary Tract in Fe-
males.” In Conn's Current Therapy. Edited by Robert E.
Rakel. Philadelphia: W. B. Saunders Company, 1998.
Robertson. Jack R., and David B. Hebert. “Gynecologic Urolo-
gy.” In Current Obstetric & Gynecologic Diagnosis &
Treatment. Edited by Alan H. DeCherney and Martin L.
Pernoll. Stamford, CT: Appleton & Lange, 1994.
Ying, Zhou Zhong, and Jin Hui De, “Genitourinary Diseases.”
In Clinical Manual of Chinese Herbal Medicine and
Acupuncture. New York: Churchill Livingston, 1997.
PERIODICALS
Aune, Audun, Terje Alraek, Huo LiHua, and Anders Baerheim.
“Acupuncture in the Prophylaxis of Recurrent Lower Uri-
nary Tract Infection in Adult Women.” Scandinavian
Journal of Primary Health Care 16 (1998):37-39.
Harrar, Sari. “Bladder Infection Protection.” Prevention (No-
vember 2003): 174.
Jancin, Bruce. “Presumed Cystitis Well Managed Via Tele-
phone: Large Kaiser Experience.” Family Practice News
(November 1, 2003):41.
Reid, Gregor. “Potential Preventive Strategies and Therapies in
Urinary Tract Infection.” World Journal of Urology 17
(19991:359-363.
OTHER
Hoffman, David L. “Cystitis.” HealthWorld Online. <http://www.
healthy.net/library/books/hoffman/urinary/ cystitis.htm.>
Belinda Rowland
Teresa G. Odle
Blessed thistle
Description
Blessed thistle, Cnicus benedictus (also known as
Carduus benedictus and Carbenia benedicta), is a mem-
258
her of the Asteracea, or daisy, family. The bitter- tasting,
prickly thistles are considered “noxious weeds” when
they take root and grow abundantly in open fields and
meadows. The presence of this beneficial Mediterranean
native, however, indicates fertile ground. The ancient
Romans ate the leaf fresh and boiled the root as a veg-
etable. Thistle was once used as a nutritious fodder for
cattle in Scotland, and the leaf, folded between two
slices of buttered bread, was eaten with the breakfast
meal. In the Middle Ages, thistle was one of the most
common European medicinal herbs. Shakespeare wrote
about it in his play, Much Ado About Nothing, with the
advice: “Get you some of this distilled Carduus Benedic-
tus and lay it to your heart; it is the only thing for a
qualm.” The belief in thistle as a heart tonic persists. One
English herbalist, writing in the mid-twentieth century,
declared blessed thistle “Good for all organs of the body,
especially the heart and brain.” Like many native Euro-
pean herbs, blessed thistle is credited with magical pow-
ers. It is said to be effective in exorcism, hex-breaking,
and in purification spells. Grown outside the home, this
blessed herb is said to attract peace, love, and harmony.
Blessed thistle is also known as holy thistle, St.
Benedict thistle, cardin, and spotted thistle. This herba-
ceous annual has been cultivated for centuries as a medi-
cinal herb. It was a component of many herbal remedies
used to combat the plague. The herb was cultivated in
monastery gardens as a cure for smallpox. Its specific
name is in honor of St. Benedict, the founder of a holy
order of monks.
Other thistles, including Carduus marianus or Sily-
bum marianum , also sometimes known as holy thistle,
Our Lady’s milk thistle, Marian thistle, and wild arti-
choke have similar medicinal applications, particularly
as liver tonics.
Thistles are naturalized throughout North America,
found growing wild in sunny locations and stony soils.
Blessed thistle grows from a thick taproot first forming a
rosette of narrow leaves at ground level. The stems aris-
ing from the root are erect and hairy. Dark green, narrow
leaves clasp the stem. They are deeply lobed, wavy and
toothed on the margins, and veined. Each toothed lobe
bears a prickly spine. Even the pale yellow flower heads,
blooming at the top of the stem, are covered with prickly
spines. The stem is reddish brown and branched reaching
to two feet in length. The hardy thistle will self sow and
thrive in good soil. If left to grow wild and uncultivated,
thistles may become intrusive.
General use
The entire plant is edible, though the prickly spines
can be troublesome. The herb contains B-complex vita-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
mins, calcium, iron, and manganese. Blessed thistle is
considered by many contemporary herbalists and in tra-
ditional folk use as a tonic, astringent, diaphoretic (in-
creases perspiration), emetic (induces vomiting), and
stimulant. Both the blessed thistle and milk thistles are
recommended as a liver tonic, particularly when the liver
disease is brought on by alcoholism. It has been used in
treatment of jaundice and hepatitis. A tea from the
leaves, taken warm, will increase perspiration, reduce
congestion, and help to bring down fever. A mild infu-
sion is astringent and may relieve diarrhea, but a very
strong infusion is emetic and may cause nausea and
vomiting. Blessed thistle is considered to be one of the
best herbs to stimulate the flow of milk in lactating
women (lactating women should always consult their
physicians before taking this herb), and its emmena-
gogue action (promotes menstrual discharge) helps to
regulate female hormone balance and relieve menstrual
pain. Blessed thistle has also been used to treat the vagi-
nal discharge known as leucorrhea. The herb is used in
the commercial manufacture of herbal bitters, and is
considered a general tonic and digestive. Its bitter prop-
erties increase the flow of bile and other gastric secre-
tions. The herb may stimulate appetite and relieve flatu-
lence. Blessed thistle is said to relieve melancholy and
lethargy, and was traditionally fed to mentally ill per-
sons. It acts to increase blood circulation and aids mem-
ory. Applied externally in poultice form, blessed thistle
is a good treatment for shingles, wounds, and ulcers.
The plant has antimicrobial properties. The essential oil
has been shown to have antibiotic action against infec-
tions, specifically Staphylococcus aureus and S.faecalis.
Blessed thistle has a history in folk use for the treatment
of heart ailments, cancers, and as a contraceptive, but
these, and other traditional uses, have not been con-
firmed by research.
Preparations
Collect thistle on a hot and dry mid-summer after-
noon, just as the herb begins to bloom. Harvest from the
wild in areas where herbicides are not used, or from a
cultivated garden patch. The leaves and flowering stems
may be hung to dry in a light, airy room away from direct
sunlight. Cut the dried herb and store in a clearly-labeled,
dark-glass container. Seeds may be gathered in the fall.
Tincture: Combine 4 oz of fresh, or half as much
dried, thistle leaf with 1 pt of brandy, gin, or vodka in a
glass container. The alcohol should be enough to cover
the flowers. The ratio should be close to 50/50 alcohol to
water. Stir and cover. Place the mixture in a dark cup-
board for three to five weeks. Shake the mixture several
times each day. Strain and store in a tightly-capped,
clearly labeled, dark glass bottle. A standard dose is 1-2
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
ml of the tincture three times a day. Tinctures, properly
prepared and stored, will retain medicinal potency for
two years or more.
Infusion: Use twice as much fresh, chopped herb
as dried herb. Steep 1-2 teaspoons of finely chopped
fresh or dried thistle per cup of boiled, unchlorinated
water for 10-15 minutes. Strain and cover. Drink
warm, sweetened with honey if desired. A standard
dose is three cups per day. Strong infusions of thistle
may cause diarrhea. A prepared herbal infusion will
keep for up to two days in the refrigerator and retain
its healing qualities.
Precautions
There are no reported incidents of thistle toxicity.
However, as with most medicinal herbs, they should not
be taken during pregnancy. Children under two years
should not be given the herb. Lactating women should
consult with a qualified herbalist before using the herb.
Strong infusions of blessed thistle may cause nausea
and vomiting.
Side effects
None reported.
Interactions
None reported.
Resources
BOOKS
Coon, Nelson. An American Herbal, Using Plants For Healing.
Pennsylvania: Rodale Press, 1979.
Elias, Jason and Shelagh Ryan Masline. The A to Z Guide to
Healing Herbal Remedies. Lynn Sonberg Book Associ-
ates, 1996, (Wing Books, 1997 edition).
Hoffmann, David. The New Holistic Herbal, 2nd edition.
Massachusetts: Element, 1986.
Mabey, Richard. The New Age Herbalist. New York: Simon &
Schuster, Inc., 1988.
McIntyre, Anne. The Medicinal Garden. New York: Henry Holt
and Company, 1997.
Meyer, Joseph E. The Herbalist. Clarence Meyer, 1973.
Murray, Michael T. The Healing Power of Herbs, 2nd ed. Cali-
fornia: Prima Publications, Inc., 1995
Phillips, Roger, and Nicky Foy. The Random House Book of
Herbs. New York: Random House, 1990.
Polunin, Miriam and Christopher Robbins. The Natural Phar-
macy. New York: Macmillan Publishing Company, 1992.
Thomson, William A. R. Medicines From The Earth. San Fran-
cisco: Harper & Row, 1983.
Weiss, Gaea, and Shandor Weiss. Growing & Using The Heal-
ing Herbs. NY: Wing Books, 1992.
259
Blessed thistle
Blisters
OTHER
Grieve, Mrs. M. A Modern Herbal. Available at: Botanical,
com. <http://www.botanical.eom/botanical/mgmh/t/thist
11 l.html.>
Clare Hanrahan
Blisters
Definition
Blisters are small, raised lesions where fluid has col-
lected under the skin. They may be caused by an allergic
reaction, burns, frostbite, or by excessive friction or
trauma to the skin. Blisters may also be a symptom of a
systemic illness, or of a specific skin disorder.
Description
The thin-skinned sac of a blister contains fluid, and
in most cases should not be ruptured, as rupturing can in-
troduce infection and slow the healing process. Blisters
that contain blood instead of fluid are aptly named blood
blisters, and are caused by a rupture of blood vessels be-
neath the surface of the skin, usually due to trauma.
Causes & symptoms
Blisters can be caused by a number of conditions
and environmental agents, including:
• Friction. Rubbing or pinching can cause skin irritation
and blistering. Friction blisters frequently occur on the
hands and feet.
• Disease. Blisters are symptomatic of skin disorders
such as impetigo, incontinentia pigmenti syndrome
(IPS), and pemphigus vulgaris. Blisters may also be
caused by diseases such as herpes and chickenpox.
• Contact dermatitis. Skin contact with an allergen (e.g.,
latex, cosmetics, cleaning solutions) can trigger red-
ness, irritation, rash, and blistering of the skin. Blisters
also typically appear after skin contact with poison ivy,
oak, or sumac.
• Burns. Blisters appear in cases of severe sunburn and
thermal burns.
• Frostbite. Severely frostbitten skin frequently blisters.
• Trauma. Blood blisters are caused by trauma to the
skin.
Other new causes of blisters are discovered by
clinicians. In 2002, a report discussed how a newly
260
Man with blistered arm from poison ivy. (Custom Medical
Stock Photo. Reproduced by permission.)
identified autoimmune blistering disease involving the
mucous membranes also increased the risk of some
solid cancers.
Diagnosis
Diagnosis and treatment of most minor blisters can
typically be made at home by examination of the affect-
ed area. Blisters thought to be caused by a systemic ill-
ness or disease may require professional diagnosis by a
physician, dermatologist, or other healthcare profession-
al. A medical history, physical examination, and further
medical testing may be part of the diagnostic procedure.
Treatment
Unless they are hindering movement or are extreme-
ly painful due to their size and/or location, blisters
should not be ruptured, or “popped,” as doing so can in-
troduce bacteria into the wound. If a blister does burst,
the extra skin should be left intact. Blisters that are ex-
cessively large or painful should only be punctured using
antiseptic procedures, preferably by or under the direc-
tion of a qualified healthcare professional.
Treatment of blisters depends on their cause. Blis-
ters that are symptomatic of a disease or disorder require
treatment of the illness itself. Blisters caused by friction
or trauma can be treated by cleansing with mild soap, ap-
plying an antiseptic, and covering the area with a sterile
bandage. An herbalist, aromatherapist, or holistic health-
care professional may recommend a compress of an anti-
septic or anti-microbial herb such as marigold ( Calendu-
la officinalis), thyme ( Thymus vulgaris), lavender ( La-
vandula angustifolia), or tea tree oil ( Melaleuca alterni-
folici).
The blister should be kept clean and the bandage
changed frequently. Blood blisters should be bandaged
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Impetigo — A bacterial infection of the skin char-
acterized by skin blistering.
Incontinentia pigmenti syndrome (IPS) — An in-
herited skin disorder characterized by blistered le-
sions in infancy, which heal but leave uneven pig-
mentation of the skin.
Pemphigus vulgaris — An autoimmune skin disor-
der that causes blistering of the skin and mucous
membrane.
firmly to apply pressure to the area and prevent further
blood vessel ruptures.
Allopathic treatment
Conventional medicine typically follows the same
procedures for treating skin blisters. A prescription or
over-the-counter antiseptic ointment may be recom-
mended to clean the blistered area.
Expected results
With proper treatment, most minor blisters will
heal without complication in a matter of days. More se-
rious blisters caused by severe burns and certain dis-
eases may produce permanent scarring or discoloration
of the skin.
Prevention
Friction blisters can be prevented by wearing ade-
quate protection on the area prone to blistering. For ex-
ample, long distance runners can purchase properly fit-
ting shoes. People who work with their hands or feet can
purchase special gloves or shoes and boots. For instance,
in 2002, a boot company introduced safety toe footwear
for occupational use with enough room for toes to move
freely without rubbing against steel-toe caps.
Fair-skinned individuals who are prone to sunburn
should take extra precautions to avoid skin blistering,
such as using a high SPF sunscreen (at least 30 SPF) and
wearing a large brimmed hat and long-sleeved, loose
clothing in the sun.
Resources
BOOKS
Lawless. Julia. The Complete Illustrated Guide to Aromathera-
py. Boston, MA: Element Books, 1997.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
PERIODICALS
Minter, Stephen G. “Safety Boots to Prevent Blisters.” Occupa-
tional Hazards (May 2002): 106.
Worcester, Sharon.“Risk of Solid Cancers Raised by Blistering
Disease (Study of 35 Patients).” Skin &Allergy News
(June 2002): 45.
Paula Ford-Martin
Teresa G. Odle
Blood clots
Definition
A blood clot is a mass of blood cells and blood com-
ponents that form to stop the bleeding that occurs when a
blood vessel is injured. When a blood vessel is broken,
platelets in the blood become sticky and clump together
at the site of the injury. They begin to form a mass to
stop the flow of blood.
Description
Clotting is the body’s normal response to a bleeding in-
jury. It is a necessary function to prevent a person from los-
ing too much blood. Most blood clots dissolve back into the
blood when the body has healed the vessel. Blood clots,
however, can be potentially dangerous if they occur within
healthy blood vessels, or if they do not dissolve when their
work is done. A thrombus is a blood clot that forms along
the wall of the heart or a blood vessel. This type of clot can
slow blood flow, and if the clot becomes large enough, it
may stop the flow of blood in the vessel. An embolus is a
clot that forms in one area of the body, travels through the
bloodstream, and lodges in another vessel in the body. Em-
boli are less common and more dangerous, because they
can cause a sudden blockage in blood flow (embolism),
which could be fatal. An embolism occurring in an artery
will block blood flow to an organ or tissue, and could cause
tissue damage or death. An embolism in:
• a cerebral (brain) artery can cause a stroke
• a coronary artery can cause a heart attack
• a pulmonary (lung) artery can cause shortness of breath
or death
• a retinal artery can cause sudden blindness in one eye
• an artery supplying blood to a limb can cause tissue
damage and possibly gangrene
• any artery leading to an organ can cause loss of that
organ’s function
261
Blood clots
Blood clots
This illustration features a dissected human lower leg show-
ing clot formation (thrombosis) along the length of a vein.
(Custom Medical Stock Photo. Reproduced by permission.)
Causes & symptoms
There are several factors that contribute to the forma-
tion of blood clots. Phlebitis is a condition that may in-
crease abnormal blood clot formation. Blood diseases or
other conditions — especially inflammation — that alter the
quality of the blood can also affect clot formation. Plaque
formation in the arteries (atherosclerosis) and damaged
blood vessels both increase the chance of blood clots be-
cause they slow blood flow and provide a place for
platelets to collect and form a clot. Genetic factors also
play a role in tendency to form blood clots. Diet can have
an effect on clot formation, as well. Cholesterol and satu-
rated fats, which are also implicated in atherosclerosis, can
contribute to clot formation. People whose diets are low in
essential fatty acids, vegetables, and fish, and who do not
take in proper amounts of nutrients and antioxidants are
also at a higher risk for clots. Conditions or body positions
that slow blood circulation — extended bed rest or sitting in
a car or airplane for long periods of time — may also cause
262
blood clots to form; although one recent British study sug-
gests that the risk of so-called “traveler’s thrombosis” is
not as great as has been thought. Blood clots can be caused
by increased fibrinogen (a blood-clotting factor) due to es-
trogen in the late stages of pregnancy and from long-term
use of birth control pills. Other factors include varicose
veins, childbirth, sickle cell anemia, smoking, obesity,
liver disease, and cardiovascular disorders.
There may be no obvious symptoms of a blood clot.
When symptoms do occur, they often appear suddenly,
and point to the location of the clot. Extreme dizziness
that occurs without warning can indicate a clot in a cere-
bral artery. Sudden complete or partial blindness in one
eye could indicate a clot within the retinal artery. A hard
blue bulge in a vein, or unexpected pain in an arm or leg,
along with numbness, weakness, or another sign that
blood is not reaching the area, could indicate a blood
clot. Blisters or ulcers on the skin may occur as well. A
clot in an artery near a major organ like the heart or lung
will produce pain or decreased activity in that organ.
Gangrene (death of tissue) may occur if blood flow to a
region is blocked for an extended period of time.
Diagnosis
The patient will describe the severity and location of
the pain he or she has been experiencing. A physician
may also notice such physical signs of a blood clot as the
swelling blue bulge, discoloration of a limb, or an ulcer.
Medical personnel will also check for a missing or low-
ered pulse or blood pressure in a limb. A Doppler ultra-
sound examination, angiography, or arteriography may
be used to detect the location of the clot.
Treatment
Nutritional therapy may include the following: vita-
mins B 3 (niacin), B 6 , C, and E; fatty acid and garlic sup-
plements; and the minerals zinc, magnesium, and man-
ganese. Herbal remedies may include cayenne (Cap-
sicum frutescens), other hot peppers, and gingko ( Gink-
go biloba ) to help reduce the protein fibrin, which is a
necessary factor in blood clots. Bilberry ( Vaccinium
myrtillus), turmeric ( Curcuma longa ), and ginger ( Zin-
giber officinale ) help reduce platelets’ stickiness, which
is essential for clot formation. Onion ( Allium sepa ) and
garlic (A. sativum ) help reduce fibrin and platelet sticki-
ness. Patients who are taking prescribed anticoagulant
drugs should consult their doctors before starting vita-
min, nutritional, or herbal therapies.
Hydrotherapy treatment for blood clots can include
contrast applications. The patient alternates using hot
and cold treatments on the body in the area of the clot to
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
increase blood flow. A naturopath will recommend spe-
cific remedies based on the symptoms and personality of
a particular patient. A remedy for blood clots may in-
clude Hamamelis. Massage can be helpful if blood clots
are a result of poor circulation, although care should be
taken if a person suffers from phlebitis, since a clot
could mobilize and lodge elsewhere.
Allopathic treatment
Anticoagulant (anticlotting) drugs are usually pre-
scribed for patients with blood clots. Streptokinase is a
drug that will help dissolve clots that are already present
in the body. Heparin inhibits platelet clumping, and can be
prescribed after surgery, when blood is likely to clot. A
new and promising treatment to prevent clot formation as-
sociated with septic shock is a recombinant form of acti-
vated human protein C, a natural anticoagulant. Doctors
may prescribe aspirin for people who are at risk for having
blood clots, although aspirin can injure the stomach lin-
ing. Patients may want to ask their doctors about what can
be done to minimize damage from aspirin. Surgery is only
recommended to remove blood clots that appear to be life-
threatening or will cause tissue death if not removed.
Expected results
If a clot goes undetected it is potentially dangerous,
and could lead to a stroke, heart attack, or other serious
complication. It is important to have any sudden unex-
plained pain or loss of function checked out by a doctor. If
the blood flow to a limb is blocked for an extended period
of time, gangrene may set in, and the limb may require am-
putation. Diet and exercise can help prevent future clots.
Prevention
Some risk factors, such as genetically related dis-
eases, cannot be minimized. But minimizing other risk
factors will help prevent problems with blood clots.
Quitting smoking, controlling obesity, and improving
nutrition can help reduce the risk of problematic blood
clotting.
A healthy diet with high-fiber, low-cholesterol foods
and plenty of fruits and vegetables can help prevent
blood clots and many of the conditions that can lead to
blood clots, such as atherosclerosis. In addition, such
foods as garlic, ginger, onions, and hot peppers can help
reduce platelet stickiness and formation of clots. Fish
oils and supplements that add nutrients to the diet are
recommended as well.
Moderate exercise helps keep off extra weight and
improves circulation, both of which help reduce risk fac-
tors for formation of blood clots. Exercise can also re-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Embolism — Obstruction or blockage in a blood
vessel caused by an embolus.
Embolus — A clot which forms in one place in the
body and then travels and lodges elsewhere. Em-
boli is the plural of embolus.
Phlebitis — A condition in which there is inflam-
mation of the blood vessel walls.
Thrombus — A clot which forms in the heart or
blood vessel and remains there.
duce the risk of blood clots in women who use birth con-
trol pills for long periods of time. Those who must sit for
long periods of time — on an airplane, in a car, or at
work — can help prevent blood clots by wearing loose
clothing, walking, and stretching their legs whenever
possible. Flexing and releasing the lower body muscles,
even while sitting, can help improve circulation as well.
Resources
BOOKS
Cassileth, Barrie R. The Alternative Medicine Handbook: The
Complete Reference Guide to Alternative and Comple-
mentary Therapies. New York: W.W. Norton and Compa-
ny, 1998.
Somerville, Robert. The Medical Advisor: The Complete Guide
to Alternative & Conventional Treatments. Alexandria,
VA: Time Life Inc., 1996.
Strohecker, James. Alternative Medicine: The Definitive Guide.
Tiburon, CA: Future Medicine Publishing, Inc., 1994.
PERIODICALS
Adedeji, Moses O., Julio Cespedes, et al. "Pulmonary Throm-
botic Arteriopathy in Patients with Sickle Cell Disease.”
Archives of Pathology and Laboratory Medicine 125 (No-
vember 2001): 1436-1441.
“Better Than Aspirin?” Industry Week (July 7, 1997): 32.
Egermayer, Paul. "The ‘Economy Class Syndrome': Problems
With the Assessment of Risk Factors for Venous Throm-
boembolism.” Chest 120 (October 2001): 1047-1048.
Hinds, C. J. “Treatment of Sepsis With Activated Protein C:
Encouraging News for Well Selected Patients. British
Medical Journal 323 (October 23, 2001): 881-882.
OTHER
Medline Plus Health Information. “Blood clots.” March 1,
2001 [cited October 2002]. <http://www.nlm.nih.gov/
medlineplus/ency/article/00 1 1 24.htm>.
WebMDHealth. <http://my.webmd.com>.
Heather Bienvenue
Rebecca J. Frey, PhD
263
Blood clots
Blood poisoning
Blood poisoning
Definition
Blood poisoning, also known as septicemia or sep-
sis, occurs when the bloodstream becomes infected by
bacteria (i.e., staphylococci, streptococci) or fungi intro-
duced through a wound, abscess, or other injury. Sep-
ticemia may also originate from a localized infection in
the body.
Description
Over 600,000 cases of septicemia occur in the Unit-
ed States each year, and approximately two-thirds of
these cases are diagnosed in hospitalized patients. Sep-
ticemia is an extremely dangerous disorder because it
spreads rapidly throughout the body. If bacteria continue
to multiply in the bloodstream and the condition pro-
gresses to septic shock, blood pressure plummets and
organ systems begin to shut down. Septic shock leads to
multiple-organ dysfunction syndrome (MODS), and may
result in death. Although the mortality rate of patients
with sepsis has dropped from 31% in 1979 to 17.4% in
1999, over 100,000 sepsis patients die in the United
States each year. Men are more likely than women to de-
velop sepsis, and the prevalence rate among African
Americans is twice the rate seen in Caucasians.
Causes & symptoms
A septic infection can originate in any wound, in-
cluding burns, cuts, punctures, scrapes, abscesses, or a
soft tissue infection. It can also start as a specific infec-
tion such as a sinus infection or appendicitis. Invasive
surgical procedures and medical devices, such as
catheters, vascular access grafts, and intravenous lines,
also carry a risk of introducing bacteria to the blood-
stream if not properly cleaned and cared for. A large per-
centage of septicemia patients contract the infection in a
hospital setting.
Septicemia symptoms include:
• elevated white blood cell count
• fever and chills
• rapid breathing
• sudden drop in blood pressure
• tachycardia (a rapid, pounding heartbeat)
• confusion and possible loss of consciousness
• warm, flushed skin
• skin irregularities, such as subcutaneous red lines, swelling,
bleeding under the skin, or necrosis (tissue death)
264
Septic shock can occur when septicemia is not treat-
ed adequately or quickly enough. Symptoms of septic
shock include:
• a severe drop in blood pressure (systolic pressure less
than 90 mmHG and/or less than 40 mmHG of the pa-
tient’s baseline blood pressure)
• organ dysfunction (such as renal, or kidney, failure)
due to reduced blood flow to the organ systems
• loss of consciousness
There are some known risk factors for developing
septicemia. These include:
• Having a chronic disorder or disease. The body has a
difficult time fighting infection if the immune system is
already weakened.
• Use of immunosuppressive drugs. These drugs also
weaken the immune system.
• Taking intravenous medications or drugs. Needles can
introduce infectious organisms into the bloodstream if
not used in a sterile manner.
Diagnosis
There is no specific laboratory test for early diagno-
sis of septicemia. Blood cultures can sometimes deter-
mine the presence of bacteria in the bloodstream once the
infection has spread; however, blood cultures require 24
hours or longer to incubate. Given the rapidly progressing
nature of septicemia, cultures are more effective for con-
firming the diagnosis and narrowing the choice of antibi-
otics for treatment, as treatment usually must begin be-
fore the cultures are complete. In some cases, septicemia
patients may have negative blood cultures. Further analy-
sis of blood samples by a trained hematologist may be re-
quired to make a diagnosis. If the infection is thought to
have spread from a wound or injury, tissue samples from
that site may also be analyzed. Such other body fluids as
urine and sputum may be cultured for organisms.
Treatment
Septicemia is a potentially fatal, rapidly progressing
disease. Any individual who suspects they may have sep-
ticemia should seek emergency medical care immediately.
Allopathic treatment
Septicemia is treated with a course of intravenous
antibiotics. The type of antibiotic used depends on the
infectious agent. Blood cultures, wound cultures, and
other diagnostic tests will help the healthcare provider
determine which medication will be most effective. Ab-
scesses or other sites of infection are drained of pus and
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
fluids with a catheter. Blood pressure medications and
fluids are administered to stabilize blood pressure. In
cases where the patient is suffering from significant res-
piratory distress, a ventilator may be required. Further
organ support such as dialysis may be administered if the
patient progresses to septic shock.
A very promising new treatment for sepsis, activated
human protein C, was shown to cut the mortality rate of
patients with severe sepsis by 6.1% in the first 28 days
after treatment. The drug, also known as drotrecogin alfa,
was approved by the FDA in the fall of 2001. It is being
marketed under the trade name Xigris. Xigris cannot,
however, be given to patients at high risk for active bleed-
ing, including those who have just had surgery, have been
diagnosed with an aneurysm or gastrointestinal bleeding,
or are being treated with warfarin or platelet inhibitors.
Expected results
There is a 17-25% mortality rate for patients with sep-
ticemia. As the disease progresses to septic shock and
organ systems start to be involved, the prognosis worsens.
Approximately half of all patients with septic shock die.
The patient’s overall physical health — especially his or her
heart function — has a large bearing on his or her chance
for recovery. Early intervention and aggressive treatment
of localized infections offer the best chance for survival.
Prevention
Meticulous infection control techniques are the best
defense against septicemia. For hospitalized patients
who are already at a higher risk of contracting the dis-
ease, great care should be taken to treat and clean
wounds, sutures, and burns using sterile techniques in an
antiseptic environment. The same applies for maintain-
ing such invasive medical devices as intravenous lines,
catheters, and gastric and nasal tubes. The use of these
devices should be limited whenever possible.
One recently introduced preventive is the use of an-
tibiotic-coated catheters in hospitalized patients. This
practice is, however, controversial as of 2002. While
these catheters appear to be effective in lowering the sep-
sis mortality rate, some doctors are concerned that their
use may also encourage the development of new strains
of bacteria resistant to antibiotics.
Individuals can take appropriate precautions when
treating cuts, scrapes, and other minor wounds at home.
Using clean or gloved hands, these injuries should be thor-
oughly cleaned of dirt and debris with antibacterial soap and
water. A sterile compress containing a preparation of a natu-
rally antibacterial, antiseptic herbs such as tea tree ( Melaleu-
ca alternifolia ) or calendula ( Calendula officinalis) can also
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Blood culture — A test used to find and identify in-
fectious organisms in the blood. Blood is with-
drawn from the patient are placed in culture
media and the sample is observed for the growth
of bacteria. If bacteria grows, it is analyzed for
identification.
Hematologist — A physician who specializes in
the study of blood and diseases of the blood.
Intravenous — Within a vein.
Subcutaneous — Under the skin.
be used to treat the wound site. A medicated cream or anal-
gesic herbal preparation (e.g., lavender, or Lavandula an-
gustifolia ) can soothe associated pain and promote healing.
A waterproof bandage will protect the wound from dirt and
germs. Monitor the healing progress of these wounds close-
ly, and contact a healthcare provider immediately should any
of the symptoms of septicemia occur.
Resources
BOOKS
Fauci, Anthony S., et al. eds. Harrison’s Principles of Internal
Medicine. New York: McGraw Hill, 2001.
Lawless, Julia. The Complete Illustrated Guide to Aromathera-
py. Boston: Element Books, 1997.
PERIODICALS
Crowther, Mark A., and John C. Marshall. “Continuing Chal-
lenges of Sepsis Research.” Journal of the American Med-
ical Association 286 (October 17, 2001): 1894.
Hinds, C. J. “Treatment of Sepsis With Activated Protein C:
Encouraging News for Well Selected Patients.” British
Medical Journal 323 (October 23, 2001): 881-882.
"Pro & Con: Should Antibiotic-Coated Vascular Catheters Be
Used In Clinical Practice?” Internal Medicine News 34
(December 15, 2001): 6.
Sessler, Curtis N. "Top Ten List in Sepsis.” Chest 120 (October
2001): 1390-1394.
Paula Ford-Martin
Rebecca J. Frey, PhD
Bloodroot
Description
Bloodroot ( Sanguinaria canadensis) is a perennial
plant with a white flower that blooms in early spring. It
265
Bloodroot
Bloodroot
Bloodroot plants. (Photo Researchers, Inc. Reproduced by
permission.)
Due to its bacteria-fighting compounds, herbalists
often recommend bloodroot as a topical application for
skin problems such as chronic eczema, fungus, athlete’s
foot, ringworm, venereal blisters, and rashes.
Bloodroot has a long history of use as a folk remedy
for cancer. Native Americans used bloodroot to heal vari-
ous forms of cancers and tumorous growths. Many mod-
ern herbalists prescribe a salve made from the root to re-
move warts, growths, and cancerous tumors. Bloodroot is
currently the subject of several studies and experiments,
but little scientific research has been performed to sub-
stantiate the use of bloodroot as a cure for certain cancers.
Some studies have revealed that the alkaloid sanguinarine
may inhibit the formation of tumors. However, the safety
and effectiveness of its use has not been fully evaluated.
belongs to the poppy family ( Papaveraceae ) and grows
in wooded areas throughout the northeastern regions of
the United States and Canada. The leaves are palm-
shaped and the flowers have eight to 12 petals. The root
is thick and round and 1-4 in (2.5-10 cm) long. The
plant generally grows to a height of 6 in (12 cm).
Bloodroot gets its name from its bright red root that,
when cut open, oozes a crimson, blood-like juice. Other
names for bloodroot are coon root, Indian plant, snakebite,
sweet slumber, paucon, red root, and tetterwort.
Native Americans used bloodroot for medicinal,
spiritual, and practical purposes. A dye made from the
red sap of the root was used as body paint for war dances
and ceremonies, as well as to color fabric. It was used
medicinally as a remedy for fevers, cancer, rheumatism,
to induce vomiting, and as an oral antiseptic.
General use
The known active components of bloodroot are iso-
quinoline alkaloids, which have antibacterial, antimicro-
bial, expectorant, and antiseptic properties. Sanguinarine,
a primary alkaloid of bloodroot, is noted for its ability to
destroy bacteria that can cause gum disease (gingivitis)
and dental plaque. In fact, because of its bacteria-inhibit-
ing properties, sanguinarine is an ingredient in many oral
hygiene products such as toothpastes and mouthwashes.
Sanguinarine also has pain-relieving qualities. A gargle
made from bloodroot can be used to soothe a sore throat.
Bloodroot is generally prescribed as an external treat-
ment as it is poisonous if ingested in large amounts. How-
ever, bloodroot is a powerful expectorant and has been a
primary, albeit rare, internal treatment for chronic bronchi-
tis, croup, coughs, asthma, and other respiratory afflic-
tions. In fact, bloodroot was catalogued as an expectorant in
the Pharmocopoeia of the United States from 1820 to 1926.
Preparations
The parts used medicinally are the whole plant and
root, or rhizome, which is collected in the fall.
Bloodroot is an ingredient in some homeopathic
remedies, pharmaceutical preparations, cough formulas,
toothpaste, and mouthwash. It is also available as a tinc-
ture and in dried root form, chopped and in powder.
A salve made from bloodroot can be used to remove
warts and other growths.
Precautions
Bloodroot is a potentially toxic herb. Take internally
only under the supervision of a health care professional
or qualified herbalist. (Topical use on unbroken skin is
generally safe.)
Internal use of this herb should be supervised by a
health care professional.
Pregnant or nursing women or women who are try-
ing to conceive should avoid this herb.
Long term internal consumption may contribute to
glaucoma. Persons with glaucoma should not use blood-
root.
The internal use of bloodroot by children is consid-
ered unsafe.
Side effects
Internal doses in excess of 300 mg have been shown
to cause vomiting. Higher doses are considered toxic and
poisonous.
When taken in excess, bloodroot can also cause
nausea, impaired vision, intense thirst, dizziness, a
slowed heart rate, and a burning of the stomach.
266
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Alkaloid — An organic compound found in plants.
It possesses a wide range of therapeutic and some-
times toxic properties.
Antimicrobial — A substance that kills microorgan-
isms (bacteria, fungus, parasites) or stops their
growth.
Antiseptic — A substance that prevents infection.
Expectorant — A substance that acts to promote
coughing and mucus secretion from the lungs and
respiratory tract.
Perennial — A plant that grows every year without
reseeding.
Tincture — An alcohol extract of fresh or dried
herb.
Salve — Topical ointment or paste made by blend-
ing it with olive oil, then mixing it with melted
beeswax.
Bloodroot contains skin-irritating compounds.
When applied topically it may burn the skin or cause the
skin to become red.
Interactions
Toothpastes or mouthwashes usually only contain
small amounts of sanguinarine and are considered safe
for long-term use.
Resources
BOOKS
Chevalier, Andrew. The Encyclopedia of Medicinal Plants. DK
Publishing Inc., 1996.
Heinerman, John. Heinerman’s Encyclopedia of Healing Herbs
and Spices. Parker Publishing Company, 1996.
Jennifer Wurges
Bloodwort see Yarrow
Blue cohosh
Description
Blue cohosh, scientific name Caulophyllum thalic-
troides, is a perennial flowering plant that grows in moist
forest regions throughout the eastern United States. The
plant grows up to 3 ft (1 m) tall, and its greenish yellow
flowers turn into small blue berries in autumn. The root
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
of the plant, harvested in the fall, is the part that is used
medicinally, and has a bittersweet flavor. Blue cohosh is
a plant that has long been believed to conform to the
doctrine of signatures, which is an ancient idea that the
physical shape of plants gives a clue to their medicinal
uses. Blue cohosh has branches that are arranged like
limbs in spasm, and the herb has been used to treat mus-
cle spasms. It should not be confused with an unrelated
herb, black cohosh.
Blue cohosh was widely used by Native Americans
to treat a variety of conditions, ranging from parasites to
nervous disorders. The Native Americans referred to the
herb as squaw root or papoose root, because of its effec-
tiveness in treating female problems, inducing child-
birth and easing the pain of labor. Other common
names for the herb are beechdrops, blue ginseng, yellow
ginseng, and blueberry root.
Blue cohosh contains several important minerals, in-
cluding potassium, magnesium, calcium, iron, silicon
and phosphorus. An active ingredient has been isolated
from the herb called caulosaponin, a chemical that has
been shown to increase blood flow to the uterus and re-
duce uterine contractions. Blue cohosh has been shown
to be an emmenagogue, which means it helps to bring
about menstruation, and to be an anti-spasmodic, or a
substance which reduces muscle spasms.
General use
Blue cohosh is recommended as a general tonic for
gynecological problems, specifically for the uterus. Blue
cohosh is used for menstrual problems, such as amenor-
rhea (absence of menstrual cycles) and dysmenorrhea
(painful periods), and to reduce the pain of menstrual
cramps. During pregnancy, it can be used when there is
a threat of miscarriage, and to reduce false labor pains.
Used just before childbirth, it is reputed to ease pain and
facilitate the birthing process. A 1999 survey of the use
of herbal preparations among nurse-midwives found that
blue cohosh was the herb most commonly used to stimu-
late labor contractions.
Blue cohosh’s antispasmodic properties enable it to
be used in some cases of asthma, colic, and nervous
coughs. Blue cohosh is also used to reduce pain in some
cases of rheumatoid arthritis.
Blue cohosh is also used in homeopathy. The
homeopathic remedy made from blue cohosh is called
Caulophyllum, and is recommended for menstrual
cramps, PMS, dysmenorrhea, and support during child-
birth. Homeopaths may also prescribe Caulophyllum for
gout, rheumatism, false labor pains, and gonorrhea.
267
Blue cohosh
Blue cohosh
Blue cohosh leaves. (Photograph by Robert J. Huffman. Field
Mark Publications. Reproduced by permission.)
Preparations
Blue cohosh is available as dried root, capsules, and
in tinctures (liquid extracts). To prepare a tea, one ounce
of the root can be added to one pint of water and steeped
for half an hour. Two tablespoons of the tea can be taken
every two to three hours. The root can be ground into
powder, and 3-9 g (0. 1 1-0.32 oz) of it can be taken sever-
al times per day. For the herbal tincture, the recommend-
ed dosage is 5-10 drops per dose.
The homeopathic remedy Caulophyllum is available
in tablet, liquid dilution, or tincture form in a wide vari-
ety of potencies.
Precautions
Blue cohosh should be avoided during the first trimester
(three months) of pregnancy, except for cases where miscar-
riage is threatened. During the remainder of pregnancy, the
herb should be used under medical supervision.
Blue cohosh has a reputation in folk medicine as an
abortifacient, or drug used to terminate a pregnancy. It should
never be used for this purpose, as it can cause serious harm to
both mother and fetus. The compound in blue cohosh that
causes the uterus to contract is a glycoside known as caulos-
aponin. This compound causes the blood vessels in the heart
to constrict, thus having a toxic effect on heart muscle.
People diagnosed with diverticulitis, gastric ulcers,
esophageal reflux, heart disease, high blood pressure, or
ulcerative colitis should not use blue cohosh.
Side effects
The caulosaponin in blue cohosh has potentially
toxic effects in humans. The earliest case report of harm
from a mother’s use of blue cohosh was published in
1998. The infant developed congestive heart failure
shortly after birth. In the summer of 2002, the New York
City Poison Control Center reported the case of a 21-
year-old woman who developed abdominal cramps,
heavy sweating, rapid heartbeat, and nausea after taking
blue cohosh in an attempt to induce an abortion.
The side effects of blue cohosh resemble those of
nicotine. Blue cohosh has been reported to cause chest
pains, nausea and vomiting, headaches, convulsions, ex-
cessive thirst, and general weakness.
Symptoms of an overdose of blue cohosh resemble
those of nicotine poisoning. They may include muscle
weakness, convulsions, violent stomach cramps,
headache, loss of coordination, and heart failure.
Interactions
Several herbs are frequently used with blue cohosh in
formulas for improving menstrual problems, including false
unicorn root, chasteberry tree, angelica, and rue. To re-
duce the risk of miscarriage during pregnancy, blue cohosh
may be combined with false unicorn root and cramp bark.
As a general tonic to strengthen the uterus, blue cohosh can
be taken with false unicorn root, motherwort, and yarrow.
With regard to prescription medications, blue cohosh
interferes with the effectiveness of nittrates and calcium
channel blockers (drugs given to treat high blood pressure
and heart disease). It opposes the activity of drugs given
to control diabetes. Blue cohosh should not be used to-
gether with prescription diuretics as it can intensify their
effects and cause a loss of potassium from the body.
Resources
BOOKS
Hoffman, David. The Complete Illustrated Holistic Herbal.
Rockport, MA: Element, 1996.
Hutchens, Alma R. Indian Herbology of North America.
Boston, MA: Shambhala, 1991.
Keville, Kathi. Herbs: An Illustrated Encyclopedia. New York:
Friedman/Fairfax, 1994.
PERIODICALS
HerbalGram (a quarterly journal of the American Botanical
Council and Herb Research Foundation). P.O. Box
144345, Austin, TX 78714-4345. (800) 373-7105.
<http://www.herbalgram.org.>
Jones. T. K., and B. M. Lawson. “Profound Neonatal Conges-
tive Heart Failure Caused by Maternal Consumption of
Blue Cohosh Herbal Medication.” Journal of Pediatrics
132 (March 1998): 550-552.
Martin, P. "Homeopathic Induction. Beyond Cimicifuga and
Caulophyllum." Midwifery Today with International Mid-
wife (Fall 2002): 28-30.
McFarlin, B. L., M. H. Gibson, J. O'Rear, and P. Harman. “A
National Survey of Herbal Preparation Use by Nurse-
Midwives for Labor Stimulation. Review of the Literature
and Recommendations for Practice.” Journal of Nurse
Midwifery 44 (May-June 1999): 205-216.
268
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Abortifacient — A drug or device used to terminate
an unwanted pregnancy. Blue cohosh has been
used as an abortifacient.
Antispasmodic — A substance that relieves spasms
in blood vessels or cramping in muscles. Blue co-
hosh has antispasmodic properties.
Caulosaponin — The chemical compound found in
blue cohosh that is used to stimulate uterine con-
tractions during labor. It can have toxic side ef-
fects in humans.
Dysmenorrhea — Painful menstruation.
Miscarriage — Case when a fetus is prematurely
ejected from the uterus during pregnancy.
Uterus — Female reproductive organ located in the
lower abdomen that contains the fetus during
pregnancy.
Rao, R. B., and R. S. Hoffman. "Nicotinic Toxicity from Tinc-
ture of Blue Cohosh ( Caulophyllum thalictroides ) Used as
an Abortifacient." Veterinary and Human Toxicology 44
(August 2002): 221-222.
Smith, C. A. “Homoeopathy for Induction of Labour."
Cochrane Database Systems Review 2001 : CD003399.
ORGANIZATIONS
American Academy of Clinical Toxicology. Ill East Park
Drive, P. O. Box 8820, Harrisburg, PA 17105. (717) 558-
7750. <www.clintox.org>.
Herb Research Foundation. 1007 Pearl Street, Boulder, CO
80302.(303) 449-2265.
National Center for Homeopathy. 801 N. Fairfax St., Suite 306,
Alexandria, VA 22314. (703) 548-7790.
Douglas Dupler
Rebecca J. Frey, PhD
Blue-green algae see Spirulina
Blue gum see Eucalyptus
Body lice see Lice infestation
Body odor
Definition
Body odor is the unpleasant smell caused by the
mixing of perspiration, or sweat, and bacteria on the
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
skin. Sweat is generally an odorless body secretion.
When bacteria multiply on the skin and break down
these secretions, however, the resulting by-products may
have a strong and disagreeable odor. This odor is often
due to poor personal hygiene, but excessive perspiration
or some other underlying disease is sometimes involved.
Causes & symptoms
People produce two kinds of sweat, eccrine and
apocrine. Eccrine sweat glands secrete a mixture of
water, salt (sodium chloride), urea, and lactic acid onto
the skin. When a person is overheated, sweat seeps over
the body, especially where the eccrine glands are numer-
ous. These glands are concentrated in the armpits, the
palms of the hands, the soles of the feet, and the fore-
head. As the sweat dries off, the skin is cooled by the
surrounding air. Eccrine glands do not release any tissue
cells or cell contents into their watery secretions.
In contrast with eccrine sweat, apocrine sweat is a
heavier liquid containing various organic substances, in-
cluding pheromone hormones. These glands are found
mostly under the arms and around the groin. They devel-
op during puberty, and are thought to serve a biological
function in sexual attraction. Apocrine glands take their
name from the fact that these glands release the apical
portion, or tip, of the secreting cell into the liquid along
with the other substances.
Sweat is essentially odorless when it is secreted, and
the sweat from the eccrine glands remains so. It creates,
however, a moist environment in which some of the bac-
teria that naturally occur on human skin can multiply.
These bacteria are attracted to the sweat produced by the
apocrine glands, and a strong odor is produced when
these substances interact. On the other hand, however,
the eccrine sweat glands may also help to regulate the
types of bacteria on the body surface. Researchers in
Germany have recently discovered that these glands se-
crete a peptide that has antimicrobial properties strong
enough to kill some disease bacteria.
People who have a condition known as hyperhidro-
sis tend to sweat excessively, and therefore, they are
more likely to develop a strong body odor. Bromhidrosis
is the name for a medical condition in which an individ-
ual’s sweat always has an unpleasant odor.
The human body normally has a slight sweaty or
musky odor. Generally, bathing with soap and water, to-
gether with the use of deodorants or antiperspirants, is
sufficient to prevent a truly unpleasant, unhealthy odor.
There are, however, several factors that may contribute
to chronic body odor. These include:
• Poor hygiene and inadequate bathing.
269
Body odor
Body odor
• An imbalance in the bacteria that inhabit the gut. An-
tibiotics may contribute to this condition.
• An inborn error of metabolism or some other problem
that may cause about 7% of those suffering from body
odor to be unable to digest certain foods. These undi-
gested foods, which are often proteins, cause the body
to give off unpleasant odors.
• Certain medications, including bupropion (Wellbutrin),
venlafaxine (Effexor), tamoxifen, and pilocarpine
(Salagen). These drugs may be responsible for the ex-
cretion of odors.
• Such disease conditions as liver disease, kidney dis-
ease, diabetes mellitus, a yeast infection, fungal in-
fections, or gastrointestinal disorders may lead to body
odor.
• Pathological skin conditions, including cancer, hem-
orrhoids, and ulcers, may produce unpleasant smelling
discharges on the skin or body surface.
• Coffee and other stimulants increase apocrine gland se-
cretion, increasing the possibility of unpleasant odors.
• States of high anxiety and stress that stimulate perspi-
ration may increase the risk of body odors.
• Chain-smoking and heavy drinking. Alcohol and nico-
tine increase the rate of perspiration.
Diagnosis
Since body odor may be caused by an underlying
condition, a thorough medical exam is recommended
along with a blood screen and blood chemistry panel.
Treatment
The following remedies are mostly for the topical
relief of body odor. For more thorough treatment, the un-
derlying conditions should also be addressed.
• Two or three charcoal capsules per day for several
weeks can help absorb waste products and reduce fer-
mentation that may be causing body odor.
• Chlorophyll tablets can be taken by mouth to absorb
body toxins and odors.
• Sage tea, Salvia officinalis, or sage extracts can be
taken internally and an undiluted alcohol extract of
sage can be used under the arms.
• Essential oils of rosemary, Rosmarinus officinalis, and
thyme. Thymus vulgaris, can be used under the arms or
on the feet.
• Baking soda or body powder will keep affected areas
dry and absorb or mask odors.
270
KEY TERMS
Apocrine — A type of glandular secretion in which
the top portion of the secreting cells is released
along with the secreted substances.
Blood chemistry panel — A general set of tests
measuring substances in the blood that may indi-
cate common diseases.
Bromhidrosis — A medical condition in which a
person's sweat always smells unpleasant.
Eccrine — A type of gland that produces a clear
watery secretion without releasing cells or cell
contents into the secretion.
Hyperhidrosis — A condition in which a person
produces excessive amounts of perspiration.
Pheromone hormones — Substances secreted in
order to bring out a response from other members
of the same species, particularly in regard to sexu-
al arousal.
Topical — Applied on the surface of the body.
• The diet should be improved to improve digestion, en-
sure regular bowel movements, and resolve constipa-
tion. There should be an increased intake of fluids to
flush the system; six to eight glasses of water should be
consumed daily.
Allopathic treatment
Mostly topical treatments are recommended. These
include the use of antiperspirants containing chlorhexi-
dine or aluminum chloride applied under the arms,
around the groin, on the feet, or under the breasts to re-
lieve odor and wetness. Deodorant preparations that do
not contain antiperspirants also work well. Topical an-
tibacterial creams or lotions may also be used. In cases of
unrelieved excess sweating, a physician may suggest sur-
gical removal of the sweat glands beneath the armpits.
Prevention
Good hygiene practices are important in preventing
body odor. These include regular baths or showers;
wearing cotton socks and non-synthetic shoes that
breathe; changing the socks once or twice daily; and
keeping the feet dry and bare as much as possible. Spe-
cial foot powders and odor-absorbing shoe inserts may
be helpful if foot odor is a particular problem.
Some foods and spices can intensify body odor.
Onions, garlic, and cumin contain oils that may cause
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
odor as they are excreted through the skin. Caffeine and
nicotine increase sweating and therefore the risk of odor.
Resources
BOOKS
Dollemore, Doug, and the Editors of Prevention Health Books
for Seniors. The Doctor's Book of Home Remedies for Se-
niors. New York: St. Martin’s Press, 2000.
The Editors of Prevention Magazine Health Books. The Doc-
tor's Book of Home Remedies II: Simple, Doctor-Ap-
proved Self-Care Solutions for 146 Common Health Con-
ditions. Emmaus, PA: Rodale Press, 2002.
PERIODICALS
Stephenson, Joan. “Sweat Defense.” Journal of the American
Medical Association 286 (December 12, 2001): 2801.
OTHER
Health World Online, <http://www.healthy.net>.
Patience Paradox
Rebecca J. Frey, PhD
Boils
Definition
Boils are bacterial infections of hair follicles and the
surrounding skin that form pustules around the follicle.
Boils are sometimes called furuncles. When several furun-
cles merge to form a single deep sore with several “heads,”
or drainage points, the result is called a carbuncle.
Description
Boils are firm, red swellings about 5-10 mm across
that are slightly raised above the skin surface. They are
sore to the touch. A boil usually has a visible central core
of pus; a carbuncle is larger and has several visible heads.
Boils occur most commonly on the face, back of the
neck, buttocks, upper legs and groin area, armpits, and
upper torso. Carbuncles are less common than single
boils; they are most likely to form at the back of the neck.
Men are more likely than women to develop carbuncles.
As the infection that causes the boil develops, an
area of inflamed tissue gradually forms a pus-filled
swelling or pimple that is painful to touch. As the boil
matures, it forms a yellowish head or point. It may either
continue to swell until the point bursts open and allows
the pus to drain, or it may be gradually reabsorbed into
the skin. It generally takes between one and two weeks
for a boil to heal completely after it comes to a head and
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Boils often occur from a bacterial infection in a hair follicle
or skin gland. (Custom Medical Stock Photo. Reproduced by
permission.)
discharges pus. The bacteria that cause the boil can
spread into other areas of the skin or even into the blood-
stream if the skin around the boil is squeezed. If the in-
fection spreads, the patient will usually develop chills,
fever, and swollen lymph nodes. Red lines may appear
on the skin running outward from the boil.
Boils and carbuncles are common problems in the
general population, particularly among adolescents and
adults. People who are most likely to develop these skin
infections include those with:
• diabetes, especially when treated by injected insulin
• alcoholism or drug abuse
• recent experience of childbirth, especially women who
are breastfeeding their babies
• poor personal hygiene
• crowded living arrangements
• jobs or hobbies that expose them to greasy or oily sub-
stances, especially petroleum products
• hair styles requiring frequent use of hair relaxers
• allergies or immune system disorders, including HIV
infection
Causes & symptoms
Boils are most often caused by Staphylococcus au-
reus (staph), a bacterium that causes an infection in an
oil gland or hair follicle. Although the surface of human
skin is usually resistant to bacterial infection, staph can
enter through a break in the skin surface, including
breaks caused by needle punctures for insulin or drug in-
jections. Hair follicles that are blocked by greasy
creams, petroleum jelly, hair relaxers, or similar products
are more vulnerable to developing boils. These bacterial
271
Boils
Boils
skin infections can be spread by shared cosmetics or
washcloths, close human contact, or by contact with pus
from another boil or carbuncle.
Carbuncles are formed when the bacteria infect sev-
eral hair follicles that are close together. Carbunculosis is
a word that is sometimes used to refer to the develop-
ment of carbuncles. The abscesses spread until they
merge with each other to form a single large area of in-
fected skin with several pus-filled heads. Patients with
carbuncles may also have a low-grade fever or feel gen-
erally unwell.
Furunculosis is a word used to refer to recurrent boils.
Many patients have repeated episodes of furunculosis that
are difficult to treat because their nasal passages carry
colonies of staph. Skin and anal colonization are fairly
common as well. Persistent furunculosis may be an indi-
cation of a depressed immune system. A physician should
be consulted if boils are a persistent problem in order to
determine whether there is an underlying disease such as
diabetes, HIV infection, or immune system disorders.
Diagnosis
A diagnosis of boils is usually made on the basis of
visual examination of the skin. For the most part, boils
are not difficult to distinguish. A doctor can make a cul-
ture from pus taken from the boil to confirm the diagno-
sis and treatment. The patient’s nasal discharge may also
be tested. In cases of persistent recurrent boils, family
members or close contacts may be examined to see if
they are carriers of staph.
Treatment
Patient education is an important part of the treat-
ment of boils. Patients need to be warned against squeez-
ing boils because of the danger of spreading the infection
into other parts of the skin or bloodstream. It is especial-
ly important to avoid squeezing boils around the mouth
or nose, because infections in these areas may be carried
to the brain, although this happens rarely. Patients should
also be advised about keeping the skin clean, washing
their hands carefully before and after touching the boil,
avoiding the use of greasy cosmetics or creams, and
keeping their towels and washcloths separate from those
of other family members.
The use of the following supplements is reported to
be effective in treating boils: zinc, 45 mg per day; vita-
min A, 50,000 IUs per day for two weeks; vitamin C, 1
g three times per day; and beta-carotene, 100,000 IUs
per day.
Taking the proper homeopathic medication in the
first stages of a boil can bring about early resolution of
272
the infection and prevent pus formation. The most likely
choices are belladonna or Hepar sulphuris. If the boil
has already formed, Mercurius vivus or silica may be
recommended to bring the pus to a head.
A variety of herbal remedies can be applied topical-
ly to fight infection. These include essential oils of berg-
amot, Citrus bergamia; chamomile, Matricaria recutita;
lavender, Lavandula officinalis; and sage. Salvia offici-
nalis; as well as tea tree oil, Melaleuca spp. Application
of a paste or poultice containing goldenseal root, Hy-
drastis canadensis, is recommended to help kill bacteria
and to reduce inflammation. Washing the skin around the
affected area with a mixture of goldenseal, Hydrastis
canadensis, and witch hazel, Hamamelis virginiana, dis-
solved in warm water is also recommended.
Allopathic treatment
Boils are usually treated with application of antibi-
otic creams, following the application of hot compresses.
The compresses help the infection to come to a head and
drain and are an important part of the treatment regime.
Carbuncles and furunculosis are usually treated with oral
antibiotics as well as antibiotic creams or ointments. The
usual course of oral antibiotics is 5-10 days; however,
patients with recurrent furunculosis may be given oral
antibiotics for longer periods. Patients with bacterial
colonies in their nasal passages are often given
mupirocin ointment (Bactroban) to apply directly to the
lining of the nose and should wash the area once a month
with an antiseptic soap such as Phisohex.
Boils or carbuncles that are very large or that do not
resolve may be opened with a sterile needle or surgical
knife to allow the pus to drain. Surgical treatment of
boils is often painful and usually leaves noticeable scars.
The increase of antibiotic- and biocide-resistant
strains of Staphylococcus aureus has caused growing
concern among doctors, as some of these strains are now
resistant to disinfectants used to clean endoscopes and
other surgical equipment. Resveratrol, which is a phy-
toalexin, or compound formed by plants at the site of a
fungal or bacterial invasion, appears to be highly effec-
tive in treating boils and other skin infections in humans
caused by 5. aureus.
Expected results
Boils usually drain or are reabsorbed in two or three
days. Recurrent boils and carbuncles, however, are fairly
common. In addition, although the spread of infection
from boils is relatively unusual, there have been deaths re-
ported from brain infections caused by squeezing boils on
the upper lip or in the tissue folds at the base of the nose.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Antiseptic — A substance that works to inhibit the
growth and reproduction of bacteria and viruses.
Biocide — Any chemical that works to kill microor-
ganisms and other forms of life by poisoning. Hos-
pital disinfectants are examples of biocides.
Carbuncle — A localized skin inflammation con-
sisting of deep interconnected boils.
Compress — Cloth applied to heat, cold or med-
ication to the skin.
Follicle — The small sac at the base of a hair shaft.
The follicle lies below the skin surface.
Furuncle — The medical name for a boil.
Phytoalexin — A type of compound formed in a
plant at the site of invasion by microorganisms
that helps the plant resist disease. A phytoalexin
called resveratrol appears to be useful in treating
boils.
Pustule — A small raised pimple or blister-like
swelling of the skin that contains pus.
Prevention
To minimize the risk of developing bacterial skin in-
fections the skin should be kept clean; to avoid spreading
the infection, washcloths, towels, and facial cosmetics
should not be shared with others. A healthy diet should
be maintained and allergic foods should be eliminated.
This will ensure that the immune system will be support-
ed, and that boils will be prevented.
Resources
BOOKS
Conn, Rex B., ed., et. al. Current Diagnosis 9. Philadelphia:
W.B. Saunders, 1997.
Rakel, Robert E., ed. Conn’s Current Therapy. Philadelphia:
W.B. Saunders, 1998.
Tierney, Jr., Lawrence, ed., et. al. Current Medical Diagnosis &
Treatment, 1998. Connecticut: Appleton & Lange, 1997.
Turkington, Carol A., and Jeffrey S. Dover. Skin Deep: An A-Z
of Skin Disorders, Treatments, and Health. New York:
Facts On File, 1996.
PERIODICALS
Amir, L. “Breastfeeding and Staphylococcus aureus: Three
Case Reports.” Breastfeeding Review 10 (March 2002):
15-18.
Chan, M. M. “Antimicrobial Effect of Resveratrol on Dermato-
phytes and Bacterial Pathogens of the Skin.” Biochemical
Pharmacology 63 (January 15, 2002): 99-104.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Fraise, A. P. “Susceptibility of Antibiotic-Resistant Cocci to
Biocides.” Journal of Applied Microbiology 92 (2002
Supplement): 158S-162S.
Kaur.B. J., H. Singh, and A. Lin-Greenberg. “Irritant Contact
Dermatitis Complicated by Deep-Seated Staphylococcal
Infection Caused by a Hair Relaxer.” Journal of the Na-
tional Medical Association 94 (February 2002): 121-123.
Oliveira, D. C., A. Tomasz, and H. de Lencastre. “Secrets of
Success of a Human Pathogen: Molecular Evolution of
Pandemic Clones of Methicillin-Resistant Staphylococcus
aureus.” Lancet Infectious Diseases 2 (March 2002): ISO-
189.
Patience Paradox
Rebecca J. Frey, PhD
Bonemeal
Description
Bonemeal is a product created from the waste resulting
from the slaughter of animals, especially beef cattle, by meat
processors. It is a white powder made by grinding either raw
or steamed animal bones. This results in a product that con-
tains the same nutrients necessary for the production of, and
maintenance of, bone in both humans and animals.
The composition of bonemeal can vary. Phospho-
rus, in the form of chemical compounds related to phos-
phates, makes up 20-30% of the powder. In addition to
its mineral content, depending upon the amount of ten-
don and muscle left on the bones, bonemeal can be a
fairly good source of protein.
The nutrients typically present in bonemeal include
the minerals calcium, phosphorus, iron, magnesium
and zinc, as well as traces of other elements. Bonemeal,
especially when not steamed or cooked, is also rich in vi-
tamins A and D.
General use
Calcium is the most significant nutrient in bone-
meal. Calcium is particularly significant to women be-
cause of its essential role in the prevention of osteoporo-
sis. A 1999 report of the American Dietetic Association
and Dietitians of Canada entitled Women's Health and
Nutrition states that either osteoporosis or osteopenia af-
fects more than 30 million Americans (mostly women).
That same report states that osteoporosis is an irre-
versible disease process. However, it has been found that
increasing bone mass early in life may prevent its occur-
rence or at least lessen its severity. Bone is living tissue
273
Bonemeal
Boneset
that is, like other cells in the body, in a constant state of
buildup and breakdown. This process of bone buildup and
breakdown is very dependent upon the amount of calci-
um taken in. Calcium, especially when ingested along
with vitamin D, increases bone mass, and can actually
sustain the health of bones during the later portions of a
woman’s life when the body naturally loses bone during
menopause and old age. It is estimated that menopausal
women age 50-60 can lose 10-40% of their bone mass.
It is consistently reported that American women are
not meeting even minimum requirements for calcium in-
take according to the recommendations of the American
Dietetic Association (ADA). Although the ADA recom-
mends that people’s intake of calcium be consumed via
foods rich in this element, such as low-fat dairy foods, it
further recognizes that some people cannot eat these
foods at all, or cannot take in sufficient quantities to max-
imize bone health. It therefore concludes that for those
persons who cannot consume sufficient calcium rich
foods, it will usually be necessary for them to take sup-
plements containing calcium, and sometimes vitamin D
as well. Bonemeal provides both of these nutrients. Re-
cent research even reports that calcium supplements can
help prevent formation of kidney stones when combined
with a fairly low animal protein, low salt diet. Doctors
once advised a low-calcium diet to prevent kidney stones.
Bonemeal, with its 20-30% phosphate content, is an
important organic fertilizer used in gardening of all
types. Raw bonemeal works more slowly as a fertilizer
than steamed bonemeal. Both work more slowly than
other fertilizers, making bonemeal an ideal source of
nourishment for bulb plants, such as tulips, crocuses,
daffodils, and irises, that are planted several months be-
fore growth and blooming occur.
Preparations
Bonemeal tablets are available from health food
stores. A typical dose of four tablets per day would com-
monly contain the following nutrients:
• calcium: 880 mg
• phosphorus: 400 mg
• iron: 1.8 mg
• natural vitamin A: 4,000 units
• natural vitamin D: 400 units
• red bone marrow: 15 mg
Precautions
Phosphates present in bonemeal could potentially be
leached into water systems if bonemeal fertilizer is used
along shorelines. Phosphates have the capability to dras-
274
KEY TERMS
Osteopenia — A disease of the bone, characterized
by reduced bone mass leading to increased sus-
ceptibility to fractures. It is common among
teenaged girls, and is often responsible for frac-
tures of the lower arm.
Ruminant — Any of various hoofed, even-toed,
usually horned mammals of the suborder Rumi-
nantia, such as cattle, sheep, goats, deer, and gi-
raffes.
tically alter the chemical makeup of lakes and rivers, and
can kill aquatic life if present in sufficient quantities.
Many bonemeal products contain high, even danger-
ous, levels of lead. Labels should be read carefully to
make sure the product has been tested. Unfortunately, pre-
liminary research in the United Kingdom in 2002 found
that the bone-boosting effects of calcium supplements did
not have the same long-lasting effects of drinking milk.
Resources
PERIODICALS
Affenito.Sandra G., and Jane Kerstetter. “Position of the Amer-
ican Dietetic Association and Dietitians of Canada:
Women's Health and Nutrition.” Journal of the American
Dietetic Association 1999.
“Calcium Supplements’ Effects Short-lives.” Nutraceuticals In-
ternational (January 2002).
“Unrestricted Calcium Intake Protects Against Recurrent Kid-
ney Stones Better than a Restricted Calcium Diet.” Envi-
ronmental Nutrition (March 2002): 3.
OTHER
MacDonald, Sarah. Phosphorus Boosters. Canada/Nova Scotia
Agreement on the Agricultural Component of the Green
Plan.
New Zealand Federal Ministry of Agriculture. Part II: Address-
ing The Issue. 1997.
Vitamin Power. “Bone Meal Plus.” http://vitaminpower.com/.
Joan Schonbeck
Teresa G. Odle
Boneset
Description
Boneset ( Eupatorium perfoliatum ) is a common
perennial that is native to the eastern United States and
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Canada, with a range from Nova Scotia to Florida. Other
names for boneset are feverwort, sweat plant, and thor-
oughwort. The Native American name for boneset trans-
lates into ague-weed (ague is the name for malarial
fever). The common name, boneset, comes from break-
bone fever, an influenza-like illness causing severe bone
pain that was treated with Eupatorium perfoliatum.
Boneset prefers a damp environment and is found in
marshes and meadows, often at the edge of a wooded
area. Although boneset can reach a height of 5 ft (1.5 m),
it is usually only 2-4 ft (0.6-1. 2 m) tall. It has an erect,
round, hairy stem that branches at the top. The leaves are
large (4-8 in, or 10-20 cm, long), directly across from
one another, and are joined at the stem. Lower leaves are
large, and they become progressively smaller higher up
the plant. They are spear shaped with toothed edges and
pointy tips, have prominent veins, a rough topside, and a
downy, dotted, sticky underside.
Boneset blooms between July and September.
Large, numerous, white or purple flower clusters, which
appear at the ends of the branches, are comprised of
10-20 florets (small flowers). Boneset has a faint aroma
and a very bitter taste.
Constituents and bioactivities
Boneset contains a wide variety of compounds with
biological activity that contribute to its medicinal value.
Constituents of boneset include:
• sesquiterpene lactones (euccannabinolide, eufoliatin,
eufoliatorin, eupafolin, euperfolide, euperfolitin, and
helenalin)
• polysaccharides (4-0-methylglucuroxylans)
• flavonoids (astragalin, eupatorin, hyperoside, kaempfer-
ol, quercitin, rutin, etc.)
• diterpenes (dendroidinic acid and hebenolide)
• sterol
• volatile oil
• tannic acid
• resin
• gum
Sesquiterpene lactones have antimicrobial, antitumor,
and cytotoxic activities. The flavonoid eupatorin has cyto-
toxic activity. Sesquiterpene lactones and polysaccharides
stimulate the immune system. Boneset extracts also acti-
vate defense mechanisms against viral infections.
Boneset has stimulant, febrifuge (reduces body tem-
perature), laxative (promotes bowel movements), di-
aphoretic (promotes sweating), bitter, tonic (restores tis-
sue tone), anti-spasmodic (relieves muscle spasms).
Boneset. (© PlantaPhile, Germany. Reproduced by permission.)
carminative (relieves intestinal gas), and astringent
(causes skin contraction) activities.
General use
Boneset was used by Native Americans (who later
taught the colonists) to treat influenza, colds, and other
infectious diseases as well as fever, arthritis, and rheuma-
tism. By the eighteenth and nineteenth centuries, Euro-
pean settlers considered boneset to be a cure-all. As a re-
sult, boneset was used to treat many different diseases
and conditions. It was, perhaps, among the most widely
used herbal medicines in the United States. Dried boneset
was kept on hand by families, as well as doctors, for im-
mediate use, especially during the flu season.
Boneset is used to treat colds, influenza, fevers,
coughs, upper respiratory tract congestion, migraine,
headache, skin conditions, worms, malaria, constipation,
arthritis, muscular rheumatism, jaundice, and general de-
bility. Boneset is also used to treat secondary infections that
arise during colds or flu. Secondary infections, such as
bronchitis, pneumonia, or tonsillitis, are infections that
occur while the patient has another illness. Currently,
herbalists recommend boneset primarily for relieving the
aches and pains associated with fever, clearing congestion,
and relieving pain caused by arthritis and rheumatism.
Boneset is considered to be among the best remedies
for the flu. Its wide spectrum of activities brings relief to
the many symptoms associated with the flu. It helps reduce
fever by promoting sweating, reduces aches and pains, and
relieves congestion by loosening phlegm and promoting
coughing. Boneset also stimulates the immune system,
which promotes the destruction of the influenza virus.
Preparations
All above-ground portions of the plant have medici-
nal value. Boneset is harvested after flowering has
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
275
Boneset
Bone spurs
begun. The biological activities can be extracted either in
water or alcohol, or the plant can be used as the fresh or
dried herb. Boneset is used in the dried form and is avail-
able commercially as dried flowers and leaves, as a tinc-
ture (an alcohol solution), and in tablets and capsules.
Boneset is usually taken as an infusion (tea). To
make the infusion, 2-3 teaspoons of dried herb are
steeped in one cup of boiling water for 10-15 minutes.
To improve boneset ’s bitter taste, lemon and honey may
be added to the infusion, or the infusion may be mixed
with a flavorful herbal tea or fruit juice.
Boneset may be taken as soon as flu symptoms ap-
pear. To treat influenza, fever, or colds, one cup of hot
boneset infusion should be drunk every two hours — up
to six cups daily — for two days. Then the dose can be
reduced to four cups daily. High doses shouldn't be
taken over a long period of time. The tea should be
stopped if it has been used for a week and has not
helped improve symptoms. To act as a diaphoretic, the
patient should remain in bed covered with multiple
blankets. Sweating begins after the patient has drunk
four to five doses of the hot infusion. Up to four cups
may be drunk within six hours; however, the patient
should not drink more than six cups within 24 hours.
Alternatively, 2-4 ml of the tincture may be taken three
times a day.
When taken in larger doses, boneset infusion can act
as an emetic (causes vomiting) and purgative (causes
evacuation of the bowels). Boneset infusion is drunk
cold, in moderate doses (one-fourth cup), to act as a
tonic to treat indigestion and general debility.
Boneset may be taken in combination with
cayenne, elder flowers, ginger, lemon balm, pepper-
mint, or yarrow to treat influenza. For bronchial con-
ditions, boneset may be taken with pleurisy root and
elecampane.
Precautions
Fresh boneset contains tremerol, a toxic chemical
which can cause rapid breathing and vomiting. Higher
doses can cause coma and death. Dried boneset does not
contain tremerol. Boneset may cause liver toxicity, so al-
coholics and people with liver disease should consult an
herbalist before using this herb. Boneset should not be
taken for longer than two weeks at a time.
Side effects
Boneset does not generally cause any serious side
effects. However, taking large doses of boneset may
cause nausea or diarrhea. Boneset may cause liver toxi-
city in chronic high doses.
276
KEY TERMS
Cytotoxic — An agent that destroys the cells of a
specific organ. Anticancer agents are cytotoxic.
Diaphoretic — An agent that induces sweating that
is usually used to treat fever.
Perennial — A plant that regrows each year from its
roots.
Tonic — An agent that restores normal tone to tis-
sues. Tonics are used to treat indigestion, general
debility, and other disorders.
Interactions
As of early 2000, there was no evidence of interac-
tions between boneset and other herbals or conventional
medicines.
Resources
PERIODICALS
Sharma, Om P., Rajinder K. Dawra, Nitin P. Kurade, and Pri-
tam D. Sharma. “A Review of the Toxicosis and Biologi-
cal Properties of the Genus Eupatorium.” Natural Toxins 6
(1998): 1-14.
OTHER
“Boneset.” A Modern Herbal, <http://www.botanical.com/botan
ical/mgmh/b/bonese65 ,html.>
“Boneset.” Planet Botanic, <http://www.planetbotanic.com/
boneset.htmx
Hoffman, David L. "Boneset.” HealthWorld Online. <http://
www.healthy.net/library/books/hoffman/materiamedica/
boneset.htm.>
Belinda Rowland
Bone spurs
Definition
Bone spurs are abnormal, bony growths at the end
of bones. They are most commonly located in the spine
or other weight-bearing joints.
Description
Bone spurs may grow on the ends of bones in any
part of the body. The spurs have no protective cartilage,
as other bones do, and may rub against other bones,
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
blood vessels, or nerves. The spurs may cause slight dis-
comfort, or severe pain.
Causes & symptoms
Bone spurs have several possible causes. Some are a re-
sult of osteoarthritis. This condition begins without symp-
toms from age 20-30, and is marked by the loss of cartilage
in the joints. Once the cartilage is gone, there is no cushion
to protect the joints from the strain of physical activity or
bearing weight. The bones rub together and bone spurs may
grow in and around the joints. By the age of 70, almost
everyone is afflicted with this condition. Bone spurs can also
be found in older adults who have disk problems. As people
grow older, the disks in the spinal column can become tough
and shrink. The distance between the vertebrae decreases as
the disks shrink, and bone spurs, or knobby growths, then
appear on the vertebrae. Bone spurs are also found in those
who have placed an excessive amount of stress on their bod-
ies, such as dancers, athletes, and laborers.
Spurs in particular regions of the spine may cause
pain in a specific area. Those located in the upper verte-
brae of the neck (cervical region) may cause stiffness
and pain in the back and neck.
Spurs located in the feet can be particularly painful.
Bone spurs occur most often on the heel (heel spurs),
but can be found on any part of the foot that has been
under pressure. This condition can be caused by shoes
that fit improperly, excessive use, or heredity.
Most bone spurs cause pain because of their move-
ment against nerves or other bones. Pain or stiffness in
the back or neck, or tingling in the hands, arms, or neck,
can indicate bone spurs on the spine. Headaches and
dizziness may also occur, and a person may not be able
to keep balanced. A heel spur can cause a sharp pain
when weight is placed on one or both feet. If there is a
severe, shooting pain in the neck or back with slight
movement, this could be a sign of a bone spur pinching a
nerve or interfering with muscle movement.
Diagnosis
A medical practitioner may order a computer assisted
tomography (CAT) scan or x ray to rule out other causes
of back pain and to help locate any bone spurs that exist.
An electromyography (EMG) can look at the condition of
nerves that supply muscles to see if they are affected by
bone spurs. Magnetic resonance imaging (MRI) can look
at bones, nerves, and disks to check for abnormalities.
Treatment
Exercise and a healthy weight are key ingredients to
managing the pain associated with bone spurs. Exercise
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Bone Spur
A bone spur. (Illustration by GGS Information Services, Inc.
The Gale Group.)
may be limited by the location of the spur and its effects
on movement. Swimming or other forms of water activi-
ty, such as water aerobics, may be less stressful for the
body, and can also increase flexibility and mobility.
Weight loss can also be beneficial in alleviating the pain
associated with bone spurs, since less weight puts less
stress on any joints which are lacking cartilage or
plagued with bone spurs.
There are several options for managing the pain
caused by bone spurs and increasing movement. A chiro-
practor may use manipulation and physical therapy to re-
lieve pain associated with bone spurs in the vertebrae.
Physical therapy may also increase movement of the af-
fected area. Acupuncture can be used to relieve some
joint pain. A homeopath will assess more than a patient’s
physical condition to determine the proper remedy. The
types of conditions that trigger the pain are important in-
formation for a homeopath. Guided imagery can help
alleviate pain. Feldenkrais method can be used to re-
train the body’s movement when it is inhibited by pain.
Yoga is another movement therapy that can help de-
crease the stress placed on affected areas, as well as help
the body to relax and strengthen muscles. Sodium in the
diet may help break down calcium so that it can be re-
sorbed into the blood. Those on a low-sodium diet for
health reasons should talk to their doctors before increas-
ing the sodium in their diets.
Allopathic treatment
A doctor will usually prescribe anti-inflammatory
painkillers, such as aspirin or ibuprofen, to help relieve
pain. Resting and keeping pressure off of the affected
area can also help diminish the pain. A back or neck
brace can provide additional support and relieve pres-
sure. A foam cushion placed in the shoe, with a hole cut
277
Bone spurs
Borage oil
out for the spur, can help relieve the pain of a spur on the
foot. Severe cases may call for surgery, but this relief
may be temporary, since bone spurs can grow back in the
same place.
Expected results
Once bone spurs form, patients can use different
therapies to manage the pain associated with this ailment
and to help improve their range of movement. While
surgery may be used to remove a bone spur in severe
cases, there is a chance that another could grow to take
its place.
Prevention
Maintaining a healthy body weight and reducing
stress on one’s joints are steps individuals can take to re-
duce the chance of bone spurs. Exercises which work the
muscles of the whole body, such as walking, biking,
swimming, and tennis, are recommended for weight loss
and muscle strength.
Resources
BOOKS
Somerville, Robert. The Medical Advisor: The Complete Guide
to Alternative & Conventional Treatments. Alexandria,
VA: Time Life Inc., 1996.
PERIODICALS
“Better than aspirin?” Industry Week (July 7, 1997): 32.
OTHER
DrKoop.com. Osteoarthritis, [cited July 17, 2000].<http://
www.drkoop.com.>
National Institute of Arthritis and Musculoskeletal and Skin
Diseases. Osteoarthritis. [May 1, 1999].
Footcare Direct. HammertoesIBone Spurs, [cited July 17,
2000]. <http://www.footcare direct. com.>
Heather Bienvenue
Borage oil
Description
Borage, whose botanical name is Borago officinalis ,
is an annual herb in the Boraginaceae family. There are
as many as 2,500 species in this family of plants. The
specific designation officinalis indicates the herb’s inclu-
sion in official listings of medicinal plants. Borage is a
wild-growing, hardy native of the Mediterranean region,
cultivated and naturalized throughout Great Britain and
278
North America. Traditionally associated with courage,
borage was used to flavor the wine for soldiers preparing
for battle. The English word “borage” may be derived
from the word borrach, a Celtic word meaning “a person
of courage.” In folk tradition throughout its long history
of recorded use, borage was believed to dispel melan-
choly and ease grief and sadness. According to the an-
cient Greek physician Dioscorides, borage can “cheer
the heart and lift the depressed spirits.” Common names
for the herb include burrage, common bugloss, star
flower, tailwort, or beebread. Borage self-seeds freely
and flourishes in rich, well-drained soil in full sun. It is a
good companion herb in the cottage garden, attracting
honey bees and imparting strength and insect resistance
to nearby plants, particularly strawberry and tomato.
Borage’s silvery-green, oblong to ovate, textured
leaves form a basal rosette, then grow alternately up a
succulent hollow round stem containing a clear mucilage.
The leaves and sprawling branches are covered in bristly
white hairs that impart a silvery sheen to the herb and are
irritating to the skin on contact. Borage can reach a height
of 2 ft (0.6 m), with leaves as long as 5 in ( 13 cm). The
five-petaled star-shaped blue flowers, each with five
black anthers, grow in loose, downward-turning clusters
at the apex of the stems. Borage may bloom continuously
from early spring until frost. The large, brownish-black
seeds are three-sided. They may be viable for as long as
eight years. The roots are shallow and spreading.
General use
Borage seed oil
In contrast to borage’s centuries of use as a herb,
borage seed oil has been used only for the last 10 years.
Borage oil, extracted from the seeds by cold pressing,
contains omega-6 essential fatty acids, with as much as
a 25-30% concentration of gamma linolenic acid (GLA).
GLA is a derivative of the omega-6 fatty acids. It is an
essential fatty acid used by the body to produce
prostaglandins, the hormone-like substances in the body
that may be out of balance in premenstrual syndrome
(PMS) or during menopause. GLA also appears to re-
duce the adherence of plaque (abnormal patches of hard-
ened deposits) to artery walls, thus lowering the risk of
coronary heart disease. GLA helps to relieve PMS, reg-
ulate the menstrual cycle, and ease the hot flashes and
mood swings of menopause.
At present, borage seed oil is best known for its anti-
inflammatory properties. The oil has been shown in clin-
ical studies with human subjects to be useful in treating
the following conditions:
• rheumatoid arthritis
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• atopic eczema
• infantile seborrheic dermatitis
• Raynaud’s phenomenon
• Sjogren’s syndrome
•juvenile rheumatoid arthritis (JRA)
In addition, the GLA in borage seed oil prevents the
formation of blood clots, helps to keep cell membranes
flexible, and supports the body’s immune function.
Other claims for borage seed oil that have not been
tested in clinical studies include its use as a remedy for
hangovers, as an anti-aging preparation, and as a wrinkle
reducer. Various borage oil products that make these
claims, however, are readily available over the Internet.
Culinary and medicinal uses
Borage’s culinary and medicinal uses have been
known for at least 2000 years. Borage is a cooling,
cleansing, and refreshing herb with adaptogenic, demul-
cent, diuretic, expectorant, and anti-inflammatory prop-
erties. The entire plant contains mucilage, tannin, essen-
tial oil, potassium, calcium, pyrrolizioline alkaloids,
saponins, and vitamin C, as well as a high amount of
mineral salts. The leaves have been used as an adrenal
tonic to balance and restore the health of the adrenal
glands following periods of stress. A tea made from the
leaves and blossoms will also promote lactation, relieve
fevers, and promote sweating. The soothing mucilage in
borage makes it a beneficial treatment for dry cough and
throat irritation. Borage tea is also a good remedy to use
with such digestive disturbances as gastritis and irrita-
ble bowel syndrome. European herbalists use borage tea
to restore strength during convalescence. It may be of
particular benefit during recovery from surgery or fol-
lowing steroid treatment. Borage tea is also helpful in
clearing up such skin problems as boils and rashes, and
has been used as an eyewash.
About a dozen clinical tests of the medicinal applica-
tions of borage in human subjects have been conducted
since 1989. In addition, some researchers are now testing
the effects of borage on skin cells in animal studies.
Preparations
The leaves, flowers, and seeds of borage have nutri-
tive and medicinal properties. Harvest borage leaves on a
dry day, just as the plant begins to blossom. Strip the
leaves from the stems and spread out on a tray. The plant
has a high water content and the leaves may discolor if
dried in direct heat. Place the drying trays in a warm,
airy room out of direct sun. When thoroughly dry, store
the leaves in dark, tightly-sealed containers. Borage
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
flowers can be collected by gently pulling on the stamen
tips to separate the blossom from the green backing at-
tached to the stem. The blossoms may be used fresh, or
frozen individually in ice-cube trays for later use.
Infusion: Place 2 oz (56 g) of fresh borage leaves in
a warmed glass container. Bring 2.5 cups (590 ml) of
fresh, nonchlorinated water to the boiling point, add it to
the herbs. Cover. Allow the tea to steep for 10 minutes,
strain, and drink warm. The prepared tea can be stored
for two days in the refrigerator. Borage tea may be en-
joyed by the cupful up to three times a day. Some herbal-
ists suggest combining borage with hawthorn berries
( Crataegus oxyacantha) as a heart tonic.
Poultice: Chop fresh borage leaves and stems in suf-
ficient quantity to cover the area being treated. Cover the
herb with a strip of cotton gauze to hold the poultice in
place. The poultice may be soothing and healing to skin
inflammations, though the prickly hairs may be irritating.
Culinary: Borage leaves, eaten fresh, have a crisp, cool
taste, reminiscent of cucumber but with a somewhat prickly
texture. Borage blossoms are sometimes used as a garnish
on salads or crystallized and used to decorate cakes.
Borage oil is available commercially as bottled oil
and in capsule form. One manufacturer offers a package
containing 90 capsules for $20. The usual recommended
doses of GLA range from 100-300 mg daily (1 tbsp of
bottled oil or 1-3 capsules). The dosage and duration of
use, however, are best determined by a qualified herbal
practitioner.
Precautions
Borage oil has been shown to contain small amounts
of such pyrrolizidine alkaloids (PAs) as lycopsamine,
amabiline, and thesinine. Some pyrrolizidine alkaloids,
particularly unsaturated ones, may be toxic to the liver
even in small amounts. Some herbalists stress that use of
borage oil should be avoided unless the preparations are
certified to be free of these potentially harmful, unsatu-
rated pyrrolizidine alkaloids. In addition, borage oil
should be refrigerated after opening to keep it stable, as
GLA is damaged in the presence of oxidation. Blending
small amounts of vitamin E or vitamin C into the oil
will also help to slow down the process of oxidation.
The long-term use of herbal borage in medicinal
preparations is not recommended.
Side effects
Some minor side effects have been reported when bor-
age preparations are taken internally, even when taken in
appropriate forms and in therapeutic dosages. These side ef-
279
Borage oil
Boron
KEY TERMS
Adaptogen — A substance that acts in nonspecific
ways to improve the body's level of functioning
and its adaptations to stress.
Antioxidant — An agent that helps to protect cells
from damage caused by free radicals, the destruc-
tive fragments of oxygen produced as a byproduct
during normal metabolic processes.
Demulcent — A substance that soothes irritated
mucous membranes. Borage contains a mucilage
that can be used as a demulcent.
Gamma linolenic acid (GLA) — An essential fatty
acid that is found in borage seed oil.
Mucilage — A gummy, gelatinous substance found
in the stems of borage that is useful for treating
throat irritations.
Raynaud's phenomenon — A vascular disorder in
which the patient's fingers ache and tingle after
exposure to cold or emotional stress, with charac-
teristic color changes from white to blue to red.
Raynaud's phenomenon may be seen in scleroder-
ma and systemic lupus erythematosus.
Sjogren's syndrome — An autoimmune disorder char-
acterized by excessive dryness of the eyes and mouth.
fects include bloating, nausea, indigestion, and headache.
External contact with fresh borage leaves may cause skin
rashes in sensitive persons. Any adverse reactions to borage
preparations (or any other herbal products used as dietary
supplements) should be reported to the Food and Drug Ad-
ministration’s Center for Food Safety and Applied Nutri-
tion (CFSAN), listed under Resources below.
Interactions
Adverse interactions have been reported between bor-
age and three types of prescription medications: anticoag-
ulants (blood thinners), anticonvulsants (drugs to prevent
seizures), and anxiolytics (tranquilizers). Borage may pro-
long bleeding time if taken together with anticoagulant
medications. Borage has also been reported to lower the
seizure threshold if taken together with anticonvulsant
medications. Lastly, borage has been reported to increase
the degree of sedation when taken with anxiolytics.
Resources
BOOKS
Bremnes, Lesley. The Complete Book of Herbs. New York:
Henry Holt, 1995.
280
Hoffmann, David. The New Holistic Herbal, 2nd ed. Boston:
Element, 1986.
McIntyre, Anne. The Complete Woman' s Herbal . London: Dor-
ling Kindersley Limited, 1988.
Ody, Penelope. The Complete Medicinal Herbal. New York:
Dorling Kindersley, 1993.
PDR for Herbal Medicines. Montvale, NJ: Medical Economics
Company, 1998.
Pelletier, Kenneth R., MD. The Best Alternative Medicine, Part
I: Western Herbal Medicine. New York: Simon & Schus-
ter, 2002.
Tyler, Varro E., Ph.D. Herbs of Choice: The Therapeutic Use of
Phytomedicinals. New York: The Haworth Press, Inc.,
1994.
ORGANIZATIONS
PERIODICALS
Chung, S., S. Kong, K. Seong, et al. “[Gamma] -Linolenic Acid
in Borage Oil Reverses Epidermal Hyperproliferation in
Guinea Pigs.” Journal of Nutrition 132 (October 2002):
3090-3097.
“ShiKai Borage Therapy.” (Shopper.) Contemporary Long
Term Care 25 (September 2002): 43.
Turon. F., P. Bachain, Y. Caro, et al. “A Direct Method for Re-
giospecific Analysis of TAG Using Alpha-MAG.” Lipids
37 (August 2002): 817-821.
ORGANIZATIONS
Herb Research Foundation. 1007 Pearl St., Suite 200, Boulder,
CO 80302. (303) 449-2265. <www.herbs.org>.
United States Food and Drug Administration (FDA), Center for
Food Safety and Applied Nutrition. 5100 Paint Branch
Parkway, College Park, MD 20740. (888) SAFEFOOD.
<www.cfsan.fda.gov>.
Clare Hanrahan
Rebecca J. Frey, PhD
Boron
Description
Boron is a trace mineral that has gained popularity
in recent years due to claims that it can strengthen bones,
build muscle mass, and boost brain activity. While such
macrominerals as calcium, magnesium, and potassium
have become household names because they make up
over 98% of the body’s mineral content, certain trace
minerals are also considered essential in very tiny
amounts to maintain health and ensure proper function-
ing of the body. They usually act as coenzymes, working
as a team with proteins to facilitate important chemical
reactions. While boron is considered essential for plants,
it is not known if the mineral is necessary for humans.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Evidence has been mounting in the last two decades,
however, that suggests boron may be an important mi-
cronutrient.
Studies indicate that boron may contribute to the
way that calcium, a vital building block of bone, and
other minerals are processed by the body. Boron appears
to increase the amount of calcium absorbed from food
and lower the amount excreted by the body. These ef-
fects may help to keep bones strong. Boron may also im-
prove mental functioning, strengthen the immune sys-
tem, boost energy utilization, and affect cholesterol pro-
duction. While the effects of a boron-free diet have not
been observed in people, animal studies suggest that a
lack of boron can be unhealthy. In one investigation, for
example, a boron-deficient diet fed to animals seemed to
increase the amount of calcium they lost. It also ap-
peared to have a negative effect on bone development
and energy utilization. It is not certain, however, that
study results such as this confirm the nutritional impor-
tance of boron for human beings. As of 2000, research is
still necessary to determine if boron can produce signifi-
cant health benefits safely and effectively. The proper
dosage of the mineral has not yet been established.
General use
While not extensively studied, boron has been tout-
ed as having a number of beneficial effects. Some people
take it to help treat osteoporosis or arthritis and to allevi-
ate menopausal symptoms. It has been reported to en-
hance mental activity, memory, and hand-eye coordina-
tion. Some body builders and athletes take boron supple-
ments as a muscle-enhancing agent despite the fact that
there is no evidence to support this use. Overall, boron
appears to have the most potential as a possible bone-
builder and brain booster.
The effects of boron on bone strength were investi-
gated in a small study of 12 postmenopausal women be-
tween the ages of 48 and 82, published in the FASEB
Journal in 1987. The women had received a low-boron
diet (containing about 0.25 mg a day of the mineral) for
several months before being given daily boron supple-
ments of 3 mg. Once the women increased their intake of
boron, they were able to retain more bone-building min-
erals such as calcium and magnesium. This effect was
greater in women who started out with low levels of mag-
nesium. Boron supplements also significantly increased
levels of estrogen and testosterone, especially in the mag-
nesium-deficient group. The results of this study suggest
that getting an adequate amount of boron, whether
through dietary intake or boron supplements, may help to
maintain strong bones by allowing the body to use calci-
um and other important minerals more efficiently.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Most of the research suggesting that boron may be
helpful for arthritis is indirect and circumstantial. Early
studies in sheep and chickens indicated that boron may
be useful in helping to treat the disease. There is also an
interesting relationship between the incidence of arthritis
and boron intake in certain geographical locations. In
parts of the world where boron intake is high (intake can
range anywhere from 3-10 mg), usually as a result of
high boron levels in the soil and water, the number of
people who develop arthritis tends to be lower than in
areas where people consume less of the mineral. Boron
levels in the water and soil are usually highest in arid cli-
mates, such as the desert regions of the United States and
South America, the Red Sea region of the Middle East,
and parts of Australia. There are few human studies of
boron in relation to arthritis, although one small investi-
gation in people has suggested that boron may help to re-
lieve symptoms of the disease.
While there is some evidence that boron may be
helpful in the treatment of postmenopausal osteoporosis,
the mineral does not appear to ease the symptoms associ-
ated with menopause. In a five-week study involving 46
menopausal women, about 50% of those who received
boron supplements experienced more frequent and severe
hot flashes (as well as night sweats) and generally had an
increase in menopausal symptoms. Over a third of the
women who received boron reported that the mineral
made no difference at all in their symptoms. Boron had a
beneficial effect in only 15% of the women who took it.
These findings suggest that boron may actually aggravate
menopausal symptoms more often than it alleviates them.
Researchers from the Grand Forks Human Nutrition
Research Center, which is affiliated with the United
States Department of Agriculture (USDA), investigated
the role of boron in brain and psychological function in
several studies involving humans and animals. In one
study, increasing boron intake in rats receiving a boron-
deficient diet seemed to increase mental activity. Studies
conducted in people suggested that a lack of boron can
decrease mental activity and have a negative effect on
hand-eye coordination, the ability to concentrate, and
short-term memory. These findings seem to indicate an
important role for boron in keeping the brain fit.
The use of boron by body builders stems from its
apparent ability to increase testosterone levels. Because
testosterone is known to play an important role in the
development of muscles, some weight lifters have taken
boron supplements because they believe it will increase
levels of male hormone and make them stronger. There
is no evidence, however, that boron can increase muscle
mass or athletic performance. Boron supplements are
generally not considered effective as a muscle-enhanc-
ing agent.
281
Boron
Boswellia
Preparations
A recommended daily allowance (RDA) for boron has
not been established. The estimated dosage of boron, which
is available as an over-the-counter dietary supplement, is
generally 3 mg a day. Even without taking supplements,
most people get anywhere from 1-3 mg of boron through
their diets. For this reason, some authorities suggest avoid-
ing boron supplements altogether and eating foods known
to contain the mineral. Good sources of boron include
fruits, especially pears, apples, peaches, grapes, and raisins;
leafy vegetables; peanuts and other nuts; and beans. Beer
and wine also contain boron. Drinking water can be a good
source of the mineral depending on geographical location.
Getting too much of the mineral through food and drink is
not considered a significant risk because boron is present
only in very small amounts in plants and animals.
Precautions
Boron is not known to be harmful when taken in
recommended dosages, though there are some precau-
tions to consider. Boron appears to increase estrogen lev-
els, especially in women receiving estrogen therapy. For
this reason, women receiving hormone therapy should
talk to their doctors before taking boron supplements.
Combining the mineral with estrogen drugs may result in
elevated and potentially unhealthy levels of female hor-
mone. However, it is considered safe for women on es-
trogen therapy to eat boron-containing foods. In fact,
many of the fruits and vegetables containing the mineral
are believed to contribute to good health.
The long-term health risks associated with taking
boron supplements are unknown.
Side effects
When taken in recommended dosages, boron has
not been associated with any significant or bothersome
side effects. At very high dosages, boron may cause nau-
sea and vomiting, diarrhea, and headaches.
Interactions
Combining boron and estrogen-containing drugs
may cause an undesirable increase in estrogen levels.
Resources
BOOKS
Sifton, David W. PDR Family Guide to Natural Medicines and
Healing Therapies. New York: Three Rivers Press, 1999.
PERIODICALS
Nielsen F.H., C.D. Hunt, and L.M. Mullen, et al. “Effect of di-
etary boron on mineral, estrogen, and testosterone metab-
282
KEY TERMS
Hot flash — A temporary sensation of warmth that
starts in the chest and radiates into the neck and
face, usually associated with the menopause in
women. It is sometimes called a hot flush.
Micronutrient — An element essential to health
that is required only in very small amounts. Mi-
cronutrients are sometimes called trace elements.
Osteoporosis — An age-related disease in which
bones become fragile and prone to debilitating
fractures.
olism in postmenopausal women.” FASEB Journal (1987):
394-7.
ORGANIZATIONS
Grand Forks Human Nutrition Research Center. 2420 2nd Ave
North. Grand Forks, ND 58202. <http://www.gfhnrc.ars.
usda.gov.>
OTHER
Discovery Health, <http://www.discoveryhealth.com>.
Greg Annussek
Boswellia
Description
Boswellia is the purified resin made from the gum
from the Boswellia serrata or Boswellia carter i trees.
For medicinal purposes, the products of these two trees
are used in similar ways.
B. serrata is a moderately large branching tree that
grows in the hilly regions of India. It grows to a height of
about 12 ft (4 m). The sticky resin, or sap, from the tree
is also called Indian frankincense, Indian olibanum,
dhup, and salai guggul. B. carteri is a related tree that
grows in parts of North Africa, especially Somalia, and
in some parts of Saudi Arabia. The resin from this tree is
called frankincense.
General use
Boswellia is a significant herb in the Ayurvedic sys-
tem of health and healing. Ayurvedic medicine is a
Hindu-based system of individualized healing that has
been practiced in India for more than 2,000 years. It is a
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
complex system that recognizes different human tem-
peraments and body types. Each of these types have dif-
ferent qualities that affect the health and natural balance
of the person.
Disease can result from any of seven major causes:
heredity, congenital, internal, external trauma, seasonal,
habits, or supernatural factors. Disease can also be
caused by misuse of the five senses: sight, touch, taste,
hearing, and smell. Diagnoses are made through ques-
tioning, observation, examination, and interpretation.
Health is restored by evaluating the exact cause of the
imbalance causing the disease or condition and then pre-
scribing herbs, exercises, diet changes, and/or medita-
tion to help restore the natural balance of body, mind,
and spirit. Cures are highly individualized, so that the
same symptoms may require different remedies in differ-
ent people.
Boswellia is a guggul. A guggul (sometimes spelled
guggal) is a sticky gum resin that comes from the sap of a
tree. Ayurvedic healers have used boswellia for centuries
to treat arthritis and rheumatism. In traditional Ayurvedic
medicine, it has many other uses. These included being
used as an antiseptic, expectorant, and diuretic.
In traditional Ayurvedic medicine, many conditions
are treated with boswellia. These include:
• arithritis and rheumatism
• asthma
• bronchitis
• diarrhea
•jaundice
• ringworm and other skin diseases
• syphillis
• ulcers
• undescended testicles
Modern usage has focused on the use of B. serrata.
This is most likely to be used by Western herbalists and
found in natural products stores. Modern herbalists use
boswellia primarily to treat arthritis and other inflamma-
tory conditions. Boswellia can be taken internally or can
be applied as a component of anti-arthritis cream.
Some very promising scientific evidence backs up
this traditional use of boswellia. Compounds isolated
from boswellia have demonstrated anti-inflammatory in
laboratory studies. In experimental animals they reduced
swelling as effectively as non-steroidal anti-inflammato-
ry drugs (NSAIDs) such as ibuprofen (Advil, Nuprin,
Motrin) and produced none of the side effects such as ir-
ritation of the stomach seen with NSAIDs. This could
prove important for people who must take anti-inflam-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
rnatory drugs for a long period of time. Other animal
studies have suggested that boswellia lowers cholesterol
and triglyceride (a type of fat) levels in the blood.
In other controlled human studies, boswellia was
shown to decrease the duration of bronchial asthma, possi-
bly by blocking formation of the chemicals that cause the
blood vessels to contract. It has also been shown to be safe
and effective in human studies for the treatment of arthritis.
Preparations
Boswellia is harvested from trees in late October by
cutting away a flap of bark 6-8 in (15-20 cm) wide. For
about two weeks, the gum is then scraped away from this
wound. This material is then purified and used in healing.
Commercially available boswellia is standardized as
an extract to a strength of 60-65% boswellic acid.
Dosage varies depending on the patient’s condition. For
example, people with rheumatic conditions might take
150 mg of boswellic acid three times per day. Follow the
directions on commercially available tablets. Creams
containing boswellic acid can be applied externally.
Precautions
Some herbalists suggest that pregnant women, peo-
ple with immune system diseases such as AIDS, and the
frail elderly not take boswellia.
Side effects
Generally boswellia appears to be well tolerated
with very few side effects. In rare cases it can cause diar-
rhea, nausea, and skin rash.
Interactions
There are few, if any, studies of how boswellia inter-
acts with traditional Western medicines. It has been used
for many years in combination with other Ayurvedic
herbs without incident. With interest in boswellia interest
high in modern research laboratories, more information
on drug interactions is likely to be forthcoming.
Resources
BOOKS
Graedon, Joe, and Teresa Graedon. The People’s Pharmacy
Guide to Plome and Herbal Remedies. New York: St. Mar-
tin's Press, 1999.
Peirce, Andrea. The American Pharmaceutical Association
Practical Guide to Natural Medicines New York: William
Morrow and Company, 1999.
PDR for Herbal Medicines. Montvale, New Jersey: Medical
Economics Company, 1998.
283
Boswellia
Botanical medicine
KEY TERMS
Diuretic — A diuretic is any substance that increas-
es the production of urine.
Expectorant — Any substance that promotes the
expulsion of mucus from the lungs.
ORGANIZATIONS
American School of Ayurvedic Sciences. 2115 1 12th Avenue,
NE, Bellevue, WA 98004. (425)453-8002.
The Ayurvedic Institute. P. O. Box 23445, Albuquerque, MN
87112. (505)291-9698.
Tish Davidson
Botanical medicine
Definition
Botanical medicine is a vital component of the heal-
ing arts that draws on the accumulated and developing
knowledge of the medicinal properties of plants in the
prevention and treatment of disease. Botanical medicine
includes medical herbalism, a healing art that relies on
the synergistic and curative properties of plants to treat
symptoms and disease and maintain health, and phar-
mocognosy, the study of natural products. Botanical
medicine is an important component of numerous tradi-
tional medical systems and therapies, including tradi-
tional Chinese medicine (TCM), Ayurvedic medicine,
naturopathy, indigenous and shamanic medicine, home-
opathy, flower essence therapy, and aromatherapy.
Botanical medicine has survived for many thousands of
years in some form and in all cultures throughout the
world. The study of the plant lore of these various cul-
tures is known as ethnobotany.
Plants have been used since prehistoric times as med-
icinal remedies applied in various ways to provide relief
from irritations as minor as a mosquito bite to situations as
catastrophic as the plague. In modern medicine, some
drugs are derived from plants, and many of these medi-
cines are used in ways that are similar to their traditional
uses. Many more drugs in modern medicine, however, are
synthetic, and part of the reason for this trend is economic:
plants can rarely be patented, so a pharmaceutical compa-
ny will not gain the exclusive right to sell a plant-derived
medication even after expensive research and marketing.
Also, the processing of plants into a medicine cannot be as
284
easily standardized and controlled as the manufacturing of
a synthetic. As a result, the efficacy and safety of only a
relative few of the traditionally used botanical remedies
have been verified by clinical research. Approximately
only 5,000 of the estimated 500,000 known species (in-
cluding subspecies) of plants have been identified and
studied for their medicinal properties.
Origins
The knowledge of the healing properties of herbs
has been preserved from the time of the clay tablets of
the ancient Sumerians over 5,000 years ago, to the sa-
cred texts and pharmacopoeias of the Hindu and Chinese
cultures, to the works of Greek and Roman physicians
preserved by Byzantine scholars, to the European folk
herbalists and physicians such as Nicholas Culpeper and,
more recently, to the Native American herbalists. One of
the earliest records of botanical medicine is the Pen
T’Shao Kang Mu, a work attributed to China’s Yellow
Emperor around 2500 B.c. Another is the Ebers papyrus,
an Egyptian medical text dating from 1,550 B.c. The Rig-
veda, an ancient Hindu scripture, lists more than 1,000
medicinal plants used in the ancient Ayurveda system of
medicine, already well developed by 1000 B.c.
Theophrastus, who lived from 327-285 B.c. is consid-
ered the first scientific botanist; he recorded the use of
more than 500 medicinal plants. The Greek physician
Dioscorides produced what has been called the first true
herbal text, or herbal, the De materia medica in the first
century a.d. By the Middle Ages, the monks in medieval
European monasteries were working to preserve this an-
cient knowledge by copying texts and cultivating exten-
sive gardens of medicinal plants. European folk medi-
cine was passed from generation to generation through
oral tradition, and later, with the introduction of the
printing press, the information became more widely
available in popular written texts. Colonists brought their
herbal knowledge and plant specimens to settlements in
North America and learned from the indigenous Ameri-
cans how to make use of numerous additional plants na-
tive to the New World. The first record of Native Ameri-
can herb use is the manuscript of the Native Mexican
physician Juan Badianus in 1552.
The use of herbs for medicinal purposes has been de-
veloped over the centuries by personal experimentation,
local custom, anecdote, and folk tradition. According to
the World Health Organization, an estimated 80% of the
global population continues to rely on medicinal plant
preparations to meet primary health care needs. For exam-
ple, a 2003 study found that traditional Arabic herbal med-
icine is still practiced in the Middle East. The specific
chemical constituents of herbs and their unique medicinal
action is the subject of ongoing scientific experimentation.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Benefits
Botanical medicines, when administered properly
and in designated therapeutic dosages, can be effective,
trigger fewer side effects for most patients than pharma-
ceutical drugs, and are generally less costly than pre-
scription pharmaceutical drugs.
The benefits of botanical medicine may be subtle or
dramatic, depending on the remedy used and the illness
being addressed. Herbal remedies usually have a much
slower effect than pharmaceutical drugs. Some herbal
remedies have a cumulative effect and work slowly over
time to restore balance, others are indicated for short-
term treatment of acute symptoms. Botanical medicine
may be especially beneficial when administered to help
with chronic ongoing symptoms.
Description
Traditional Chinese medicine (TCM): This system of
healing employs ancient techniques, developed over
many thousands of years. For example, among TCM’s
techniques are acupuncture, moxibustion, and herbal
formulas to restore health. Moxibustion is a process that
combines acupuncture with the traditional application of
the herb mugwort, Artemisia vulgaris , known as Ai ye or
Hao-shu. This is a method of heating specific acupunc-
ture points on the body to treat physical conditions, par-
ticularly chronic pain. When burnt, the mugwort pro-
duces a mild heat able to penetrate deeply into the mus-
cle. TCM also employs specific herbal formulas to re-
store health and maintain a dynamic balance between two
distinct forces known as yin and yang , particularly with
regard to the qi. Qi is the vital energy flowing along the
meridians or energy pathways of the body. The TCM
practitioner is a skilled observer, who relies on diagnostic
techniques, including measuring pulse rate from several
positions, and noting the general appearance of the pa-
tient, such as complexion, eyes, nails, hair, tongue, and
posture. The assessment not only includes consideration
of the patient’s symptomatic complaints, but of numerous
personal characteristics including family history,
lifestyle, emotional health, environment, diet, and exer-
cise. The medicinal herbs prescribed are usually prepared
as a formula based on the unique needs of each patient.
Ayurvedic medicine: This system of healing, literal-
ly meaning the science of life or longevity, has been
practiced in India for more than 5,000 years. Ayurvedic
medicine is concerned equally with the body, mind, and
spirit of the person and combines natural therapies to re-
store balance and harmony. Ayurvedic physicians, like
the practitioners of traditional Chinese medicine, use ed-
ucated observation in diagnosis. In Ayurvedic medicine,
there are three basic doshas, or metabolic body types.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
The success of Ayurvedic treatment depends on the prop-
er diagnosis of imbalances in these characteristic as-
pects. Ayurvedic medicine emphasizes self-care strate-
gies such as a healthy diet, yoga, meditation, breathing,
and exercises to restore the innate harmony of the body.
Taste is an important indicator of the medicinal proper-
ties of an herb. Plants are categorized according to six
plant essences: sweet, sour, salty, pungent, bitter, and as-
tringent. An understanding of how these plant essences
act in the body is a necessary component in Ayurvedic
medicine for prescribing herbal remedies.
Indigenous and shamanic medicine: These rely on
extensive folk knowledge of botanical and animal medi-
cine combined with ceremonial ritual in the treatment of
disease. The particular form of indigenous medicine is
unique to each tribe. The specific herbal remedies are
primarily passed on through oral tradition.
Naturopathy: Naturopathic medicine was estab-
lished in the eighteenth and nineteenth centuries. The
naturopathic doctor, or naturopath, uses gentle methods
to boost the body’s healing, including nutritional supple-
ments, herbal remedies, proper diet, and exercise to re-
store health. The doctor works with the patient to edu-
cate him or her on ways to restore and maintain a healthy
balance in the internal environment that will prevent fur-
ther illness. Licensed naturopathic doctors pass rational
exams that include basic clinical botanical medicine
competency, as well as homeopathy.
Homeopathy: Homeopathy was founded in the late
eighteenth century by the German physician Samuel
Hahnemann. Homeopathy embraces the philosophy of
“like cures like.” Homeopathy uses extremely dilute so-
lutions of herbs, animal products, and chemicals that are
believed to hold a “trace memory” or energetic imprint
of the substance used. Sold as over-the-counter medi-
cine, homeopathic remedies are exempt from govern-
ment regulations applied to pharmaceuticals. Homeo-
pathic remedies may be sold without proof of safety and
efficacy as long as they are labeled with the directions
for use and the level of dilution.
Flower essences: The use of flower essences at-
tempts to address a more subtle energy beyond the phys-
ical symptoms, to treat the emotional and mental roots of
disease. The English physician Edward Bach developed
a method of extracting what he considered the essence of
flowers with the ability to address a broad range of psy-
chological conditions of the human spirit. This system
became known as Bach flower remedies. This botanical
therapy attempts to match the energetic essence of par-
ticular flowers with the same energy in the higher self of
an individual, thus strengthening the higher energies and
promoting self-realization and restoring health. Bach’s
285
Botanical medicine
Botanical medicine
theory was that the source of all illness could be found in
the conflict between the demands of one’s higher self,
striving to realize its full potential, and the individual
personality or ego with its limiting beliefs and actions
that obstruct and block this self-realization. The reme-
dies are believed to have a subtle, soul-healing effect
based on an instinctual soul rapport with the particular
herb.
Aromatherapy: Aromatherapy uses the essential oil
of various herbs extracted by steam distillation or cold
pressing of flower, leaf, stem, or root to treat various
physical and emotional problems. Herbs have long been
valued for their healing fragrance. In 1564 an alchemist
named Giovanni Battista della Porta wrote about meth-
ods used to separate essential oils from the aromatic dis-
tilled waters that had been used in previous centuries.
Modern-day aromatherapy was developed by the French
chemist Rene-Maurice Gattefosse, in 1937. Aromathera-
py identifies the distinct healing properties of various
pure essential oils. The small size of the molecules in es-
sential oils enables the chemicals to penetrate bodily tis-
sue easily and to act rapidly on the limbic system which
is believed to be the seat of emotions.
Preparations
The quality of any herbal remedy and the chemical
constituents found in the herb depends greatly on the
conditions of weather and the soil where the herb was
grown, the timing and care in harvesting, and the manner
of preparation and storage. Herbs are prepared in a vari-
ety of ways depending on the part of the plant that is
medicinally active and the results sought. The list of
kinds of herbal preparations is long and varied. Some of
these preparations include:
• Infusion. Infusion is appropriate for extracting medici-
nal properties of the leaf, flower, and stem of the plant.
Either fresh or dried herb may be used. A standard in-
fusion combines 1 tsp of dried herb, or 2 tsp of
chopped fresh herb, per cup of water. Fresh, nonchlori-
nated water is brought to the boiling point in a non-
metallic pot, and the herbs are added. A cover prevents
the escape of volatile oils. The tea is infused for 10 to
15 minutes, strained, and can be consumed warm or
cold. The prepared tea will keep up to two days in the
refrigerator.
• Decoction. Decoction is the best method to extract the
mineral salts and other healing components from the
coarser herb materials, such as the root, bark, seeds, and
stem of the plant. One ounce of the dried plant materi-
als, or 2 oz of fresh plant parts, is added to 1 pt of pure,
unchlorinated water in a non-metallic pot. The mixture
is brought to a boil, and then the heat is lowered, so the
286
mixture can simmer for about 30 minutes. After strain-
ing and covering, a decoction may be refrigerated for up
to two days and retain its healing qualities.
• Tincture. Tincture is a method to prepare a concentrat-
ed form of the fresh herbal remedy for therapeutic use.
These solutions, properly prepared and stored, will re-
tain medicinal potency for many years. To prepare a
tincture, a clean glass container is packed with chopped
fresh or dried herb, and enough good quality brandy or
vodka to cover is poured over the herb. The
alcohol/water ratio varies, dependent on the plant and
the intended extract. The concentration (depending on
the herb) is 25-90%; often the ratio of alcohol to water
is about 50/50. The container then needs to be sealed
with an airtight lid. The mixture needs to be left in a
darkened place to steep for two weeks, and shaken
daily. After straining the mixture through a cheesecloth
or muslin bag and pouring it into a dark bottle for stor-
age, it is ready for use. Dosage depends on the herb and
its designated use. A standard dosage is 2-4 ml of the
tincture three times a day. Other fluid extracts may be
prepared with glycerine or vinegar.
• Capsule. A capsule is a convenient form for ingesting
dried, powdered herbs, usually contained in a gelatin
capsule. Gelatin capsules are available in the standard
size 00 which holds 200-250 mg of powdered herb.
Prepared capsules should be stored in dark glass con-
tainers.
• Oil infusion. With this method, the chopped fresh or
dried herb is placed in a glass storage container. Enough
cold-pressed vegetable oil, such as sunflower or olive
oil, is poured into the jar to cover the herb completely.
This mixture is sealed and placed on a sunny windowsill
for two or three weeks. The infused oil is strained into
another jar of the chopped fresh or dried herb. This mix-
ture steeps on a sunny windowsill for another two
weeks. After being strained through cheesecloth, this in-
fused oil can be stored in a cool, dark location.
• Ointments. These are prepared with powdered or fresh-
ly chopped plant parts combined with melted petrole-
um jelly or beeswax and vegetable oil. The mixture is
simmered in a double boiler for about two hours. The
mixture is strained through cheesecloth and poured into
small glass storage containers. Ointments provide a
spreadable consistency and protective layer for topical
application of medicinal herbs to the skin.
• Poultice. A poultice is a hot mixture of the chopped
fresh or dry herb that has been boiled briefly, and
cooled to a tolerable temperature before application to
the affected area. A small amount of oil should be ap-
plied to the skin prior to placing the poultice to prevent
the herb from sticking. The poultice can be covered
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
with a gauze strip to hold it in place. The poultice can
be refreshed every two or three hours as needed.
• Essential oils. This is the highly concentrated extract of
an herb obtained through steam distillation or cold
compress methods. Essential oils should be diluted in
water or in a nontoxic carrier oil before application to
the skin to prevent contact dermatitis or sensitization.
Essential oils are used for topical application, in bath
water, and in aromatherapy. The toxicity of the concen-
trated essential oil varies depending on the chemical
constituents of the herb.
The above list is by no means exhaustive. There are
many other botanical medicine preparations available.
Precautions
Herbal remedies prepared by infusion, decoction, or
alcohol tincture from the appropriate plant part, such as
the leaf, root, or flower are generally safe when ingested
in properly designated therapeutic dosages. However,
many herbs have specific contraindications for use when
certain medical conditions are present and by pregnant
or lactating women. Some herbs are toxic, even deadly,
in large amounts, and there is little research on the
chronic toxicity that may result from prolonged use.
Herbal remedies are sold in the United States as dietary
supplements and are not regulated by the Food and Drug
Administration (FDA) for content or efficacy. Self-diag-
nosis and treatment with botanical medicinals may be
risky. A consultation with a certified clinical herbalist or
naturopathic physician is prudent before undertaking a
course of treatment. A 2002 report said that patients
often fail to inform their physicians about herbal prod-
ucts they are using, and that patients don’t think of them
as medicines. Yet many botanical remedies can interact
with allopathic medicines and either cancel their effects
or cause adverse effects. For example, garlic, ginseng,
ginkgo, feverfew, licorice, and other common remedies
have anticoagulant properties that can put patients as risk
of bleeding during surgery.
Advances in communication technology have made
warnings about herbal remedies more important than
ever. The Internet includes many sites with unregulated
and often unhealthful advice about use of herbal reme-
dies. Many herbalists and allopathic physicians urge pa-
tients to use caution when seeking information on herbal
treatments on the Internet. One cancer-related study
found that only 36% of the web sites found in a search
offered information that complied with regulatory guide-
lines regarding unsubstantiated claims about treatment or
cure of disease.
Essential oils should not be taken internally without
expert guidance due to the potential for toxicity even in
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
very small amounts. They are not to be used in any form
by pregnant or lactating women without competent med-
ical consultation. Essential oil extracts do not contain the
full range of phytochemicals present in the whole plant.
Homeopathic remedies are safe because of their ex-
tremely dilute nature. These remedies must not be relied
upon for treatment of any serious illness or injury. If symp-
toms persist, other qualified medical help should be sought.
Side effects
Herbs contain numerous phytochemicals formed in
the metabolic process of the plant. These chemicals act
on the body in different ways; some of these act on the
whole body, while some act on a specific organ or sys-
tem. An herb’s effect may be due to a particular chemical
in the herb, or it may be due to an interaction among
constituents within the plant. Interactions with other
herbs, or with pharmacological drugs, is a matter of con-
cern and a growing area of research.
The pure essential oils of aromatic plants, extracted
by steam distillation or cold pressing techniques have
been used for more than a century in medicines, food,
drink, perfumes, detergents, soaps, cosmetics, in various
industrial applications, and in aromatherapy. Some com-
pounds found in plant oils can cause sensitization even
in very small amounts. Side effects from external appli-
cation of some essential oils may include mild skin irri-
tation, such as itching and burning; sensitization, which
may lead to recurrent mild to severe adverse reactions
such as burning and rash each time the essential oil is
used; and phototoxicity, a situation in which certain es-
sential oils react with ultraviolet light and cause reac-
tions from mild skin blotching to severe burning any
time the skin is exposed to sunlight.
Research & general acceptance
Botanical treatments are generally accepted as part
of mainstream medical treatment around the world ex-
cept in the United States, where herbal remedies are sold
as dietary supplements. As of 2003, the branch of the
FDA that regulates botanical products under the rubric of
dietary supplements is the Center for Food Safety and
Applied Nutrition (CFSAN). Under the Dietary Supple-
ment Health and Education Act of 1994 (DSHEA), the
manufacturer of a botanical preparation is responsible
for ensuring that it is safe before marketing it; the FDA
is responsible for taking legal action if the product
proves to be unsafe after it is marketed. The other gov-
ernment agency that has some oversight over botanical
preparations in the United States is the National Center
for Complementary and Alternative Medicine (NCCAM)
287
Botanical medicine
Botanical medicine
of the National Institutes of Health, established by an act
of Congress in 1998. NCCAM also supports research
into botanical products, herbalism, and other alternative
therapies that make use of plant-derived products.
In Germany, an expert committee known as the
Commission E was established by the government in
1978 to evaluate the safety and efficacy of the 300 herbs
and herb combinations sold in that country. No equiva-
lent regulatory commission exists in the United States.
Determining the safety or toxicity of essential oils
has primarily been accomplished through animal testing.
Human trials of essential oils using volunteers have also
been conducted. Some regulation of and guidelines for
the use of essential oils, particularly in food, is accom-
plished by the World Health Organization (WHO), the
Council of Europe, and the U.S. Food and Drug Admin-
istration (FDA). Two sources of information on the safe-
ty of essential oils used in aromatherapy are the Re-
search Institute for Fragrance Materials, and the Interna-
tional Fragrance Research Association. These organiza-
tions conduct ongoing research evaluations of essential
oils and publish the findings in the journal, Food and
Chemicals Toxicity.
Homeopathic remedies have been tested clinically
and, in 1997, an international team of researchers re-
viewed more than one hundred controlled studies and
concluded that the collective results of 26 of these con-
trolled studies indicate that homeopathic remedies pro-
duce a somewhat greater benefit than a placebo in the
treatment of illness.
Training & certification
Naturopathic physicians are licensed as primary
care physicians in many states and complete a four-year
graduate level course at a naturopathic medical school.
Naturopaths are trained in nutritional medicine, homeo-
pathic medicine, botanical medicine, hydrotherapy,
psychology, and counseling.
Traditional Chinese medicine practitioners are heir
to the benefits of thousands of years of tradition. This an-
cient system of health care is experiencing a revival in
China after efforts by Chinese Nationalists in the 1930s
to eliminate traditional Chinese medical practices in favor
of Western medical methods. The ancient way persisted,
and traditional Chinese medicine is taught in Chinese
medical schools using the traditional medical literature.
By the 1990s, China had opened its hospitals to American
students of acupuncture and Chinese herbology.
Western herbalism is taught in numerous schools
of herbal medicine in the United States, as well as
through correspondence and on-line courses. Certifica-
288
tion as a clinical herbalist is not required in the U.S. and
herbal remedies are widely available commercially as
food supplements without a medical prescription.
Resources
BOOKS
Burton Goldberg Group. Alternative Medicine: The Definitive
Guide. Washington: Future Medicine Publishing, Inc.,
1993.
Kowalchik, Claire, and William H. Hylton. Rodale’s Illustrated
Encyclopedia of Herbs. Pennsylvania: Rodale Press, 1987.
McIntyre, Anne. The Medicinal Garden. New York: Henry Holt
and Company, Inc., 1997.
Pelletier, Kenneth R., MD. The Best Alternative Medicine, Part
I, "Western Herbal Medicine.” New York: Simon &
Schuster, 2002.
Price, Shirley. Practical Aromatherapy, 3rd ed. London, UK:
Thorsons, 1994.
PERIODICALS
Arora, S., K. Kaur, and S. Kaur. “Indian Medicinal Plants as a
Reservoir of Protective Phytochemicals.” Teratogenesis,
Carcinogenesis, and Mutagenesis (2003) (Supplement 1):
295-300.
Azaizeh, H., S. Fulder, K. Khalil, and O. Said. “Ethnobotanical
Knowledge of Local Arab Practitioners in the Middle
Eastern Region.” Fitoterapia 74 (February 2003): 98-108.
De Vos, P. "An Herbal El Dorado: The Quest for Botanical
Wealth in the Spanish Empire.” Endeavour 27 (2003):
117-121.
Kinsel, J. F., and S. E. Straus. "Complementary and Alternative
Therapeutics: Rigorous Research Is Needed to Support
Claims.” Annual Review of Pharmacology and Toxicology
43 (2003): 463-484.
Loman, D. G. “The Use of Complementary and Alternative
Health Care Practices Among Children.” Journal of Pedi-
atric Health Care 17 (March-April 2003): 58-63.
Matthews. H. B., G.W. Lucier, and K.D. Fisher. “Medicinal
Herbs in the United States: Research Needs.” Environmen-
tal Health Perspectives. 107 (October 1999): 773-778.
McNamara, Damian. "Warn Patients About Bad Herbal Advice
on Web.” Family Practice News (January 1, 2002) : 8.
Torpy, Janet M. “Integrating Complementary Therapy Into
Care.” Journal of the American Medical Association 1
(January 16, 2002) : 306.
ORGANIZATIONS
American Association of Naturopathic Physicians. <http://www.
naturopathic.org.>
American Botanical Council, <http://www.herbalgram.org.>
Flower Essence Society, <http://www.flowersociety.org/about.
htm.>
National Center for Complementary and Alternative Medicine
(NCCAM) Clearinghouse. P.O. Box 7923, Gaithersburg,
MD 20898-7923. (888) 644-6226. <http://nccam.nih.gov>.
National Center for Homeopathy, <http://www.homeopathic.org.>
U. S. Food and Drug Administration (FDA). 5600 Fishers Lane,
Rockville, MD 20857. (888) 463-6332. <http://www.fda.
gov>.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Ethnobotany — The study of the plant lore and
agricultural practices of a people or culture.
Limbic system — The structures of the brain con-
cerned with emotion and motivation.
Pharmacopoeia — A book describing drugs, chemi-
cals, and medicinal preparations, especially one rec-
ognized as an authority and serving as a standard.
Sensitization — The process of becoming sensitive
or hypersensitive.
OTHER
American Association of Naturopathic Physicians. “What Is A
Naturopathic Physician?” http://www.naturopathic.org/
Basics/Definition.html.
Baker, Joanne. “Aromatherapy, Massage and Chinese Medi-
cine.” http://www.positivehealth.com/permit/Aritcles/
Aromatherapy /jobaker.htm.
Gardenchild, Lyn, and Martin Watt. “AIDS, HIV & Aroma-
therapy.” Aromatherapy Global Online Research Archives.
htttp://www.nature-helps.com/agora/aidsanda.htm.
Katz, Richard, and Patricia Kaminski. “The Twelve Windows of
Plant Perception." http://www.flowersociety.org/twelve.htm.
"Naturopathy.” http://www.noaw.com/Naturopathy/naturopathy.
htm.
Vanhove, Michel. “Aromatherapy.” http://www.nature-helps.
com/infopage/engels/HISTORY 1 .HTM.
Watt, Martin. “Essential oil safety-The known and the un-
known.” Aromatherapy Global Online Research Archives.
http://www.fragrant.demon.co.uk/eosafety.html.
"What Is Traditional Chinese Medicine (TCM)?” Chinese Medi-
cine and Acupuncture in Canada. http://www.medicine
chinese.com/intro.html.
Wicke, Roger, Ph.D. "A World History of Herbology and
Herbalism: Oppressed Arts.” Rocky Mountain Herbal In-
stitute . http : //w w w.rmhiherbal. org .
Clare Hanrahan
Teresa G. Odle
Rebecca J. Frey, PhD
Botulism see Food poisoning
Breast disease see Fibrocystic breast disease
Breast cancer
Definition
Breast cancer is the abnormal growth and uncon-
trolled division of cells in the breast. Cancer cells invade
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
and destroy surrounding normal tissue, and can spread
throughout the body via blood or lymph fluid (clear fluid
bathing body cells) to start a new cancer in another part
of the body.
Description
Every woman is at risk for breast cancer and the dis-
ease was diagnosed more than 200,000 times in 2002 in
the United States. When a woman lives to be 85, there is
a one out of nine chance that she will develop the condi-
tion sometime during the rest of her life. As a woman
ages, her risk of developing breast cancer rises dramati-
cally regardless of her family history. The breast cancer
risk of a 25-year-old woman is only one out of 19,608;
by age 45, it is one in 93. In fact, 80% of all breast can-
cers are found in women over age 50.
Causes & symptoms
There are a number of risk factors for the develop-
ment of breast cancer, including:
• family history of breast cancer in mother or sister
• early onset of menstruation and late menopause
• reproductive history (women who had no children or
have children late in life and women who have never
breastfed have increased risk)
• history of abnormal breast biopsies
However, more than 70% of women who get breast
cancer have no known risk factors. While a breast cancer
gene was discovered in 1994, only about 5% of breast
cancers are believed to be related to the gene.
In addition, some studies suggest that high fat diets,
bottle feeding instead of breastfeeding, or consuming al-
cohol may contribute to the risk profile. Other aspects of
nutrition and lifestyle in Western countries may be re-
sponsible for higher rates of breast cancer in our soci-
eties. For example, aromatic hydrocarbons in tobacco
and certain hydrocarbons in well-done meat may act as
carcinogens. While some studies had suggested a link
between hormone replacement therapies (HRTs) con-
tributing to breast cancer, many did not take them seri-
ously. However, a landmark study released in 2003
proved the risk was greater than thought. The Women’s
Health Initiative found that even relatively short-term
use of estrogen plus progestin is associated with in-
creased risk of breast cancer, diagnosis at a more ad-
vanced stage of the disease, and a higher number of ab-
normal mammograms. The longer a woman used HRT,
the more her risk increased.
It is important to realize that not all lumps detected
in the breast are cancerous. Many are benign and require
289
Breast cancer
Breast cancer
A breast cancer cell. (Phototake NYC. Reproduced by per-
mission.)
only the removal of the lump. While having several risk
factors may boost a woman’s chances of having breast
cancer, the interplay of factors is complex. The best way
to assess breast cancer risk is by doing monthly self ex-
aminations to detect any lump at an early stage. The sec-
ond is to have a regular mammogram, an x ray of the
front and side of the breast that will detect cysts or tu-
mors at the earliest possible stage. Seeking risk assess-
ment consultation at one of the many breast cancer cen-
ters located throughout the United States is also helpful.
Changes in the breast that may indicate breast can-
cer include:
• lump or thickening in breast or armpit
• changes in a nipple (thickening, pulling in, bleeding, or
discharge)
• dimpled or reddened skin over the breast
• change in size or shape
• abnormality on a mammogram
Diagnosis
More than 90% of all breast cancers are detected by
mammogram (a low-dose x ray of the breast). Mammo-
grams should be done to evaluate a suspicious lump.
Screening mammograms should be ordered according to
the doctor’s guidelines. Despite the controversy about
the cost-effectiveness of mammograms for women in
their 40s, most doctors agree with the current American
Cancer Society guidelines that recommend screening
mammograms every year or two for women between 40
and 49, and every year after age 50. Women with a fami-
ly history of breast cancer may want to have a mammo-
gram every year after age 40.
A typical mammography screening includes two
views of each breast (one from above, and one from the
side). Normally, the technologist examines the x-ray
films immediately to make sure views are complete. A
radiologist determines if further views or follow-up ul-
trasound studies are needed.
If anything irregular is detected, such as a mass,
changes from earlier mammograms, abnormalities of the
skin, or enlargement of the lymph nodes, further testing
may be recommended. This could include an ultrasound
of the breast, a biopsy or needle sampling, or consulta-
tion with a breast surgeon.
Biopsy of the breast is a removal of breast tissue for
examination by a pathologist. An excisional biopsy is a
surgical procedure in which the entire lump area and
some surrounding tissue is removed for examination. If
the mass is very large, an incisional biopsy is done
where only a portion of the area is removed and ana-
lyzed. Needle biopsy can be done in two methods. An
aspiration needle biopsy uses a very fine needle to with-
draw cells and fluid from the mass for analysis. A large
core needle biopsy uses a larger diameter needle to re-
move small pieces of tissue from the mass that can be
analyzed. These analyses can determine whether the
mass is benign (noncancerous) or cancerous and there-
fore, whether further treatment is required.
To find out if the cancer has spread to other parts of
the body (metastasized), doctors remove some underarm
lymph nodes to test for cancer cells that have spread and
to assist in making decisions for treatment. A newer
technique, called sentinel lymph node biopsy, allows
physicians to check the sentinel node, or the one that
first receives fluid drained from the cancerous area, to
preserve as many lymph nodes as possible. If this node is
free of cancer cells, the cancer should not have spread
any further than locally. Checking to see if there are can-
cer cells in the lymph nodes is also a way to tell how ad-
vanced the cancer is (“staging” cancer). Breast cancer is
rated from Stage 0 to Stage IV. Staging uses the diagnos-
tic information to tell the cancer physician (oncologist)
how widespread the disease is and includes:
• Stage I. The cancer is no larger than 2 cm and no can-
cer cells are found in the lymph nodes.
• Stage II. The cancer is no larger than 2 cm but has
spread to the lymph nodes or is larger than 2 cm but has
not spread to the lymph nodes.
290
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• Stage IIIA. Tumor is larger than 5 cm and has spread to
the lymph nodes or is smaller than 5 cm, but has spread
to the lymph nodes, which have grown into each other.
• Stage IIIB. Cancer has spread to tissues near the breast
or to lymph nodes inside the chest wall, along the
breastbone.
• Stage IV. Cancer has spread to skin and lymph nodes
near the collarbone or to other organs of the body.
Treatment
The best chance for successful treatment is to find
breast cancer early. Breast cancer is a life-threatening
disease, and a correct diagnosis and appropriate treat-
ment with surgery, chemotherapy, and/or radiation is
critical to controlling the illness.
Acupuncture and guided imagery may be useful
tools in treating pain symptoms and side effects of
chemotherapy associated with breast cancer. Acupunc-
ture involves the placement of a series of thin needles
into the skin at targeted locations on the body, known as
acupoints, in order to harmonize the energy flow within
the human body.
Guided imagery involves creating a visual mental
image of pain. Once the pain can be visualized, the pa-
tient can adjust the image to make it more pleasing, and
thus more manageable, to them.
A number of herbal remedies are also available to
lessen pain symptoms and chemotherapy side effects, and
to promote relaxation and healing. However, breast can-
cer patients should consult with their healthcare profes-
sional before taking them. Depending on the preparation
and the type of herb, these remedies may interact with or
enhance the effects of other prescribed medications.
Results of a clinical trial performed at the National
Cancer Institute of Milan, Italy, have indicated that home-
opathic remedies of belladonna ( Atropa belladonna) can
be useful in relieving the discomfort, warmth, and
swelling of the skin associated with radiotherapy for
breast cancer (i.e., radiodermatitis). As with all homeo-
pathic remedies, the prescription of belladonna depends
on an individual’s overall symptom picture, mood, and
temperament, and should be prepared by a trained home-
opathic professional. When used as a homeopathic reme-
dy, belladonna is administered in a highly diluted form to
trigger the body’s natural healing response without risk of
belladonna poisoning or overdose. There are many other
herbs that help in relieving the nausea that accompanies
chemotherapy, including ginger ( Zingiber officinale).
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
This illustration shows the frequency of breast cancer de-
veloping in the four quadrants of the breast and the nipple.
(Illustration by Electronic Illustrators Group. The Gale Group.)
Allopathic treatment
Treatment options include surgery, chemotherapy,
and radiation. Breast cancer is treated in two ways: lo-
cally to eliminate tumor cells from the breast by surgery
and radiation, and to systemically destroy cancer cells
that have traveled to other parts of the body. Systemic
therapy includes the use of drugs in chemotherapy and
hormonal treatments to reduce the amount of estrogen
circulating in the blood.
Surgery
The extent of surgery depends on the type of breast
cancer, whether the disease has spread, and the patient’s
age and health. If the tumor is less than about 1.6 in (4.1
cm) or there is not much chance it will return, then the
patient and doctor may opt for removal of the tumor
alone (lumpectomy) followed by radiation therapy.
Studies have shown that conservative treatment (a
lumpectomy or partial mastectomy) offers the same odds
of survival as does removal of the entire breast (total
mastectomy) in someone with a small breast tumor that
has not spread into the nearby lymph nodes. New studies
291
Breast cancer
Breast cancer
suggest that after lumpectomy, a combination of
chemotherapy and radiation offers the best chance of
long-term survival. Recent studies also show that breast
conserving surgery leads to better quality of life follow-
ing breast cancer for women of all ages.
If the tumor is larger, a total (or simple) mastectomy
may be needed. If the cancer has spread to the chest
muscles, most doctors believe a radical mastectomy is
the best solution. This operation is now used only when
the cancer has spread to the chest muscle.
In a lumpectomy, the doctor removes:
• the lump
• some of the tissue around the lump
• some of the lymph nodes under the arm may be re-
moved (auxiliary dissection) and tested to see if the
cancer has spread there
Even if no cancer is found in the nodes, radiation al-
ways follows lumpectomy and treatment may include
chemotherapy.
In a modified radical mastectomy, the doctor re-
moves:
• the entire breast
• the underarm lymph nodes
• the lining over the chest muscle (but not the muscles
themselves)
A radical mastectomy is almost never done, but if
necessary the doctor removes:
• the breast
• the chest muscles
• all of the lymph nodes under the arm
Surgery can be combined with breast reconstruction
(creating a new breast-shaped mound), either right away
or later on. Patients who want breast reconstruction
should tell the doctor before surgery, since this could
change the way the surgeon operates.
Removing the tumor and a border of normal tissue
around it will remove the cancer while saving most of
the breast tissue. However, the longer a tumor has been
growing in the breast, the more likely it will be that the
cancer cells have spread to the lymph nodes. These
nodes under the arm or in the chest are a common place
for breast cancer cells to spread. During surgery, some of
the nodes are removed to check for cancer cells.
The presence of cancer cells in the lymph nodes
may require more extensive surgery. If the cancer has
spread to the nodes, the patient will need either radiation,
chemotherapy, hormone therapy, or a combination of all
three after surgery. This is called “adjuvant therapy.”
292
Radiation
Once the cancer has been removed, the doctor may
recommend radiation to destroy or shrink any remaining
breast cancer cells. Radiation stops the cancer cells from
dividing. It works especially well on fast-growing tu-
mors. Unfortunately, it also stops some types of healthy
cells from dividing. Healthy cells that divide quickly,
like those of the skin and hair, are affected the most. This
is why radiation can cause fatigue, skin problems, and
hair loss.
Chemotherapy
Breast cancer surgery may be followed by chemo-
therapy in even the earliest stages. Chemotherapy is ad-
ministered either orally or by injection into a blood ves-
sel. It is usually given in cycles, followed by a period of
time for recovery, followed by another course of drugs.
Treatment time may range between four to nine months.
There may be significant side effects with some
types of chemotherapy, including nausea and vomiting,
temporary hair loss, mouth or vaginal sores, fatigue,
weakened immune system, and infertility. However,
chemotherapy for early breast cancer uses medications
that cause fewer side effects.
Hormone therapy
The growth of some breast cancer cells may be
slowed by the drug tamoxifen, an anti-estrogen medica-
tion. Given each day as a pill, tamoxifen travels through-
out the bloodstream, slowing or stopping cancer cell
growth. Tamoxifen treatment lasts at least two years, and
often as long as five. Research suggests that tamoxifen
may lower the chance that a breast cancer can return by
between 25% and 35%.
Side effects of tamoxifen may include a slightly
higher risk of cancer of the lining of the uterus (endome-
trial cancer). The risk increases if the drug is taken for
more than five years. Other side effects include
menopause-like symptoms, such as weight gain, hot
flashes, and mood swings.
In rare cases, the surgeon may suggest removal of
the ovaries (oophorectomy) in premenopausal women as
a way of eliminating the main source of estrogen, which
can boost the growth of some breast tumors.
Stem cell treatment
Stem cell treatment is used to treat advanced breast
cancer. By first removing a woman’s stem cells from her
bone marrow or blood, the doctor can use very high
doses of chemotherapy or radiation to kill cancer cells.
Because this also kills healthy white blood cells, leaving
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Adjuvant therapy — Treatment involving radiation,
chemotherapy (drug treatment), or hormone thera-
py, or a combination of all three.
Aspiration biopsy — The removal of cells in fluid or
tissue from a mass or cyst using a needle for micro-
scopic examination and diagnosis.
Benign — Not malignant, noncancerous.
Biopsy — Surgical removal and testing of tissue to
determine if it is malignant.
Estrogen-receptor assay — A test to see if a breast
cancer needs estrogen to grow.
Homeopathic — Practice that uses remedies and
treatments that cause similar effects to the symp-
toms they are intended to treat in an effort to stim-
ulate the body's natural immune response system.
Hormones — Chemical produced by glands in the
body that circulate in the blood and control the ac-
tions of cells and organs. Estrogens are hormones
that affect breast cancer growth.
Hormone therapy — Treating breast cancer by
changing the hormone balance of the body, in-
stead of by using cell-killing drugs.
Lumpectomy — Surgical procedure in which only
the cancerous tumor is removed, together with a
rim of normal tissue.
Lymph nodes — Small, bean-shaped masses of tis-
sue scattered along the lymphatic system that act
as filters: removing fluids, bacteria, or cancer cells
that travel through the lymph system. Breast cancer
cells in the lymph nodes under the arm or in the
chest are a sign that the cancer has spread, and
that it might recur.
Malignant — Cancerous.
Mammography — X-ray imaging of the breast that
can often detect lesions in the tissue too small or
too deep to be felt.
Progestin — A type of hormone used to treat some
types of breast cancer.
Radiodermatitis — Red, irritated, and inflamed skin
caused by x rays, radiation treatment, or other type
of radiation exposure.
the woman vulnerable to infection, the stem cells are
then replaced, where they restore the body’s ability to
fight infection.
Expected results
The prognosis for breast cancer depends on the type
and stage of cancer. Most patients can return to a normal
lifestyle within a month or so after surgery. Exercises
can help the patient regain strength and flexibility, and
avoid building up too much fluid. Arm, shoulder, and
chest exercises may aid in the patient’s recovery.
It is normal after breast cancer treatment to be de-
pressed or moody, to cry, lose appetite, or feel unworthy or
less interested in sex. If these problems last for an extended
time, individual counseling is appropriate. Many women
have also found that attending a support group of breast
cancer survivors to be an invaluable help during this stage.
Prevention
While breast cancer cannot be prevented, it can be
diagnosed from a mammogram at an early stage when it
is most treatable. Despite recent questions about the ef-
fectiveness of mammography in preventing breast cancer,
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
it remains effective in screening for and detecting signs of
breast cancer. A baseline mammogram should be done by
age 35, so that a normal x ray can be used to compare fu-
ture mammograms, even when there is no reason to be-
lieve there is a lump or cyst. In addition, women should
check their own breasts at the same time each month. The
American Cancer Society (ACS) publishes guidelines
recommending how often and at what ages women
should have screening mammograms. The ACS updated
its guidelines in 2003 to recommend annual screening
mammograms for women beginning at age 40.
In 1998, the National Surgical Adjuvant Breast and
Bowel Project (NSABP) released the results of a six-
year study called the Breast Cancer Prevention Trial
(BCPT) that analyzed the breast cancer prevention qual-
ities of the drug tamoxifen (Novadex). The study con-
cluded that tamoxifen reduced the incidence of breast
cancer in women at high risk of developing this disease.
Researchers reported a 49% reduction in diagnoses of
invasive breast cancer among women who took tamox-
ifen, and a 50% decrease in diagnoses of noninvasive
breast tumors, such as ductal or lobular carcinoma in
situ. More recent studies suggest that tamoxifen also
helps prevent breast cancer in women over age 60.
293
Breast cancer
Breast-feeding problems
However, the drug has also been associated with blood
clotting problems and an increased risk of uterine can-
cer in some patients.
A clinical study comparing tamoxifen and ralox-
ifene, an osteoporosis drug, began in 1999. Ralox-
ifene is thought to have breast cancer prevention prop-
erties similar to tamoxifen, but with fewer harmful
side effects.
Resources
BOOKS
Lauersen, Niels, and Eileen Stukane. The Complete Book of
Breast Care. New York: Fawcett Columbine, 1998.
Porter, Margit Esser. Hope is Contagious: The Breast Cancer
Treatment Survival Handbook. New York: Simon &
Schuster, 1997.
PERIODICALS
Balzarini, A., et al. "Efficacy of Homeopathic Treatment of
Skin Reactions During Radiotherapy for Breast Cancer: A
Randomised, Double-Blind Clinical Trial.” British Home-
opathic Journal 89, no. 1 (January 2000): 8-12.
“Does Tamoxifen Prevent Breast Cancer?” Journal of Family
Practice 50, no. 12 (December 2001): 1023.
“Early Detection Saves Lives.” Women’ s Health Weekly (No-
vember 14, 2003): 13.
“HRT Linked to Higher Breast Cancer Risk, Later Diagnosis,
Abnormal Mammograms.” Women's Health Weekly (July
17, 2003):2.
“Nutrition and Lifestyle Factors Affect the Risk of Developing
Breast Cancer.” Health & Medicine Week (July 28, 2003):
48.
“Quality of Life Seems to be Better After Conservative Treat-
ment of Breast Cancer.” Women's Health Weekly (July 17,
2003): 22.
“Sentinel Lymph Node Biopsy is Accurate for Staging.”
Women s Health Weekly (June 5, 2003):4.
Smith, Robert A., et al. “American Cancer Society Guidelines
for Breast Cancer Screening: Update 2003.” Cancer
(May-June 2003): 141.
Zoler, Michael L. “Mammograhpy Analysis Slammed (No
Change in Recommendations).” Internal Medicine News
34, no. 23 (December 1, 2001): 1.
ORGANIZATIONS
American Cancer Society. (800) ACS-2345. <http://www.
cancer.org>.
Cancer Care, Inc. 275 7th Ave., New York, NY, 10001. (800)
813-HOPE, info@cancercare.org. <http://www.cancer
careinc.org>.
CancerNet. (800) 4-CANCER, <http://wwwicic.nci.nih.gov>.
National Alliance of Breast Cancer Organizations. 9 East 37th
St., 10th floor, New York, NY 10016. (888) 80-NABCO.
<http://www.nabco.org>.
Paula Ford-Martin
Teresa G. Odle
294
Breast-feeding problems
Definition
The term “breast-feeding problems” is used to de-
scribe a variety of physical, behavioral, and emotional
difficulties with nursing an infant.
Description
Breast-feeding, or nursing, is the practice of nour-
ishing an infant with the milk in the human breast. Full-
term babies have a natural suckling instinct, and breast-
feeding comes naturally to most as soon as they leave the
womb. After delivery, levels of prolactin, the hormone
that triggers milk product, begin to rise in the body. At
first, babies feed on a nutrient-rich substance known as
colostrum, which is produced by the breast before milk
production begins. New mothers will experience en-
gorgement in the days following the birth of their babies,
where breast milk “comes in” and engorges the breasts.
After this time, regular feedings and proper breast-feed-
ing techniques usually ensure a healthy milk supply for
most babies until it is time to wean. However, breast-
feeding can be a complex process and in many cases,
there is a problem with the infant’s suckling technique,
the mother’s milk supply, or other factors, and breast-
feeding problems result.
Causes & symptoms
Inadequate weight gain and a failure to thrive in
nursing infants is the most obvious sign that there is a
breast-feeding problem.
A number of factors may interfere with successful
breast-feeding. These include:
• Milk supply problems. A variety of factors can cause
an inadequate supply in new mothers. Milk production
is largely a supply and demand process. If the baby
does not feed frequently enough, milk production will
adjust itself, going down accordingly. A study pub-
lished in 2002 showed that women who gave birth to a
second child within two years of the birth of their first
child produced about 30 percent more breast milk in
the first week after birth with their second baby.
• Latching problems. Some babies, particularly preterm
infants, have difficulty suckling. This can be due to an
abnormality of the mouth, or simply to a lack of coor-
dination of the jaw muscles. In addition, the mother
may not be placing her breast into the infant’s mouth
properly.
• Scheduling problems. Breastfed infants should be
nursed at least once every three hours during the day,
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
and should go no more than five hours at night between
feedings. Scheduling also becomes a problem for
women who work outside the home, as they often find
that their milk flow diminishes after they return to work.
• Nipple and breast problems. Infants may have difficulty
latching on to inverted or flat nipples. Other structural
problems such as insufficient mammary glandular tis-
sue, may result in reduced milk production. In addition,
cracked and sore nipples and breast infections (masti-
tis) can make nursing painful.
• Retained placenta. If a woman’s milk has not “come
in” and she continues to experience abnormal bleeding
after delivery, she may still be retaining pieces of the
placenta within her uterus.
• Stomach sleeping. A nursing mother who sleeps on her
stomach may experience decreased milk production
due to the extended pressure on her breasts.
• Stress and fatigue. New mothers need proper rest in
order to produce an adequate milk supply. The ability
to relax is also fundamental to proper breast-feeding.
Women who are stressed can have difficulty achieving
milk “let-down,” the sensation of the mammary glands
releasing milk.
• Psychological issues. Some women are unable to
breastfeed because of preconceived notions about the
practice, or ideas instilled by their parents and peers,
that have put up a psychological barrier for them. A
2002 study showed that most women are uncomfort-
able breast feeding in public and may even abandon the
practice because they don’t want to be shut off from
others or feel squeamish about feeding their babies
even in front of friends and family members.
Diagnosis
Breast-feeding problems are first determined by an
infant’s inability to gain weight. Most babies lose some
weight in the first week of life. However, they should re-
gain the weight quickly and be back at their birthweighl
at two weeks of age. An average weight gain of 6-8 oz
per week should be maintained through the second or
third month. After that, growth charts can demonstrate
whether the child is gaining adequate weight.
Once a problem has been established, a healthcare
practitioner will ask questions about the baby’s feeding
schedule and may observe the mother’s breast-feeding
technique so he or she can determine if an improper latch-
ing technique or inadequate suckling is causing the diffi-
culty. Lactation counselors can be helpful in diagnosing
these problems. Further physical examination and tests
may be necessary to determine if structural breast prob-
lems or placental fragments are causing the difficulties.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Treatment
Proper treatment for breast-feeding difficulties de-
pends on the cause of the problem.
Inadequate milk production
Milk production can be boosted in several ways. The
easiest way is for the mother to encourage more frequent
feedings at the breast. If this is impractical or the baby does
not cooperate, milk production can often be increased
through intermittent use of a breast pump, a device that ex-
presses milk from the breast. Breast pumps are available in
manual and electric models, and can be purchased or rent-
ed. Pumped breast milk can be bottled or frozen, and fed
by bottle to the baby at a later time, although if milk pro-
duction is a problem the mother will probably want to put
the baby to the breast at every opportunity.
Milk thistle, ( Silybum marianum) is sometimes pre-
scribed to promote increased breast milk secretion. Al-
though the herb is considered safe for nursing mothers, it
should be acquired from a reputable source and pre-
scribed by an herbalist, naturopathic physician, or other
healthcare professional familiar with its use.
Each breast contains both foremilk and the richer,
fat laden hindmilk. Infants need the nutrients and fat of
the hind milk, but must get through the foremilk to reach
it. This is why it is important that the mother completely
empty one breast before starting the baby on the other
one. This can be accomplished by nursing at least 10
minutes per breast. If the baby does not completely
empty a breast, the job can be finished with the aid of a
breast pump. The next time the mother nurses, she
should start the child on the opposite breast.
Latching problems
To ensure proper breast-feeding, the mother should en-
courage the baby to latch on to the entire nipple, with his or
her lips past the outside perimeter of the areola, before start-
ing to suck. The mother will likely have to guide the breast
into the baby’s mouth, and repositioning may be required.
Practice makes perfect, and sometimes all an infant
needs to improve his latching and suckling technique is
time. If the baby has a structural problem in his mouth,
such as a cleft palate, a breast pump may be required to
keep milk production going. In some cases where suck-
ling does not improve, feeding with a supplementary nu-
trition system may be required. The system consists of a
feeding bottle containing the mother’s own breast-
pumped milk, and two tubes that run down from the bot-
tle and attach to the nipples. Milk flows easily from the
tubes with a weak sucking action from the baby. Both
baby and mother can still maintain closeness while pro-
viding the baby with adequate milk flow.
295
Breast-feeding problems
Breath therapy
Scheduling problems
Nursing infants who are sleeping through the night with-
out a feeding are probably not getting enough milk. They
should go no longer than five hours at night without feeding,
and may require waking to ensure they get enough to eat.
Women who have returned to work can use a
portable breast pump at least once during the work day
to encourage sustained milk flow and to store milk for
their babies to eat during their time away from home.
Nipple and breast problems
Liquid vitamin E applied regularly to sore or
cracked nipples can soothe the pain and help the healing
process. Women who think they have a breast infection
should see their healthcare provider immediately, as they
will probably require a course of antibiotics.
Retained placenta
Minor surgery known as a dilatation and curettage
(D and C) is usually required to remove pieces of placen-
ta that were retained by the uterus. Once the placenta has
been removed, prolactin levels should rise, stimulating
milk production.
Stress and fatigue
Relaxation exercises, yoga, meditation, massage,
and aromatherapy can all be useful tools for relieving
stress. Women should establish a quiet, restful environ-
ment for nursing. Warm compresses to the breast may
also assist in milk let down. If it is feasible, taking naps
when the baby is sleeping can help to ease the fatigue
caused by nighttime feedings.
Psychological issues
Support from family and friends is necessary for any
new mother, especially one that chooses to nurse her child. If
no familiar support network exists, women may seek help
from groups for nursing mothers such as the LaLeche league.
Many hospitals offer mothers and their spouses
classes on breast-feeding techniques and nursing issues.
Women who have negative feelings about breast-feeding
may find classes helpful in overcoming these issues.
Expected results
In most cases, treatment for breast-feeding problems
is successful and mother and baby do well. Other women
may be able to breastfeed in limited amounts, but require
supplementing their child’s diet with formula to ensure
proper weight gain and adequate nutrition. For a small
296
KEY TERMS
Latching — A term used to describe a baby's mouth
hold on his or her mother's nipple.
Prolactin — A hormone secreted after delivery
which stimulates the production of milk.
percentage of women, physical problems or psychologi-
cal issues may prevent successful nursing altogether.
Prevention
The best way for a new mother to prevent nursing
problems is to take care of herself by eating right, drinking
plenty of fluids, and staying rested and relaxed. It’s impor-
tant, because breast feeding incidence and duration are both
associated with reduced breast cancer risk in women, ac-
cording to a large international study released in 2002.
Resources
BOOKS
Eisenberg, Arlene et al. What to Expect the First Year. 2nd edi-
tion. New York: Workman Publishing, 1996.
Eiger, Marvin S., and Sally Olds. The Complete Book of
Breast-feeding. New York: Bantam Books, 1999.
PERIODICALS
“Milk Production and Number of Births (Breastfeeding).’’ Spe-
cial Delivery (Fall 2002): 18.
PERIODICALS
“Mothers Uncomfortable Breastfeeding in Public.” Australian
Nursing Journal (July 2002):31.
PERIODICALS
Worcester, Sharon. “Breast-feeding Linked to Reduced Breast
Ca Risk (Duration and Incidence).” OB GYN News (Sep-
tember 1,2002): 18-21.
ORGANIZATIONS
The LaLeche League. 1400 N. Meacham Rd., Schaumburg, IL
60173-4048. (847) 519-7730. http://www.lalecheleague.org.
Paula Ford-Martin
Teresa G. Odle
Breath therapy
Definition
Breath therapy is an umbrella term covering a broad
range of therapeutic approaches that emphasize the impor-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
tance of breathing and its potential to affect human health.
Most breath therapies employ specific types of breathing
exercises, often done in conjunction with other practices.
In addition to the ones mentioned here, other yoga-like
breath therapies include qigong and t’ai chi ch’uan.
Origins
The therapeutic use of many breath techniques has
been explored in various forms since ancient times.
Yoga
Developed thousands of years ago in India, yoga
today takes many forms. Patanjali, sometimes known as
the “Father of Yoga,” codified yoga philosophy and tech-
nique in his Yoga Sutras, written sometime during the
last several centuries of the pre-Christian era.
Breathwork
Breathwork refers to a number of different breath-
based therapies, most of which have developed since the
1970s. Rebirthing, also known as intuitive breathing,
uses breathing techniques (in conjunction with affirma-
tions and other cognitive practices) as a form of psy-
chotherapy. The intent is for the person to reexperience
and release birth trauma and other emotional and psy-
chological blockages.
Relaxation response
Dr. Herbert Benson of Harvard Medical School
began studying the physiological effects of breathing and
meditation techniques on the human body in the 1960s.
This led him to pinpoint a specific psycho-physiological
condition said to offer various therapeutic effects. In the
1970s, Benson founded the Mind/Body Medical Institute
at Harvard.
Benefits
Most breath therapies are commonly used both to
promote general well-being and to address specific psy-
chological, physical, and/or spiritual conditions. General
benefits may include reduced stress, enhanced energy
and vitality, and (in the case of yoga and other similar
practices) increased flexibility. Breath therapies have
also been used to treat a wide range of specific com-
plaints, such as asthma, high blood pressure, headaches,
and rheumatoid arthritis. Breathing exercises have
helped some children avoid asthma attacks and improve
lung function. Breathing therapy has been used to help
reduce anger, exhaustion, hostility, and risk of new heart
problems in some people who have had heart surgery.
Yoga, in particular, is increasingly being used as a com-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
panion therapy to conventional treatment for such criti-
cal illnesses as cancer, heart disease, and HIV/AIDS.
Used as a form of psychotherapy, both breathwork
and meditation are said to help practitioners address old
conflicts, enhance their self-esteem, and achieve greater
peace of mind.
In addition to these benefits, spiritual seekers may
explore these therapies to achieve higher consciousness.
Description
Yoga
Most schools of yoga incorporate breathing exercis-
es (known as pranayama) as one key component, along
with physical poses (asanas) and, sometimes, chanting
and/or sitting meditation. Perhaps the most basic form of
pranayama is three-level breathing, in which the practi-
tioner first fills the abdomen, then the rib cage, and then
the upper chest, before exhaling in reverse order. Anoth-
er breathing technique sometimes used in yogic practice
is alternate-nostril breathing, in which air is taken in
through one nostril and expelled through the other, often
using the hand or a finger to close the unused nostril. A
more intensive breathing technique, often associated
with the kundalini school of yoga, is the breath of fire.
This involves pumping the diaphragm to draw in and
expel air rapidly. More advanced yogic practice may also
involve any number of other breathing techniques.
Breathwork
Various types of breathwork employ a breathing
technique originally associated with rebirthing, known
as conscious (or circular) connected breath. This tech-
nique, performed lying down, involves a continuous
cycle of inhaling and exhaling air through the mouth.
The person inhales as fully as possible and allows a nat-
ural, relaxed exhale, with no pause between intake and
release. Holotropic breathwork uses deep and rapid
breathing coordinated with dramatic sounds and rhythms
to induce psychedelic states.
Relaxation response
Based on his study of the effects of transcendental
meditation (a popular approach brought to the West by
Maharishi Mahesh Yogi of India), Dr. Herbert Benson de-
veloped a nonreligious approach to meditation that com-
bines breathing techniques, sitting quietly, and focusing
the mind in order to achieve the “relaxation response.”
Precautions
Many breath therapies are intended to be practiced in
a safe, controlled environment, under the guidance of a
297
Breath therapy
Breema
trained facilitator or teacher. As a general rule, it is wise
to ask about the training, qualifications, and experience of
such facilitators, especially before beginning a rigorous
or costly program based on a little-known therapy.
Although breathing is a natural process that is essen-
tial to maintaining human life, and breathing exercises
are generally taken to be beneficial, some precautions
may be advisable. People suffering from asthma or other
breathing-related disorders should notify their doctor
about any alternative therapy they are exploring. They
should also notify their guide in the therapy of choice
about their condition and any medication currently re-
quired. People suffering from mental disturbances or dis-
orders should be cautious about experimenting with prac-
tices designed to induce altered states of consciousness.
Side effects
Prolonged, intensive breathing can sometimes create
dizziness, or the person may even faint. Related tech-
niques used in some of the various breath therapies may
have other side effects that should be considered before
starting a therapeutic program.
Research & general acceptance
Many clinical studies over the last several decades
have demonstrated specific benefits associated with vari-
ous breathing techniques and/or breath-based therapies,
particularly certain types of yoga and meditation. Yoga
(whose effects have probably been explored more by re-
searchers than those of other breath therapies) has been
shown to lower blood pressure and respiratory rate, in-
crease skin resistance (a sign of stress reduction), and
decrease the frequency of asthma attacks.
It is now generally accepted that yoga and medita-
tion can be helpful in curbing stress and increasing flexi-
bility. But the more exotic claims made for these prac-
tices have yet to be scientifically substantiated. Other
breath therapies, such as various types of breathwork,
have not been extensively studied.
Training & certification
There is no uniform standard for training or certifica-
tion for breath therapies. Specific training can vary wide-
ly, even among the different schools of yoga. This is even
more true for the many other types of breath therapies.
Resources
BOOKS
Cassileth, Barrie R. The Alternative Medicine Handbook. New
York: W.W. Norton & Company, 1998.
298
Woodham, Anne, and David Peters. DK Encyclopedia of Heal-
ing Therapies. New York: DK Publishing, 1997.
PERIODICALS
Appels et al. Journal of Psychosomatic Research 43, no. 2
(1997): 209-217.
Peter Gregutt
Breema
Definition
Breema is both a hands-on and self-movement sys-
tem that activates the body’s self- corrective reflexes to
create a balanced state of energy.
Origins
Breema originated in a mountain village in the Near
East and was established in the United States with the
founding in 1980 of the Breema Center in Oakland, Cali-
fornia. Jon Schreiber, D.C., a graduate of the Palmer
College of Chiropractic, has been the director since then.
He incorporates Breema into his clinical practice be-
cause of its ability to vitalize and heal the body. He has
been teaching and writing about the Breema system for
over 20 years. As of 2000, Breema classes and work-
shops have been offered in many European countries, as
well as in Canada and the United States.
Benefits
According to the Breema Center, the primary benefit
of Breema is bringing individuals to a level at which they
feel nurtured rather than drained by their relationship to
their body, surroundings, people, feelings, and other aspects
of life. Breema’s nurturing atmosphere allows the mind,
body, and feelings to become present, receptive, and vital.
Secondary benefits that stem from this nurturing include:
• renewed vitality
• increased mental clarity and focus
• relief of tension
• increased flexibility
• mental and emotional balance and harmony
• gentle musculoskeletal realignment
• reduced stress
• improved nervous system function
• improved circulation and digestion
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Description
Breema has three important components. They are
bodywork, Self-Breema exercises, and the nine universal
principles of Breema.
Bodywork
Since Breema regards the body as an energy system,
the bodywork is intended “to enhance the flow of life en-
ergy and bring one to the present.” A person receiving a
Breema treatment is fully clothed and works with the in-
structor or practitioner lying down or seated on a padded
floor. The bodywork is a harmonious choreography of
supported movements, gradual leaning, gentle stretching
and bending, holding postures, “nurturing brushes,” and
rhythmic tapping. Breema treatments are tailored to each
recipient at each visit; there is no standard program or
sequence. Treatment sessions can last from about 30
minutes to an hour.
Self-Breema exercises
Self-Breema exercises are done individually, so that
the person can “experience being both the practitioner
and recipient at the same time.” The program emphasizes
the naturalness of all Self-Breema moves and postures.
No muscular force or unusual contortions of the body are
involved. Like the bodywork sessions, Self-Breema exer-
cises are customized for each individual to support and
balance the flow of life energy through the body, release
tension, and increase vitality and dexterity.
Universal principles
Breema maintains that its universal principles gov-
ern all of life as well as bodywork and health mainte-
nance. They include:
• mutual support/mutual benefit
• no judgment
• full participation, or using the whole body
• body comfortable
• single moment/single activity
• gentleness and firmness
• no extra
• no force
• no hurry/no pause
The Breema principles are intended to free people
from the conceptual body, defined as “the ideas and im-
ages of our body that we carry in our mind.” The aim of
Breema is “to increase vitality, not to fight sickness, and
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Self-Breema — A personalized form of Breema
bodywork that the individual performs on his or
her own body, without an instructor as partner. It
is intended to supplement Breema bodywork
treatment sessions with an instructor.
to create an atmosphere which allows the body to move
toward a natural state of balance.”
Working with the nine principles of Breema is
thought to create a receptive mind, supportive feelings,
and a relaxed body. The energy that is usually consumed
by conflict between mind and feelings and physical ten-
sion becomes available.
Preparations
Breema treatments don’t require special preparation
other than the wearing of loose and comfortable clothing
that allows free movement.
Precautions
Common sense precautions for any kind of body-
work include seeking advice from a qualified medical
practitioner before starting a new program. This precau-
tion is particularly important for persons with chronic
heart or lung disease, persons recovering from surgery or
acute illness, or persons with arthritis or other disorders
that affect the muscles and joints.
Side effects
There are no known side effects of Breema therapy
in healthy people.
Research & general acceptance
As of 2000, no published information is available
regarding independent scientific studies of Breema.
Training & certification
The Breema Center in Oakland is the world head-
quarters for training and certifying instructors and practi-
tioners. It offers a 165-hour practitioner certificate pro-
gram in Breema bodywork. The required hours include a
series of classes that lead to proficiency in a wide variety
of sequences and Self-Breema exercises, along with a
thorough knowledge of Breema principles. The certifi-
cate program takes a minimum of six months to com-
plete. The Breema Center is a vocational school licensed
299
Breema
Brewer's yeast
by the State of California Bureau for Private Postsec-
ondary and Vocational Education. To become an instruc-
tor, certified Breema practitioners must have years of ex-
perience, receive extensive training with Dr. Schreiber,
and fulfill annual continuing education requirements.
Resources
ORGANIZATIONS
The Breema Center. 6076 Claremont Ave. Oakland, CA 94618.
(510) 428-0937. Fax (510) 428-9235. http://www.breema.
com.
Rebecca Frey, PhD
Brewer's yeast
Description
Brewer’s yeast is an ingredient that is used to fer-
ment sugars to alcohol in the brewing of beer. It consists
of the ground, dried cells of Saccharomyces cerevisiae, a
one-celled plant that is a variety of fungus.
Brewer’s yeast contains all the essential amino
acids, 14 minerals, and 17 vitamins. It is one of the best
natural sources of the B-complex vitamins thiamin, ri-
boflavin, niacin, B 6 , pantothenic acid, biotin, and folic
acid. It is also high in minerals, including chromium,
zinc, iron, phosphorus, and selenium. Brewer’s yeast is
also a good source of protein. It contains approximately
16 g of protein per 30 g of powdered yeast. Brewer’s
yeast is a good source of RNA, an immune-enhancing
nucleic acid that may help in the prevention of degenera-
tive diseases and slowing the aging process.
General use
Vegetarians have used brewer’s yeast as a source of
protein, vitamins, and minerals for many years. In addi-
tion to being an excellent nutritional supplement, brew-
er’s yeast is often recommended to regulate blood sugar
levels, improve the health of the skin, control diarrhea,
lower cholesterol, and repel insects.
Brewer’s yeast is one of the best sources of the miner-
al chromium. Two tablespoons of brewer’s yeast yields
about 120 micrograms (p.g) of chromium, an amount
equal to the recommended daily allowance. Chromium is
an important factor in regulating blood sugar levels. High
levels of chromium increase glucose tolerance. Diabetes
and hypoglycemia are two conditions in which blood
sugar levels are unstable. Brewer’s yeast has been reported
300
to help improve symptoms of diabetes and hypoglycemia,
and may act to prevent diabetes from developing in per-
sons with a family history of diabetes and in those who
have problems with blood sugar metabolism. One Danish
study reported that people with hypoglycemia showed an
improvement in their symptoms after taking 2 tbsp of
brewer’s yeast every day for one month.
B-complex vitamins are important for healthy skin
and nails. Persons deficient in these vitamins may bene-
fit from taking brewer’s yeast as it is rich in B-complex
vitamins. A compound derived from brewer’s yeast, skin
respiratory factor (SRF) reportedly has wound healing
properties. SRF has been a component in over-the-
counter hemorrhoid remedies for more than four
decades. SRF also has been used to treat skin problems.
Brewer’s yeast has been used in the treatment of contact
dermatitis, a condition of the skin characterized by red,
itchy, and inflamed skin.
Another component of brewer’s yeast also has
wound healing properties. Glucan, a substance derived
from the yeast, has been shown to improve wound heal-
ing in mice by activating macrophages and promoting
the growth of skin cells and capillaries.
Brewer’s yeast may help to prevent constipation.
Thirty grams of brewer’s yeast contains approximately
6 grams of dietary fiber (24% of the recommended
daily amount). Fiber is an important part of the diet as
it helps increase the bulk of fecal matter, thereby pro-
moting healthy bowels and intestines. Brewer’s yeast
has also been found to be helpful in cases of diarrhea.
The yeast acts to encourage the growth of good bacteria
in the intestines.
Studies show that brewer’s yeast may be helpful in
decreasing cholesterol and raising HDL levels (the good
cholesterol). A study performed at Syracuse University
in New York reported that persons who consumed 2 tbsp
of brewer’s yeast daily for two months reduced their
cholesterol levels by 10%.
Pet owners have known about the ability of brewer’s
yeast ability to repel ticks and fleas for many years.
Wafers that contain brewer’s yeast can be given to ani-
mals for this purpose. Powdered brewer’s yeast may be
sprinkled on the animal’s food also. The large amounts
of thiamine in brewer’s yeast may act to repel mosqui-
toes from humans as well.
Generous doses of brewer’s yeast may help to pre-
vent cancers such as prostate cancer. When combined
with wheat germ, brewer’s yeast is helpful in preventing
heart problems. Brewer’s yeast may also be helpful in
the treatment of fatigue or low energy.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Preparations
Brewer’s yeast is available at most health food stores
in tablets, flakes, and a powdered form. Brewer’s yeast
can be added to foods (soups, casseroles, baked goods) to
increase their nutritional value. It is also a popular addi-
tion to drinks, juices, and shakes. Brewer’s yeast does not
require refrigeration and has a long shelf life.
Do not confuse brewer’s yeast should not be con-
fused with torula yeast, nutritional yeast, or baker’s
yeast. These yeasts are not a high source of chromium.
Brewer’s yeast should also not be confused with the
yeast that causes vaginal infections, Candida albicans,
although persons who are sensitive to these conditions
should use caution when taking brewer’s yeast.
The quality of brewer’s yeast varies depending upon
the manufacturer. Some packaged brewer’s yeasts are
processed to remove the alcohol and/or chemical
byproducts that may be left behind in the brewing
process. This processing phase lowers the nutritional
quality of the yeast. High quality brewer’s yeast is grown
on molasses or sugar beets and is grown specifically for
supplemental purposes. As a result, there is no need for
further processing. Brewer’s yeast powder is often bitter
tasting. Some powders are “debittered.”
Brewer’s yeast contains higher levels of phosphorus
than calcium. Too much phosphorus may deplete the
body of calcium. To create a balance, some manufactur-
ers add calcium to their brewer’s yeast.
When prescribing brewer’s yeast as a food supple-
ment, doctors often recommend a daily dosage of 1-2 tbsp.
Ticks and fleas can be prevented by sprinkling in
pets sprinkle powdered brewer’s yeast on the animal’s
food in a dosage of 1 tsp for cats and 1 tsp per pound of
body weight for dogs.
Precautions
Daily dosage on the product label should not be ex-
ceeded.
Those allergic to yeast or susceptible to yeast infec-
tions should contact their health care practitioner before
taking brewer’s yeast.
Persons with gout, vaginal infections, or Candida
albicans should avoid using brewer’s yeast.
Persons with diabetes should consult their health
care practitioner before using brewer’s yeast. Brewer’s
yeast may interfere with insulin requirements.
The use of brewer’s yeast in persons with an im-
paired immune system may lead to an infection.
Persons with an intestinal disease should not take
brewer’s yeast.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Scanning electron micrograph of brewer’s yeast. (Andrew
Syred/Science Photo Library/Photo Researchers, Inc. Repro-
duced by permission.)
Brewer’s yeast is safe in pregnant or nursing women
at doses of 1-2 tbsp per day.
Side effects
Initial use may cause bloating and gas. To lessen
these effects, it is best to begin with small amounts of
brewer’s yeast (less than 1 tsp daily) and gradually work
up to the recommended dosage.
If nausea or diarrhea occur, one should stop taking
brewer’s yeast and contact a health care practitioner.
Interactions
There are no known interactions.
Resources
BOOKS
Griffith, H. Winter. Minerals, Supplements & Vitamins: The Es-
sential Guide. Arizona:Fischer Books, 2000.
Prevention Magazine. The Complete Book of Alternative Nutri-
tion. Pennsylvania: Rodale Press, Inc., 1997.
Jennifer Wurges
Bromelain
Description
Bromelain, also known as bromelin, is a protein-digest-
ing enzyme extracted from the flesh and stem of the pineap-
301
Bromelain
Bromelain
pie plant. Ananas comosus. Although the people of Guade-
loupe introduced Christopher Columbus to the fruit in 1493,
Europeans did not recognize the pineapple’s beneficial at-
tributes until later. Pineapple had a long history of traditional
use among the native peoples of Central and South America.
They applied pineapple dressings to wounds and skin in-
juries to reduce inflammation, and eased stomachaches and
indigestion by drinking the juice of the fruit.
Bromelain was first isolated from pineapple juice in
1891 and introduced as a therapeutic supplement in
1957. The active ingredients of bromelain are found in
the juice and stem of the pineapple plant, but the stem
contains more bromelain than the fruit.
General use
Bromelain is most notable for its effectiveness in the
reduction of inflammation and decreasing swelling, but
the scope of its benefits continues to increase. As a nat-
ural anti-inflammatory enzyme, bromelain has many
uses. Arthritis patients may reduce the swelling that
causes joint pain by taking bromelain. Bromelain may
also be helpful for the pain, numbness, tingling, aching,
and loss of motor and sensory function in the fingers re-
sulting from carpal tunnel syndrome (CTS).
The protease enzyme is beneficial in reducing the
clumping of platelets (small platelike bodies in the
blood), the formation of plaques in the arteries, and the
formation of blood clots. All these effects help to pre-
vent and treat cardiovascular disease. Bromelain has also
been discovered to have anti-tumor action, as well as
helping the body absorb medications.
Although bromelain is often labeled an alternative
treatment, mainstream medical research continues to
study its effectiveness in the prevention and treatment of
hematomas, or localized blood clots. Bromelain has been
found useful in the reduction of swelling and congestion
in the affected tissue after an athletic injury or surgery. It
is commonly used in Germany for this purpose.
Bromelain’s anti-clotting activity may be useful in
preventing strokes, one of the most feared results of ob-
structions in the circulatory system. Due to the lack of oxy-
genated blood flowing to the brain, a stroke can cause per-
manent damage to the affected area of the central nervous
system. Bromelain is thought to help maintain healthy car-
diac tissue and reduce the risk of stroke by its anti-inflam-
matory activity. By preventing mild infection or inflamma-
tion caused by the fatty substances inside the blood vessels
where plaque may form, bromelain helps to reduce inflam-
mation by digesting the byproducts of tissue repair.
Bromelain is helpful to people with colds due to its
ability to reduce mucus and keep it moving out of the
302
body. Bromelain has also been shown to reduce the
painful inflammation associated with costochondritis, an
inflammation of the cartilage that attaches the ribs to the
breastbone. In addition, bromelain appears to be benefi-
cial to asthma patients. Asthma is caused by spasms of
the bronchial passages that restrict the flow of air in and
out of the lungs. Taking bromelain may reduce the ex-
cess mucus that tends to collect in the respiratory sys-
tems of asthma patients. In addition, people who suffer
from hay fever and similar seasonal allergies may also
be helped by bromelain’s antiinflammatory activity.
Additional benefits of bromelain include reducing
the painful symptoms of varicose veins, including dull
aches, tired legs and feet, and itchy skin.
Research has also shown that bromelain benefits
cows as well as humans. Bromelain has been shown to
reduce the white blood cell count in cows with mastitis.
This reduction increases the quality of their milk. Re-
searchers have found that bromelain works to reduce in-
flammation by interfering with the synthesis of
prostaglandins and other inflammatory substances.
Preparations
Bromelain is available as a dietary supplement that
is offered in several different tablet strengths. For
rheumatoid arthritis, the recommended dosage of
bromelain is 250-750 mg, taken two or three times a day
between or before meals. In Germany, the standard
dosage to reduce swelling after surgery is 80-320 mg
daily. The supplement has found to offer the most benefit
when taken on an empty stomach, and its therapeutic ef-
fects are also enhanced when taken in higher doses.
Increasing the dosage of bromelain to 400-1,000 mg per
day has shown to reduce the symptoms of angina pectoris
(the severe pain and feeling of constriction about the heart
that often radiates to the left shoulder and down the left arm).
Precautions
Bromelain has shown to be generally safe when
taken in moderate doses, although a preliminary report
links an increased heart rate with the use of the supple-
ment. People with an inflammation of the stomach lining
should not use digestive enzyme supplements such as
bromelain. In addition, the safe use of bromelain in preg-
nant or nursing women, small children, and people with
kidney or liver disease has not been established.
Side effects
While bromelain can be taken safely without side
effects in moderate doses, there are anecdotal reports of
allergic reactions to it. Other side effects that have been
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Mastitis — Inflammation of the breast.
Menorrhagia — Excessive bleeding at the time of a
menstrual period, either in amount of blood or
number of days, of both.
Plaque — An abnormal hardened deposit on the
inner wall of an artery.
Protease enzyme — Any of a group of enzymes
that help to break down proteins into smaller
amino acid compounds. Bromelain belongs to this
enzyme group.
observed include nausea, vomiting, diarrhea, and men-
orrhagia (excessively heavy menstrual flow).
Interactions
Because of bromelain’s anti-clotting activity, it should
not be combined with other blood-thinning medications,
such as warfarin (Coumadin), heparin, or aspirin. It is also
possible that bromelain could cause problems with bleed-
ing if it is combined with other complementary therapies
that thin the blood, such as garlic or gingko biloba.
Resources
PERIODICALS
Kelly, G.S. “Bromelain: A Literature Review and Discussion of
Its Therapeutic Applications.” Alternative Medicine Re-
view (November 1, 1996).
Petry, Judy J. “Nutritional supplements and surgical patients.”
AORN Journal (June 1997).
ORGANIZATIONS
American Botanical Council. PO Box 201660. Austin, TX
78720-1660.
OTHER
HealthWorld Online, [cited January 17, 2001]. <http://
www.healthy.net >
Beth Kapes
Bronchitis
Definition
Bronchitis is an inflammation of the air passages be-
tween the nose and the lungs, including the windpipe, or
trachea, and the larger air tubes called bronchi that bring
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
air into the lungs from the trachea. When bronchitis is
mild and brief in duration, it is called acute. Chronic
bronchitis is recurrent, has a prolonged course, and is
often a sign of a serious underlying lung disease.
Description
Acute bronchitis
Bronchitis is an inflammation of the breathing air-
ways accompanied by coughing and spitting up of
phlegm. It can be caused by exposure to a cold or the flu,
infection, or irritants. Although the symptoms of acute
and chronic bronchitis are similar, their causes and treat-
ments are different. Acute bronchitis is most common in
winter. It usually follows an upper respiratory infection,
and may be accompanied by a secondary bacterial infec-
tion. Acute bronchitis usually resolves within two weeks,
although the cough may persist longer. Like any upper
airway inflammatory process, acute bronchitis can in-
crease a person’s likelihood of developing pneumonia.
Anyone can get acute bronchitis, but infants, young
children, and the elderly are more likely to come down with
the disease. Smokers and people with heart or lung diseases
are at a higher risk of developing acute bronchitis. Individu-
als exposed to chemical fumes or high levels of air pollution
also have a greater chance of developing acute bronchitis.
Chronic bronchitis
Chronic bronchitis is one of a group of diseases that
fall under the name chronic obstructive pulmonary disease
(COPD). Other diseases in this category include emphyse-
ma and chronic asthmatic bronchitis. Chronic bronchitis is
a major cause of disability and death in the United States.
The American Lung Association estimates that about 14
million Americans suffer from the disease. Chronic bron-
chitis shows symptoms similar to acute bronchitis, but it re-
curs and is present for at least three months a year. Until re-
cently, more men than women developed chronic bronchi-
tis, but as the number of women who smoke has increased,
so has their rate of chronic bronchitis. Because this disease
progresses slowly, middle-aged and older people are more
likely to be diagnosed with chronic bronchitis.
Causes & symptoms
Acute bronchitis
Acute bronchitis usually begins with the symptoms of a
cold, such as a runny nose, sneezing, and dry cough. How-
ever, the cough soon becomes deep and painful. Coughing
brings up a greenish yellow phlegm or sputum. These symp-
toms may be accompanied by a fever of up to 102°F
303
Bronchitis
Bronchitis
This patient’s chest x-ray reveals evidence of chronic bronchi-
tis. (Custom Medical Stock Photo. Reproduced by permission.)
(38.8°C). Wheezing after coughing is common. About 90%
of acute bronchitis is caused by a bacterial infection.
In uncomplicated acute bronchitis, the fever and
most other symptoms, except the cough, disappear after
three to five days. Coughing may continue for several
weeks. Acute bronchitis is often complicated by a bacte-
rial infection, in which case the fever and a general feel-
ing of illness persist.
Chronic bronchitis
Chronic bronchitis is caused by inhaling respiratory
tract irritants; it may also be due to recurrent bouts of
acute bronchitis. The most common cause, however, is
the irritation of cigarette smoke. The cells that line the
respiratory system contain fine, hair-like outgrowths
called cilia. Normally, the cilia of many cells beat rhyth-
mically to move mucus along the airways. When smoke
or other irritants are inhaled or when there is irritation
from repeated dry coughing, the cilia become paralyzed
or snap off and the airways become inflamed, narrowed,
and clogged. This leads to difficulty breathing and can
progress to the life-threatening disease emphysema. A
mild cough is usually the first visible sign of chronic
bronchitis. Coughing brings up phlegm, and wheezing
and shortness of breath may accompany the cough.
Diagnosis
General
Initial diagnosis of bronchitis is based on observing
the patient’s symptoms and health history. The physician
304
will do chest examination with a stethoscope for specific
sounds that indicate lung inflammation and airway nar-
rowing. A sputum culture may be performed, particularly
if the sputum is green or has blood in it, to determine
whether a bacterial infection is present and to identify
the disease-causing organism so that an appropriate an-
tibiotic can be selected. Occasionally, in diagnosing a
chronic lung disorder, the sample of sputum is collected
using a procedure called a bronchoscopy.
Chronic bronchitis
A pulmonary function test is important in diagnos-
ing chronic bronchitis and other variations of COPD.
This test uses an instrument called a spirometer to mea-
sure the volume of air entering and leaving the lungs.
The doctor may do a chest x ray, an electrocardiogram
(ECG), and blood tests as well. Other tests may be used
to measure how effectively oxygen and carbon dioxide
are being exchanged in the lungs.
Treatment
The treatment of chronic bronchitis is complex and
depends on the stage of chronic bronchitis and whether
other health problems are present. Lifestyle changes, such
as quitting smoking and avoiding secondhand smoke or
polluted air, are an important first step. Controlled exer-
cise performed on a regular basis is also important.
There are a multitude of botanical and herbal medicines
that can be used to treat bronchitis. Examples from aro-
matherapy include essential oils of any of the following:
benzoin, Styrax benzoin; camphor, Cinnamomum campho-
ra; eucalyptus. Eucalyptus globulus; lavender, Lavandula
officinalis; pine, Finns sylvestris; sandalwood, Santalum
album; or thyme. Thymus vulgaris. Any one or combination
of these oils should be added to water and inhaled in a
warm steam. They can also be dabbed on to a cloth, and the
aroma can be breathed in deeply through the nose. A mix-
ture of the essential oils of clove, Eugenia aromaticum; cin-
namon, Cinnamomum zeylanicum; lemon balm, Melissa of-
Jicianalis; and lavender, Lavandula officinalis , is reported to
be particularly effective when taken as a steam inhalation.
Herbalists recommend taking a tea, syrup or tincture
of any of the following: mullein, Verbascum thapsus;
coltsfoot, Tussilago farfara; aniseed, Pimpinella
anisum; hyssop, Hyssopus officinalis; elecampane. Inula
helenium; and garlic, Allium sativum. The Chinese herb
ephedra, also called ma huang ox Ephedra sinica, may
be recommended as long as heart disease or high blood
pressure is not a problem. Ephedra is only used in herbal
combinations and when coughing and wheezing are pre-
sent. There are many remedies in traditional Chinese
medicine for coughing and phlegm.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Recommended homeopathic remedies include
Aconite 6c, Kali bichromicum 6c, and Phosphorus 6c.
Acupuncture can be useful in preventing chronic
bronchitis attacks and in resolving colds that lead to
acute attacks.
For a mild case of acute bronchitis over-the-
counter remedies of homeopathic medicine, tradition-
al Chinese medicine, and Ayurveda are widely avail-
able and quite helpful. Practitioners of these disci-
plines can be very effective and should be consulted in
dealing with more severe or chronic cases. Hy-
drotherapy and massage with tapping and cupping is
also recommended in bronchitis to loosen mucus, im-
prove breathing, and heighten the immune response to
the condition.
The juice of a lemon squeezed into a cup of water
should be consumed to clear out mucus. Hot, spicy foods
can help open the air passages. These foods include gar-
lic, onions, chili peppers, and horseradish, and should be
consumed liberally.
Allopathic treatment
Acute bronchitis
When no secondary infection is present, acute bron-
chitis is treated in the same way as the common cold.
Home care includes drinking plenty of fluids, resting,
not smoking, increasing moisture in the air with a cool
mist humidifier, and taking acetaminophen (Datril,
Tylenol, Panadol) for fever and pain. Aspirin should not
be given to children because of its association with
seizures in children. Cough syrups are recommended to
reduce coughing, soothe irritation, and increase expecto-
ration of mucus.
It is important for mucus to be cleared from the
lungs. The use of cough suppressants should be limited
because when coughing is suppressed, the mucus accu-
mulates in the plugged airways and may become a
breeding ground for pneumonia bacteria. If the patient is
coughing up phlegm, the cough should be allowed to
continue to bring up mucus and irritants from the lungs.
Cough medicines with expectorants may, therefore, be
helpful. Expectorant cough medicines are used to thin
the mucus in the lungs, making it easier to cough up and
expel. People who are unsure about what type of med-
ications are in over-the-counter cough syrups should ask
their pharmacist for an explanation.
If a secondary bacterial infection is present, the
infection may be treated with an antibiotic. Patients
need to take the entire amount of antibiotic pre-
scribed. However, in 2002, a new study showed that
antibiotics really don’t do anything to help acute bron-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
chitis. The drug is mostly prescribed to make the
physician and the patient feel like they are “doing
something.” Inn a double blind study, treatment with
cough suppressant medication and inhaled albuterol
reported the same improvement as those patients who
took antibiotics.
Chronic bronchitis
Drug therapy uses bronchodilators to relax the mus-
cles of the bronchial tubes and allow increased airflow.
They can be taken by mouth or inhaled using a nebulizer.
Common bronchodilators include albuterol (Ventolin,
Proventil, Apo-Salvent) and metaproterenol (Alupent,
Orciprenaline, Metaprel, Dey-Dose). Anti-inflammatory
medications are added to reduce swelling of the airway
tissue. Corticosteroids, such as prednisone, can be taken
orally or intravenously. Other steroids are inhaled. Med-
ications are also given to reduce the quantity of mucus.
As the disease progresses, the patient may need supple-
mental oxygen. A one-time pneumonia vaccination may
also be recommended.
In 2002, a new drug therapy was approved to treat
chronic bronchitis, as well as other pulmonary diseases.
Called Severent Diskus, or salmeterol, it is a long-acting
bronchodilator that can be inhaled twice a day and will
last for 12 hours. It works well for patients with the
chronic form of bronchitis, but is not intended for use in
acute episodes.
Expected results
When treated, acute bronchitis normally resolves
in one to two weeks without complications, although a
cough may continue for several more weeks. Unfortu-
nately, there is no cure for chronic bronchitis, and the
disease can often lead to or coexist with emphysema.
On the whole, all forms of COPD are a leading cause
of death.
Prevention
The best way to prevent bronchitis is not to begin
smoking or to stop smoking. Smokers are 10 times more
likely to die of COPD than non-smokers. Smokers who
stop show improvement in lung function. Other preven-
tative steps include avoiding chemical and environmental
irritants, such as air pollution, and maintaining good
overall health.
Supplementation with vitamins A, C, and E, zinc
and bioflavonoids may also be helpful in preventing re-
currence and secondary infections. Dairy products,
sugar foods and eggs should be avoided, as they may in-
crease the tendency to form mucus in the lungs.
305
Bronchitis
Bruises
KEY TERMS
Bronchoscopy — An examination of the lungs and air-
way passages using a flexible fiberoptic instrument.
Emphysema — A disease involving destruction of
air sacs in the lungs, so that they do not take in
oxygen easily and have the tendency to retain air
within the lungs.
Mucus — The slippery secretion of the mucous
membranes of the respiratory tract.
Phlegm — A thick secretion of mucus produced in re-
sponse to irritation that may clog the airway passages.
Sputum — Mucus and other substances coughed
up from the lungs.
Trachea — A cartilage tube in the area of the throat
that carries air to the lungs.
Resources
BOOKS
The Burton Goldberg Group. Alternative Medicine: The Defini-
tive Guide. Washington: Future Medicine Publishing, 1995.
The Editors of Time-Life Books. The Medical Advisor: The
Complete Guide to Alternative and Conventional Treat-
ments. VA: Time-Life. Inc., 1996.
PERIODICALS
Evans, AT, S Husain, and L Durairaj. “Antibiotics Won’t Do
Anything for Acute Bronchitis.” Formulary (June 2002):
286.
Mechcatie, Elizabeth. “New & Approved.” Family Practice
News (May 15, 2002): 18-21.
Tiep, Brian L. “Disease Management of COPD with Pulmonary
Rehabilitation.” Chest (December 1997).
ORGANIZATIONS
National Heart, Lung, and Blood Institute Information Center.
P.O. Box 30105, Bethesda, MD 20824-0105.
National Jewish Center for Immunology and Respiratory Med-
icine. 1400 Jackson Street, Denver, CO 80206.
Patience Paradox
Teresa G. Odle
Bruises
Definition
Bruises, or ecchymoses, are a discoloration and ten-
derness of the skin or mucous membranes due to the
leakage of blood from an injured blood vessel into the
306
tissues. Pupura refers to bruising as the result of a dis-
ease condition. A very small bruise is called a petechia.
These often appear as many tiny red dots clustered to-
gether, and could indicate a serious problem.
Description
Bruises change colors over time in a predictable pat-
tern, so that it is possible to estimate when an injury oc-
curred by the color of the bruise. Initially, a bruise will
be reddish, the color of the blood under the skin. After
one to two days, the red blood cells begin to break down,
and the bruise will darken to a blue or purplish color.
This fades to green at about day six. Around the eighth
or ninth day, the skin over the bruised area will have a
brown or yellowish appearance, and it will gradually di-
minish back to its normal color.
Long periods of standing will cause the blood that
collects in a bruise to seep through the tissues. Bruises
are actually made of little pools of blood, so the blood in
one place may flow downhill after awhile and appear in
another. For instance, bruising in the back of the ab-
domen may eventually appear in the groin; bruising in the
thigh or the knee will work its way down to the ankle.
Causes & symptoms
Healthy people may develop bruises from any injury
that doesn’t break through the skin. Vigorous exercise may
also cause bmises due to bringing about small tears in blood
vessels walls. In a condition known as purpura simplex,
there is a tendency to bruise easily due to an increased
fragility of the blood vessels. Bruises also develop easily in
the elderly, because the skin and blood vessels have a ten-
dency to become thinner and more fragile with aging, and
there is an increased use of medications that interfere with
the blood clotting system. In the condition known as purpu-
ra senilis, the elderly develop bmises from minimal contact
that may take up to several months to completely heal.
The use of nonsteroidal anti-inflammatories such as
ibuprofen (Advil) and naproxen (Aleve) may lead to in-
creased bmising. Aspirin, antidepressants, asthma med-
ications, and cortisone medications also have this effect.
The anti-clotting medications also known as blood thin-
ners, especially the drug warfarin (Coumadin), may be
the cause of particularly severe bruising.
Sometimes bruises are connected with more serious
illnesses. There are a number of diseases that cause exces-
sive bleeding or bleeding from injuries too slight to have
consequences in healthy people. An abnormal tendency to
bleed may be due to hereditary bleeding disorders, certain
prescription medications, diseases of the blood such as
leukemia, and diseases that increase the fragility of blood
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
vessels. If there are large areas of bruising or bruises de-
velop very easily, this may herald a problem. Other causes
that should be ruled out include liver disease, alcoholism,
drug addiction, and acquired immune deficiency syn-
drome (AIDS). Bruising that occurs around the navel may
indicate dangerous internal bleeding; bruising behind the
ear, called Battle’s sign, may be due to a skull fracture;
and raised bruises may point to autoimmune disease.
Diagnosis
Bruising is usually a minor problem, which does not
require a medical diagnosis. However, faced with exten-
sive bruising, bruising with no apparent cause, or bruis-
ing in certain locations, a physician will pursue an evalu-
ation that will include a number of blood tests. If the area
of the bruise becomes hard, an x ray may be required.
Treatment
Several types of topical applications are usually rec-
ommend to speed healing and to reduce the pain associ-
ated with bruises. Vitamin K cream can be applied di-
rectly to the site of injury. Astringent herbs such as witch
hazel, Hamamelis virginiana, can be used. This will
tighten the tissues and therefore diminish the bruising.
The homeopathic remedy, Arnica montana, can be ap-
plied as a cream or gel to unbroken skin.
Oral homeopathic remedies may reduce bruising,
pain, and swelling as well. Arnica montana, at 30 ml (1
oz), taken one to two times per day is highly recom-
mended. For ledum, 30 ml (1 oz) one to two times per
day is also useful.
Allopathic treatment
A bruise by itself needs no medical treatment. It is
often recommended that ice packs be applied on and off
during the first 24 hours of injury to reduce the bruising.
After that, heat, especially moist heat, is recommended
to increase the circulation and the healing of the injured
tissues. Rest, elevation of the effected part, and compres-
sion with a bandage will also retard the accumulation of
blood. Rarely, if a bruise is so large that the body cannot
completely absorb it or if the site becomes infected, it
may have to be surgically removed.
Expected results
The blood under the skin which causes the discol-
oration of bruising should be totally reabsorbed by the
body in three weeks or less. At that time, the skin color
should completely return to normal.
Sometimes, a bruise may become solid and increase
in size instead of dissolving. This may indicate blood
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
&
A close-up view of woman’s bruised left eye. (Custom Med-
ical Stock Photo. Reproduced by permission.)
trapped in the tissues, which may be need to be drained.
This is referred to as a hematoma. Less commonly, the
body may develop calcium deposits at the injury site in a
process called heterotopic ossification.
Prevention
Vitamin K promotes normal clotting in the blood,
and therefore may help reduce the tendency to bruise
easily. Green leafy vegetables, alfalfa, broccoli, sea-
weed, and fish liver oils are dietary sources of vitamin K.
Other good foods to eat would be those containing
bioflavonoids, such as reddish-blue berries. These can
assist in strengthening the connective tissue, which will
decrease the spread of blood and bruising. Zinc and vit-
amin C supplements are also recommended for this.
Resources
BOOKS
Editors of Prevention Magazine Health Books, eds. The Doc-
tors Book of Home Remedies. Prevention Health Books,
2000 .
Feinstein, Alice, ed. Prevention s Healing With Vitamins: The
Most Effective Vitamin and Mineral Treatments for Every-
day Health Problems and Serious Disease. Prevention
Health Books, 1998.
Williams, William J. Williams' Hematology. New York: Mc-
Graw-Hill, 1995.
Paula Ford-Martin
Rebecca J. Frey, PhD
307
Bruises
Bruxism
Bruxism
Definition
Bruxism is the habit of clenching and grinding the
teeth. It most often occurs at night during sleep, but may
also occur during the day. It is an unconscious behavior
or habit perhaps performed to release anxiety, aggres-
sion, or anger.
Description
Bruxism is one of the oldest disorders known, and
approximately one in four adults experience it. It can
occur in children and adolescents as well; cases of brux-
ism in children as young as 24 months have been report-
ed. Most people are not aware of the disorder until their
teeth have been damaged.
Causes & symptoms
While bruxism is typically associated with stress, it
may also be triggered by abnormal occlusion (the way the
upper and lower teeth fit together) or crooked or missing
teeth. Symptoms of bruxism include: dull headaches; sore
and tired facial muscles; earaches; sensitive teeth; and
locking, popping, and clicking of the jaw. During a dental
examination, a dentist may recognize damage resulting
from bruxism, including: enamel loss from the chewing
surfaces of teeth; flattened tooth surfaces; loosened teeth;
and fractured teeth and fillings. Left untreated, bruxism
may lead to tooth loss and jaw dysfunction.
Bruxism also appears to be associated with Rett
syndrome, an X-linked neurodegenerative disorder that
occurs almost exclusively in girls. It is not known as of
2003 why children with this disorder frequently devel-
op bruxism.
Diagnosis
Medical and dental histories, examinations, and x
rays are usually necessary to differentiate bruxism from
other conditions that may cause similar pain, such as ear
infections, dental infections, and temporomandibular
joint syndrome (TMJ). In many cases, untreated brux-
ism can lead to chronic TMJ due to the stress that pro-
longed grinding places on the jaw and the temporo-
mandibular joint.
Wearing away of the tooth surface is generally regard-
ed as the most important clinical sign of bruxism. Although
there is no universally accepted scale for measuring the de-
gree of tooth wear, a 2002 Dutch study reported on a five-
point scale that appears to be a reliable instrument for diag-
nosing bruxism. The five points are as follows:
308
• 0 = no wear.
• 1 = visible wear within the tooth enamel.
• 2 = visible wear with dentine exposure and loss of
crown height.
• 3 = loss of crown height between 1/3 and 2/3.
• 4 = loss of crown height greater than 2/3.
Treatment
Stress management and relaxation techniques, such
as hypnosis and guided imagery, may be useful in break-
ing the habit of jaw clenching and teeth grinding. Tight
jaw muscles are often relaxed by applying warm com-
presses to the sides of the face. Acupuncture may relieve
the jaw tension associated with both bruxism and TMJ.
Massage therapy and deep tissue realignment, including
rolfing, can also assist in releasing the clenching pattern.
Anti-spasmodic herbal preparations which also con-
tain central nervous system relaxant properties, such as
chamomile (, Matricaria chamomilla), may be prescribed
before bed to prevent grinding while asleep.
Biofeedback, which teaches an individual to control
muscle tension and any associated pain through thought
and visualization techniques, is also a treatment option
for bruxism. In biofeedback treatments, sensors placed
on the surface of the jaw are connected to a special ma-
chine that allows the patient and healthcare professional
to monitor a visual and/or audible readout of the level of
tension in the jaw muscles. Through relaxation and visu-
alization exercises, the patient learns to relieve the ten-
sion and can actually see or hear the results of their ef-
forts instantly through the sensor readout on the biofeed-
back equipment. Once the technique is learned and the
patient is able to recognize and differentiate between the
feelings of muscle tension and muscle relaxation, the
biofeedback equipment itself is no longer needed and the
patient has a powerful, portable, and self-administered
treatment tool to deal with pain and tension.
Allopathic treatment
To prevent further damage to the teeth and jaw,
bruxism is treated by placing a removable custom-fitted
plastic appliance called a night guard between the upper
and lower teeth. Although the clenching and grinding be-
havior may continue, the teeth wear away the plastic in-
stead of each other.
In some cases, abnormal occlusion may be adjusted
and high spots removed so that the teeth fit together in a
more comfortable position. Missing teeth may be re-
placed and crooked teeth may be straightened with or-
thodontic treatment to eliminate possible underlying
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Crown — The part of a tooth that is covered by
enamel.
Dentine — The hard major portion of a tooth
below the enamel.
Enamel — The hard outermost surface of a tooth.
High spot — An area of a tooth or restoration that
feels abnormal or uncomfortable because it hits its
opposing tooth before other teeth meet.
Night guard — A removable custom-fitted plastic ap-
pliance that fits between the upper and lower teeth
to prevent them from grinding against each other.
Occlusion — The way upper and lower teeth fit to-
gether during biting and chewing.
Rett syndrome — An X-linked disorder of the ner-
vous system found almost exclusively in girls.
Children with Rett's syndrome often develop brux-
ism, for reasons as yet unknown.
Rolfing — Based on the belief that proper align-
ment of various parts of the body is necessary for
physical and mental health, rolfing uses deep tis-
sue massage and movement exercises in an at-
tempt to bring the body into correct alignment.
Temporomandibular joint (TMJ) — The jaw joint
formed by the mandible (lower jaw bone) moving
against the temporal bone of the skull.
causes of bruxism. In cases where jaw muscles are very
tight, a dentist may prescribe muscle relaxants.
Expected results
Bruxism may cause permanent damage to teeth and
chronic jaw pain unless properly diagnosed and prompt-
ly treated. It is considered a major risk factor for the fail-
ure of dental implants. The behavior may be eliminated
if its underlying causes are found and addressed.
Prevention
Increased awareness in patients prone to anxiety, ag-
gression, or anger may prevent the habit of bruxism from
developing.
Resources
PERIODICALS
Baba, K., T. Haketa, S. Akishige, et at. “Validation of Diagnos-
tic Criteria for Sleep Bruxism.” Journal of Oral Rehabili-
tation 29 (September 2002): 872.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Coyne, B. M., and T. Montague. “Teeth Grinding, Tongue and
Lip Biting in a 24-Month-Old Boy with Meningococcal
Septicaemia. Report of a Case.” International Journal of
Paediatric Dentistry 12 (July 2002): 277-280.
Lobbezoo, F., W. J. Groenink, A. A. Kranendonk, et al. “A Re-
liability Study of Clinical Occlusal Tooth Wear Measure-
ments.” Journal of Oral Rehabilitation 29 (September
2002): 881-882.
Lynch, C. D., and R. J. McConnell. “The Cracked Tooth Syn-
drome.” Journal of the Canadian Dental Association 68
(September 2002): 470-475.
Magalhaes, M. H., J. Y. Kawamura, and L. C. Araujo. “General
and Oral Characteristics in Rett Syndrome.” Special Care
in Dentistry 22 (July-August 2002): 147-150.
Misch, C. E. “The Effect of Bruxism on Treatment Planning
for Dental Implants." Dentistry Today 21 (September
2002): 76-81.
ORGANIZATIONS
Academy of General Dentistry. Suite 1200, 211 East Chicago
Avenue, Chicago, IL 60611.(312)440-4300. <www.agd.
org>. agdjoumal@agd.org.
American Dental Association. 211 East Chicago Avenue,
Chicago, IL 60611. (312)440-2500. <www.ada.org>.
Association for Applied Psychophysiology and Biofeedback.
Suite 304, 10200 W. 44th Ave., Wheat Ridge, CO 80033-
2840. (303)422-8436. <www.aapb.org>.
Patience Paradox
Bryonia
Description
Bryonia is a toxic plant in the gourd family. There
are two species used in healing, Byronia alba and Bry-
onia diocia. B. alba is most commonly used in homeo-
pathic healing.
Bryonia is a native European perennial climbing
vine with red berries, white flowers, and a thick, white,
fleshy taproot, or primary root. The root is the part of the
plant used in healing. It has a strong, bitter odor and taste
and can cause death within hours by inflammation of the
digestive system. Bryonia is also called devil’s turnip,
common bryony, white bryony, or wild hops. In home-
opathy it is abbreviated bry.
General use
Homeopathic medicine operates on the principle
that like heals like. This means that a disease can be
cured by treating it with products that produce the same
symptoms as the disease. These products follow another
309
Bryonia
Bryonia
homeopathic law, the Law of Infinitesimal. In opposition
to traditional medicine, the Law of Infinitesimal states
that the lower a dose of curative, the more effective it is.
To achieve a low dose, the curative is diluted many,
many times until only a tiny amount, if any, remains in a
large amount of the diluting liquid.
In homeopathic terminology, the effectiveness of
remedies is proved by experimentation and reporting
done by famous homeopathic practitioners. Bryonia was
proved as a remedy by the German founder of homeopa-
thy, Dr. Samuel Hahnemann (1775-1843) in 1834.
In homeopathic medicine, bryonia is used to treat
symptoms that develop slowly. These symptoms include
feeling lethargic, tired, irritable, extremely thirsty, and
feeling excruciating pain upon the slightest movement.
Psychological symptoms include feeling mentally slug-
gish. People who need bryonia may fall into a stupor and
be confused when called back to reality, especially at
night. Some people feel indecisive and restless despite
the fact that any movement makes their symptoms worse.
Bryonia is used to treat dry, spasmodic cough that
causes pain, influenza symptoms, and severe headaches
that develop slowly. It is also used to treat chronic dis-
eases such as arthritis, painful or swollen joints, and
rheumatism.
Other conditions for which homeopathic healers
recommend bryonia include inflammation of the chest,
pleurisy, pneumonia, and other lung conditions. Byro-
nia is also said to have an effect on the digestive system.
It is used to treat abdominal pain, acute gastroenteritis,
diarrhea (especially diarrhea that is worse in the morn-
ing), nausea, and vomiting.
In homeopathic medicine the fact that certain symp-
toms get better or worse under different conditions is
used as a diagnostic tool to indicate what remedy will be
most effective. Symptoms that benefit from treatment
with bryonia get much worse with movement. The
smallest movement aggravates the person needing bry-
onia. Symptoms may get worse after eating and drink-
ing, despite the fact that people needing bryonia crave
cool drinks and food. Symptoms also get worse in heat
and in the summer. People may feel dizzy in the heat and
have trouble sleeping. Pain is worse at night and on the
right side of the body. Symptoms improve with rest, ap-
plication of pressure to the painful part of the body, re-
maining still, and a cool environment.
Homeopathy also ascribes certain personality types
to certain remedies. The bryonia personality is said to be
insecure about their financial situation, even when they
are wealthy, and thus become materialistic. People with
the bryonia personality tend to be calculating, clean-liv-
310
ing, prudent, and meticulous about details, fitting the
stereotype of an accountant or banker.
Outside of homeopathy, bryonia has a long history
of folk use. The Greeks used bryony to treat gangrene,
and in the Middle Ages it was used to treat leprosy. Mod-
ern herbalists use bryony to treat painful joints. It may be
taken internally, or the leaves may be applied externally
to increase blood flow to the painful area. It is also used
to treat asthma, bronchitis, pleurisy, and intestinal ul-
cers. Some herbalists use it to reduce blood pressure.
Preparations
The root is dug in the autumn, chopped, then pound-
ed into a pulp. For homeopathic remedies, the dried plant
material is ground finely then prepared by extensive di-
lutions. There are two homeopathic dilution scales of di-
lution, the decimal (x) scale with a dilution of 1:10 and
the centesimal (c) scale where the dilution factor is
1:100. Once the mixture is diluted, shaken, strained, then
re-diluted many times to reach the desired degree of po-
tency, the final mixture is added to lactose (a type of
sugar) tablets or pellets. These are then stored away from
light. Bryonia is available commercially in tablets in
many different strengths. Dosage depends on the symp-
toms being treated.
Homeopathic and orthodox medical practitioners
agree that by the time the initial remedy solution is dilut-
ed to strengths used in homeopathic healing, it is likely
that very few, if any, molecules of the original remedy re-
main. Homeopaths, however, believe that these remedies
continue to work through an effect called potentization
that has not yet been explained by mainstream scientists.
Precautions
Bryonia is a poisonous plant and should be used as a
folk remedy very, very cautiously. It can cause death.
When taken in the extremely dilute doses recommended
by homeopaths, it has no toxicity, although some individ-
uals may have a personal adverse reaction to the remedy.
Side effects
When taken in the recommended homeopathic di-
lute form, no side effects have been reported. When
taken in larger doses, bryonia irritates and inflames the
digestive system, which may result in death.
Interactions
Studies on interactions between bryonia and con-
ventional pharmaceuticals or other herbs have not been
found.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Gangrene — Gangrene is tissue death cause by a
lack of blood flow to the tissues followed by a
bacterial infection. It is progressive and often re-
sults in amputation of the affected part of the
body.
Leprosy — Leprosy is a chronic disease that causes
slow breakdown of bones, muscles, nerves, and
skin.
Pleurisy — The lining of the lungs becomes in-
flamed and secretes mucus into the lung cavity.
Resources
BOOKS
Chevallier, Andrew. Encyclopedia of Medicinal Plants. Boston:
DK Publishers, 1996.
Cummings, Stephen, and Dana Ullrnan. Everybody’ s Guide to
Homeopathic Medicines. 3rd edition. New York: Putnam,
1997.
Hammond, Christopher. The Complete Family Guide to Home-
opathy. London: Penguin Studio, 1995.
Lockie, Andrew, and Nicola Geddes. The Complete Guide to
Homeopathy. London: Dorling Kindersley, 1995.
Ullrnan, Robert, and Judyth Reichenberg-Ullman. Homeopath-
ic Self-Care. Rocklin, CA: Prima Publishing, 1997.
ORGANIZATIONS
Foundation for Homeopathic Education and Research. 21 Kit-
tredge Street, Berkeley, CA 94704. (510) 649-8930.
International Foundation for Homeopathy. P. O. Box 7, Ed-
monds, WA 98020. (206) 776^1147.
National Center for Homeopathy. 801 N. Fairfax Street, Suite
306, Alexandria, VA 22314. (703)548-7790.
Tish Davidson
Buchu
Description
Buchu is the bushy shrub known as Barosma betuli-
na or Auguthosma betulina. It is native to the Cape re-
gion of South Africa where it grows wild on sunny hill-
sides. It is also cultivated in other areas of Africa and in
parts of South America. Commercially buchu is used to
enhance black currant flavor in alcoholic beverages such
as cassis, a black currant brandy, and as a fragrance in
perfumes. The entire plant is strongly aromatic with a
spicy odor and mint-like taste.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Buchu grows to a height of about 6 ft (2 m). The
small, wrinkled, leathery leaves are used in healing. The
leaves have many raised oil glands on their surface that
contain the volatile oil that is the chief medicinal compo-
nent of the plant. Leaves are harvested in the summer
when the plant is in bloom and dried for future use. Two
related species, B. crenulata and B. serratifolia are often
used interchangeably with B. betulina. The Barosma
species of buchu should not be confused with Indian
buchu ( Myrtus communis). Barosma buchu leaves are
exported commercially from South Africa to Great
Britain, Netherlands, and the United States.
General use
Buchu was a traditional folk remedy of the
Khoikhoi, a native people of the Cape region of South
Africa. The Khoikhoi used buchu as a stimulant, a di-
uretic, and to relieve bloating.
Buchu was introduced in Great Britain around 1800
and was officially listed as a medicine in the British
Pharmacopoeia by 1821. British physicians used it to
treat inflammations of the urinary system including cys-
titis, urethritis, and nephritis. South African herbalists
still use it to treat these ailments.
Buchu was introduced in the United States shortly
after it appeared in Great Britain. By the mid- 1800s, it
was a popular patent medicine used for treating urinary
complaints. In the United States and Germany today,
buchu is still used by herbalists as a diuretic. It is recom-
mended to treat symptoms of high blood pressure and is
an ingredient in herbal formulas to relieve premenstrual
bloating. It is also used as a stomach tonic.
Buchu is believed to have antiseptic properties. Ger-
man herbalists recommend it as a treatment for irritable
bladder, for mild inflammations of the urinary tract, blad-
der infections, and for prostatitis. American herbalists
recommend that compresses soaked in buchu tea be ap-
plied to bruises to accelerate healing. The tea is also used
as a vaginal douche to treat yeast ( Candida ) infections.
The German Federal Health Agency’s Commission E
was established in 1978 to independently review and eval-
uate scientific literature and case studies pertaining to herb
and plant medications. The E Commission found that
buchu’s diuretic properties were of the same magnitude as
ordinary coffee or tea, which are also diuretics of weaker
forms. It declined to recommend buchu as a diuretic.
Some laboratory studies found that buchu extracts
did not inhibit the growth of any bacteria that commonly
cause urinary tract infections. On the basis of these stud-
ies, the E Commission also declined to recommend
buchu as a treatment urinary infections. The United
311
Buchu
Buckthorn
States Food and Drug Administration also declined to
approve buchu as an ingredient in non-prescription for-
mulas to relieve premenstrual symptoms.
Preparations
Buchu can be prepared as an infusion, a tincture, or
in capsules. An essential oil is produced by steam distil-
lation. The infusion is usually made by steeping 0.5 oz
(15 g) of the herb in 2 cups (500 ml) of boiling water.
This is drunk two or three times a day. Buchu is also
available in commercial herbal teas. Ten to 40 drops of
the tincture or extract is taken with water three times a
day. Commercial capsules containing 200 mg of the herb
are available and are generally taken one to three times
daily for a limited time period, usually a week or less.
Buchu is also used in combination with other herbs in
commercially available remedies. It is often used in com-
bination with corn silk (Zea maize) and juniper ( Junipe -
rus communis) in treatments for cystitis and urinary tract
infections, and is combined with uva ursi ( Arctostaphylos
uva ursi) in formulas to treat premenstrual bloating.
Precautions
Buchu should not be self-prescribed by people who
have kidney infections, pain during urination, blood in
the urine, or any problems with kidney function. Bladder
and kidney infections need prompt attention by a med-
ical doctor. Herbalists often recommend that buchu
should be avoided by pregnant or breastfeeding women.
The volatile oil of buchu contains the compound pule-
gone that stimulates the uterus to contract and is poten-
tially toxic to the kidneys and liver in excess or over pro-
longed doses.
Side effects
Due to its diosmin and essential oils (diosphenol
and pulegone) buchu is a potential kidney and liver irri-
tant in high or prolonged doses. It could also increase the
risk of a miscarriage in pregnant women.
Interactions
There has been little scientific study of the interac-
tion of buchu and Western pharmaceuticals. No interac-
tions have been reported nor have there been any reports
of herbal interactions.
Resources
BOOKS
Chevallier. Andrew. Encyclopedia of Medicinal Plants. Boston:
DK Publishers, 1996.
312
KEY TERMS
Cystitis — An inflammation or irritation of the
bladder and uterus.
Diuretic — Any substance that increases the pro-
duction or release of urine.
Nephritis — An inflammation or irritation of the
kidneys.
Prostatitis — An inflammation or irritation of the
prostate.
Tincture — An alcohol-based extract of medicinal
plants.
Urethritis — An inflammation or irritation of the
urethra, the tube that drains the bladder.
Lawless, Julia. The Illustrated Encyclopedia of Essential Oils.
Rockport, MA: Element, 1995.
Peirce, Andrea. The American Pharmaceutical Association
Practical Guide to Natural Medicines. New York: William
Morrow and Company, 1999.
PDR for Herbal Medicines. Montvale, New Jersey: Medical
Economics Company, 1998.
Tish Davidson
Buckeye see Horse chestnut
Buckthorn
Description
Buckthorn is the common name for one of several
species of shrubs or small trees of the genus Rhamnus
that are used for medicinal purposes. The two most com-
mon species are R.frangula and R. cathartica.
R. cathartica is also called common or European
buckthorn. It was known as a healing herb hundreds of
years ago in Anglo-Saxon England, where it was called
waythorn, highwaythorn, hartshorn, or ramsthorn. It is
also sometimes called purging buckthorn because of its
laxative properties. The berries of European buckthorn
can be used in healing. The ripe berries of this species
are black and the size of a pea.
R. cathartica is a shrubby tree that grows to a height
of about 18 ft (6 m). Its twigs are often tipped with small
spines, accounting for the “thorn” in its name. Common
buckthorn is found throughout Great Britain, continental
Europe, and North Africa, where it grows wild in partial
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
sun along the edges of roads and woodlands. It was in-
troduced into North America as an ornamental landscap-
ing plant, but it has naturalized and become a nuisance
plant in much of Canada and the northern United States,
where its thick growth crowds out native plants.
R.frangula is shorter, wider, and more shrublike than
R. cathartica. It grows in damp soil in Great Britain, con-
tinental Europe, and parts of Turkey. It also has been im-
ported into North America. Bark from the trunk and
branches of R. frangula is gathered and used in preparing
a laxative and a hepatic, or liver medication. R.frangula
is also called alder buckthorn, black dogwood, frangula
bark, alder dogwood, arrow wood, or Persian berries. It is
not related to North American dogwood species.
A third species of healing Rhamnus, R. purshianus ,
grows in western North America and is called California
buckthorn. Its bark also produces a laxative that is milder
than those derived from either of the other two species.
Sea buckthorn, Hippophae rhamnoides, although it is
used in healing and shares a common name with these
other species, is not related to the Rhamnus buckthorns,
nor is it used in the same ways.
General use
All three types of buckthorn are strong laxatives.
The berries of R. cathartica produce the harshest laxa-
tive effect ( cathartica is a Latin word related to “cathar-
sis”, which means purging). The fruit can be used either
dried or fresh to treat constipation and to soften stools
to give relief from hemorrhoids, anal fissures, or rectal
surgery. The berries are also sometimes mixed with other
herbs in “blood purifying” formulas.
The dried bark of R. frangula and R. purshianus is
also used as laxatives. In earlier times it was used to
cleanse the gastrointestinal tract before exploratory
surgery. Occasionally buckthorn is used in veterinary
medicine as a laxative for dogs.
The laxative effect of all these species is well docu-
mented. Buckthorn works by stimulating the large intes-
tine to contract. The contractions shorten the time that
waste material remains in the large intestine and allow
the formation of softer, moist stools.
In addition to medical uses, buckthorn contains sev-
eral different pigments used as dyes: yellow from the
leaves and bark, green from unripe berries, and blue-gray
from ripe berries. R. frangula is also a source of high-
quality charcoal used for artistic sketching.
Preparations
The berries of R. cathartica are harvested when ripe.
If used fresh, they can be pressed to yield a bitter, ex-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Decoction — Decoctions are made by simmering a
herb in water, then straining it.
Diuretic — Any substance that increases the pro-
duction of urine.
Edema — Fluid retention, often leading to swelling
in the hands and feet.
Electrolytes — Ions whose movement and balance
are essential for proper biochemical functioning
of the body.
Hepatic — A drug or medication that acts on the
liver.
tremely foul-tasting juice that can be mixed with sugar
and flavorings to produce a laxative syrup. The dried
berries are powdered, then added to liquid.
The bark of R. frangula and R. purshianus is har-
vested in the summer and dried. Young bark is preferred,
because the longer the bark is stored, the less potent its
laxative properties. Bark used medicinally should be
stored at least one year before use. Fresh bark acts as an
irritant to the gastrointestinal system. A fluid extract or a
decoction is then prepared from the bark and mixed with
water and flavorings. The ideal dose is the smallest
amount necessary to produce soft stools.
Precautions
Buckthorn should not be used by people suspected
of having appendicitis or intestinal obstructions, by
pregnant or breastfeeding women, the frail elderly, or
children under age 12.
Side effects
Buckthorn can cause nausea, vomiting, and gastroin-
testinal spasms in large doses or in sensitive individuals.
Buckthorn causes stool to move more rapidly through the
large intestine and allows the body less time to reabsorb
fluids and electrolytes. Because of this rapid movement,
electrolytes can be lost if stools are too frequent and wa-
tery. The long-term use of buckthorn can cause potassium
imbalances. In rare cases this imbalance can cause heart
irregularities, edema, and other serious health reactions.
Interactions
Potassium imbalance is worsened by taking thiazide
diuretics, corticosteroids, and licorice root.
313
Buckthorn
Bugle weed
Resources
BOOKS
PDR for Herbal Medicines. Montvale, NJ: Medical Economics
Company, 1998.
OTHER
“Plants for the Future: Rhamnus cathartica and Rhamnus fran-
gula.” [cited January 17, 2001] .<http://www.
metalab.unc.edu >
Tish Davidson
Bugle weed
Description
Bugle weed is the common name given to at least two
low-growing flowering ground cover plants which are
members of the Ajuga family, Lycopus europaens and Ly-
copus virgin: cus. Ajugas are part of the Lamiaceae, the
same grouping to which plants of the mint family belong.
Other names by which bugle weed is known include water
bugle, sweet bugle, Virginian water horehound, and
gypsy weed. Bugle weeds usually have shining, oval-
shaped leaves that are reminiscent of spinach leaves in ap-
pearance and have glandular dots on their underside. This
foliage grows thickly along the surface of a spreading
transverse root. Bugle weed blooms in spring, typically
producing flowers of a startling cobalt blue. Some species,
however, have pink or white flowers. Bugle weed flowers
are tubular and lipped in appearance, growing in whorls
along the erect spikes that rise from the dense foliage.
There are different varieties of bugle weed with
varying characteristics:
•Ajuga genevensis, or Geneva bugle weed, is one of the
taller varieties. It has very dense, dark green leaves,
which can grow to 4-5 in (10-12 cm) in length, and
produce spikes 6-12 in (15-30 cm) high with either
pink or blue flowers in clusters along the spike.
• Ajuga pyramidalis, or upright bugle weed, is a bushy, slow-
er-growing plant with very shiny leaves that are slightly
puckered. This variety also has bright blue flowers.
•Ajuga Reptans is the most common type of bugle weed.
It is smaller, with 4-10 in (10-20 cm) spikes, and
leaves 2-3 in (5-7.5 cm) in length. Its flowers are the
same cobalt blue, and leaves may be either dark green
or bronze-colored. There are several highly attractive
sub-types in the A. reptans grouping. A. reptans alba
has white flowers; Atropurpurea has bronze leaves;
burgundy glow bugle weed has three-toned white,
314
green and pink foliage; and several others are combina-
tions of these.
Bugle weed grows in either sun or shade, in well-
drained, fairly rich soil. It establishes itself rather quick-
ly and spreads via underground roots. It can become very
invasive, and generally provides a mat of dense ground
cover that does not permit the growth of weeds or other
plants. It can be propagated by dividing the plants.
It is believed that bugle weed is native to the Northern
Hemisphere, worldwide. Species of bugle weed are found
in Europe, Asia, and North America. Like other members
of the Laminaceae or mint family, bugle weed has a mild,
pleasant, mint-like aroma when it is freshly picked. It con-
tains flavone glycosides, volatile oils, and tannins.
General use
Beside its horticultural use as an attractive spreading
ground cover in rock gardens and other types of gardens,
bugle weed is useful medicinally for several different pur-
poses. It is an astringent, and is considered to have seda-
tive qualities as well. It can calm anxiety symptoms, in-
cluding heart palpitations. It is a valued cough suppres-
sant. In old herbal remedy books such as Thayer’s Fluid
and Solid Extracts, and even in the more recent A Modern
Herbal , the authors state that in addition to cough sup-
pression, bugle weed is also useful for healing tuberculo-
sis and stopping bleeding from the lungs. It has long been
recognized in Western herbal medicine as a cardiac tonic
and can actually slow a rapid heart rate and improve the
functioning of a weak heart by increasing the strength of
the heartbeat. Because of its diuretic properties, bugle
weed is useful in removing excess fluid from the body
and thus improving circulation. It has been shown to in-
hibit the body’s metabolism of iodine, and is helpful for
this reason in treating hyperthyroidism. Poultices con-
taining bugle weed leaves in combination with other
herbs have been found to speed the healing of bruised
areas. Lastly, bugle weed is useful in weaning babies as it
helps to suppress the production of breast milk.
Preparations
All parts of the bugle weed that grow above ground
are used in herbal medicine. It is collected in early spring
before the flower buds open. The entire plant is dried and
pulverized, and used as a decoction or tea. The tea is
made by pouring a cup of boiling water over one tea-
spoonful of dried bugle weed, and allowing this mixture
to steep for 10-15 minutes. This tea may be taken three
times a day. A bugle weed tincture is also available. Poul-
tices are made from the leaves, stems and flower buds,
steeped in boiling hot water. Clean white cloth is soaked
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Diuretic — A type of drug that helps remove excess
water from the body by increasing the amount lost
in urine.
Hyperthyroidism — Overactivity of the thyroid
gland and therefore, simultaneous overproduction
of thyroid hormones.
Poultice — A soft wet mass of cloth, applied warm
or hot to an injured part of the body as a therapeu-
tic measure.
Sedative — A drug or agent that calms or soothes a
patient. Bugle weed has sedative qualities.
in this mixture, cooled until warm but not hot enough to
burn the patient, and applied to the bruised area.
Precautions
Bugle weed should not be used internally if a person
has a thyroid condition unless they have consulted a physi-
cian or health care practitioner. Because of bugle weed’s
influence on thyroid function and its ability to reduce se-
cretions (including breast milk), it should be used only for
short periods and prescribed by a trained practitioner.
In addition, plants in the mint family, which in-
cludes bugle weed, are high in methyl salicylate. This
compound causes allergies in some people.
Side effects
The Complete German Commission E Monographs
includes reports of uncommon cases of long-term high-
dosage therapy with bugle weed preparations resulting in
enlargement of the thyroid gland. When this herb is used
in the treatment of hyperthyroidism, its sudden stoppage
can result in an increase in the symptoms.
Interactions
Bugle weed preparations may interfere with the use
of radioactive isotopes used in some diagnostic proce-
dures.
Resources
BOOKS
Blumenthal, Mark. The Complete German E Monographs,
Therapeutic Guide to Herbal Medicine, 1998.
Grieve, M., and C. F. Leyel. A Modern Herbal: The Medical,
Culinary, Cosmetic and Economic Properties, Cultivation
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
and Folklore of Herbs, Grasses, Fungi, Shrubs and Trees
With All of Their Modern Scientific Uses. New York:
Barnes and Noble Publishing, 1992.
Hoffman, David, and Linda Quayle. The Complete Illustrated
Herbal: A Safe and Practical Guide to Making and Using
Herbal Remedies. New York: Barnes and Noble Publish-
ing, 1999.
Joan Schonbeck
Bulimia nervosa
Definition
Bulimia nervosa is a serious and sometimes life-
threatening eating disorder affecting mainly young
women. People with bulimia, known as bulimics, con-
sume large amounts of food (binge) and then try to rid
themselves of the food and calories (purge) through fast-
ing, excessive exercise, vomiting, or use of laxatives.
Bulimics often feel that the behavior serves to reduce
stress and relieve anxiety. Because bulimia results from
an excessive concern with weight control and self-image,
and is often accompanied by depression, it is also con-
sidered a psychiatric illness.
Description
Bulimia nervosa is a serious health problem for
more than two million adolescent girls and young
women in the United States. The bingeing and purging
activity associated with this disorder can cause severe
damage, even death, although the risk of death is not as
high as for anorexia nervosa, an eating disorder that
leads to excessive weight loss.
Binge eating may in rare instances cause the stom-
ach to rupture. In the case of purging, heart failure can
result due to loss of vital minerals such as potassium.
Vomiting causes other serious problems, including acid-
related scarring of the fingers (if used to induce vomit-
ing) and damage to tooth enamel. In addition, the tube
that brings food from the mouth to the stomach (the
esophagus) often becomes inflamed and salivary glands
can become swollen. Irregular menstrual periods can
also result, and interest in sex may diminish.
Most bulimics find it difficult to stop their behavior
without professional help. Many typically recognize that
the behavior is not normal, but feel out of control. Some
bulimics struggle with other compulsive, risky behaviors
such as drug and alcohol abuse. Many also suffer from
other psychiatric illnesses, including clinical depression,
anxiety, and obsessive-compulsive disorder (OCD).
315
Bulimia nervosa
Bulimia nervosa
Most bulimics are females in their teens or early
20s. Males account for only 5-10% of all cases. People
of all races develop the disorder, but most of those diag-
nosed are white.
Bulimic behavior is often carried out in secrecy, accom-
panied by feelings of guilt or shame. Outwardly, many peo-
ple with bulimia appear healthy and successful, while inside
they have feelings of helplessness and low self-esteem.
Causes & symptoms
Causes
The cause of bulimia is unknown. Researchers be-
lieve that it may be caused by a combination of genetic
and environmental factors. Bulimia tends to run in fami-
lies. Research shows that certain brain chemicals, known
as neurotransmitters, may function abnormally in acutely
ill bulimia patients. Scientists also believe there may be a
link between bulimia and other psychiatric problems,
such as depression and OCD. Environmental influences
include participation in work or sports that emphasize
thinness, such as modeling, dancing, or gymnastics. Fam-
ily pressures also may play a role. One study found that
mothers who are extremely concerned about their daugh-
ters’ physical attractiveness and weight may help to cause
bulimia. In addition, girls with eating disorders tend to
have fathers and brothers who criticize their weight.
Symptoms
According to the American Anorexia/Bulimia Asso-
ciation, Inc., warning signs of bulimia include:
• eating large amounts of food uncontrollably (bingeing)
• vomiting, abusing laxatives or diuretics, or engaging in
fasting, dieting, or vigorous exercise (purging)
• preoccupation with body weight
• using the bathroom frequently after meals
• depression or mood swings
• irregular menstrual periods
• onset of dental problems, swollen cheeks or glands,
heartburn or bloating
Diagnosis
Bulimia is treated most successfully when diag-
nosed early. But because the bulimic may deny there is a
problem, getting medical help is often delayed. A com-
plete physical examination in order to rule out other ill-
nesses is the first step toward diagnosis.
According to the American Psychiatric Association,
a diagnosis of bulimia requires that a person have all of
the following symptoms: >
316
• recurrent episodes of binge eating (minimum average
of two binge-eating episodes a week for at least three
months)
• a feeling of lack of control over eating during the
binges
• regular use of one or more of the following to prevent
weight gain: self-induced vomiting, use of laxatives or
diuretics, strict dieting or fasting, or vigorous exercise
• persistent over-concern with body shape and weight
Treatment
Alternative therapies may be used as complemen-
tary to conventional treatment program for bulimic pa-
tients. They include diet, nutritional therapy, herbal ther-
apy, homeopathy, hydrotherapy, biofeedback training,
hypnotherapy, massage therapy and light therapy.
Diet
The following dietary changes may be helpful for
bulimic patients:
• Eat small but nutritious meals at regularly scheduled
hours.
• Avoid sweet, baked goods or any other foods that may
cause craving.
• Avoid allergenic foods.
• Limit intake of alcohol, caffeine, monosodium gluta-
mate (MSG), and salty foods.
Nutritional therapy
The following supplements may help improve bu-
limic symptoms and prevent deficiency of essential vita-
mins and minerals:
• Multivitamin and mineral supplement to prevent defi-
ciency of essential nutrients.
• Vitamin B complex with C.
• Zinc supplement. Bulimic patients may have zinc defi-
ciency, and zinc is an important mineral needed by the
body for normal hormonal activity and enzymatic func-
tion.
Homeopathy
A homeopathic physician may prescribe patient-
specific remedies for the treatment of bulimia.
Light therapy
Light therapy. Exposure to artificial light, available
through full spectrum light bulbs or specially designed
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
"light boxes,” may be useful in reducing bulimic episodes,
especially during the dark winter months.
Hypnotherapy
Hypnotherapy may help resolve unconscious issues
that contribute to bulimic behavior.
Exercise
Yoga, qigong, t’ai chi or dance not only make pa-
tients physically healthier but also make them feel better
about themselves.
Other treatments.
Other potentially beneficial treatments for bulimia
include Chinese herbal therapy, hydrotherapy or biofeed-
back training.
Allopathic treatment
Early treatment of bulimia with a combination of
drug and behavioral therapies is necessary to prevent se-
rious health consequences. A comprehensive treatment
plan is called for in order to address the complex interac-
tion of physical and psychological problems of bulimia.
Behavioral approaches include individual psy-
chotherapy, group therapy, and family therapy. Cogni-
tive behavioral therapy, which teaches patients how
to change abnormal thoughts and behavior, is also
used. Nutrition counseling and self-help groups are
often helpful.
Antidepressants commonly used to treat bulimia in-
clude desipramine (Norpramin), imipramine (Tofranil),
and fluoxetine (Prozac). These medications also may
treat any co-existing depression.
In addition to professional treatment, family support
plays an important role in helping the bulimic person.
Encouragement and caring can provide the support need-
ed to convince the sick person to get help, stay with
treatment, or try again after a failure. Family members
can help locate resources, such as eating disorder clinics
in local hospitals or treatment programs in colleges de-
signed for students.
Expected results
Bulimia may become chronic and lead to serious
health problems, including seizures, irregular heartbeat,
and thin bones. In rare cases, it can be fatal.
Timely therapy and medication can effectively man-
age the disorder and help the bulimic look forward to a
normal, productive, and fulfilling life.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Binge — To consume large amounts of food uncon-
trollably within a short time period.
Diuretic — A drug that promotes the formation and
excretion of urine.
Neurotransmitters — Certain brain chemicals that
may function abnormally in acutely ill bulimic pa-
tients.
Obsessive-compulsive disorder (OCD) — A disor-
der that may accompany bulimia, characterized
by the tendency to perform repetitive acts or ritu-
als in order to relieve anxiety.
Purge — To rid the body of food and calories, com-
monly by vomiting or using laxatives.
Prevention
There is no known method to prevent bulimia.
Resources
BOOKS
The Burton Goldberg Group. Alternative Medicine: The Defin-
itive Guide. Fife, WA: Future Medicine Publishing, 1995.
Cassell, Dana K. The Encyclopedia of Obesity and Eating Dis-
orders. New York, NY: Facts on File, Inc., 1994.
Jablow, Martha M. A Parent's Guide to Eating Disorders and
Obesity. New York, NY: Dell Publishing, 1992.
Kubersky, Rachel. Everything You Need to Know about Eating
Disorders. New York, NY: The Rosen Publishing Group,
Inc., 1992.
The Medical Advisor: The Complete Guide to Alternative &
Conventional Treatments. Richmond, VA: TimeLife Edu-
cation, 1997.
PERIODICALS
Berg, Frances M. “Eating Disorders Affect Both the Mind and
Body.” Healthy Weight Journal. 9/2 (1995): 27-31.
Cismoski, Janet, et al. “Teen Nutrition.” Whose Kids? ..Out-
Kids! 6 (1995).
Levine, Michael P. 'TO Things Men Can Do and Be to Help
Prevent Eating Disorders." Healthy Weight Journal. 9/1
(1995): 15.
ORGANIZATIONS
American Anorexia/Bulimia Association, Inc. 293 Central Park
West, Suite IR, New York, NY 10024. (212) 501-8351.
Anorexia Nervosa and Related Eating Disorders, Inc. PO Box
5102. Eugene, OR 97405. (541) 344-1144.
Center for the Study of Anorexia and Bulimia, 1 W. 91st St.,
New York, NY 10024. (212) 595-3449.
Eating Disorder Awareness & Prevention, Inc. 603 Stewart St.,
Suite 803, Seattle, WA 98101. (206) 382-3587.
317
Bulimia nervosa
Bunion
National Association of Anorexia Nervosa and Associated Dis-
orders. Box 7, Highland Park, IL 60035. (708) 831-3438.
National Eating Disorders Organization. 6655 South Yale Ave,
Tulsa, OK 74136. (918) 481-4044.
Mai Tran
Bunion
Definition
A bunion is an abnormal enlargement of the joint
(the first metatarsophalangeal joint, or MTPJ) at the base
of the great or big toe (hallux). It is caused by inflamma-
tion and usually results from chronic irritation and pres-
sure from poorly fitting footwear.
Description
A displacement of two major bones of the foot (hal-
lux valgus) causes bunions, although not everyone with
this displacement will develop the joint swelling and
bone overgrowth that characterize a bunion. One of the
bones involved is called the first metatarsal bone. This
bone is long and slender, with the big toe attached on
one end and the other end connected to foot bones closer
to the ankle. This foot bone is displaced in the direction
of the four other metatarsals connected with the toes.
The other bone involved is the big toe itself, which is
displaced toward the smaller toes. As the big toe contin-
ues to move toward the smaller toes, it may become dis-
placed under or over the second toe. The displacement of
these two foot bones causes a projection of bone on the
inside portion of the forefoot. The skin over this projec-
tion often becomes inflamed from rubbing against the
shoe, and a callus may form.
The joint contains a small sac (bursa) filled with
fluid that cushions the bones and helps the joint to move
smoothly. When a bunion forms, this sac becomes in-
flamed and thickened. Inflammation of the bursa is
called bursitis. The swelling in the joint causes addition-
al pain and pressure in the toe.
Bunions can also form on the bones that attach the
little toe to the foot (the fifth metatarsal bone). These
bunions are called tailor’s bunion or bunionette.
Causes & symptoms
Bunions may form as a result of abnormal motion of
the foot during walking or running. One common exam-
ple of an abnormal movement is an excessive amount of
318
stress placed upon the inside of the foot. This leads to
friction and irritation of the involved structures. Age has
also been noted as a factor in developing bunions, in part
because the underlying bone displacement worsens over
time unless corrective measures are taken.
Wearing improperly fitting shoes, especially those
with a narrow toe box and excessive heel height, often
causes the formation of a bunion. This forefoot deformity
is seen more often in women than men. The higher fre-
quency in females may be related to the strong link be-
tween footwear fashion and bunions. In fact, in a recent
survey of more than 350 women, nearly 90% wore shoes
that were at least one size too small or too narrow. Shoes
without proper arch supports contribute to bunions, since
they allow the foot to roll inward (pronate,) putting more
pressure on the joint of the big toe.
Because genetic factors can predispose people to
hallux valgus bone displacement, a strong family history
of bunions can increase the likelihood of developing this
foot disorder. Various arthritic conditions and several ge-
netic and neuromuscular diseases, such as Down syn-
drome and Marfan syndrome, cause muscle imbalances
that can create bunions from displacement of the first
metatarsal and big toe. Other possible causes of bunions
are leg-length discrepancies (with the bunion present on
the longer leg) and trauma occurring to the joint of the
big toe. Persons with flat feet or gout are at increased
risk for developing bunions.
Symptoms of bunions include the common signs of
inflammation such as redness, swelling, and pain. The
discomfort is primarily located along the inside of the
foot just behind the big toe. Because of friction, a callus
may develop over the bunion. If an overlapping of the
toes is allowed, additional rubbing and pain occurs. In-
flammation of this area causes a decrease in motion with
associated discomfort in the joint between the big toe
and the first metatarsal. If allowed to worsen, the skin
over the bunion may break down causing an ulcer, which
also presents a problem of potential infection. (Foot ul-
cers can be particularly dangerous for people with dia-
betes, who may have trouble feeling the ulcer forming
and healing if it becomes infected.)
Diagnosis
A thorough medical history and physical exam by a
physician is always necessary for the proper diagnosis of
bunions and other foot conditions. X rays can help con-
firm the diagnosis by showing the bone displacement,
joint swelling, and, in some cases, the overgrowth of
bone that characterizes bunions. Doctors will also con-
sider the possibility that the joint pain is caused by or
complicated by arthritis (which causes destruction of the
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
cartilage of the joint), gout (which causes the accumula-
tion of uric acid crystals in the joint), tiny fractures of a
bone in the foot (stress fractures), or infection, and may
order additional tests to rule out these possibilities.
Treatment
The first step in treating a bunion is to remove as
much pressure from the area as possible. A foam-rubber
pad may be worn at night while sleeping to separate the
big toe from the other toes. Various taping techniques
can be useful to realign the toe and decrease friction and
rubbing that may be present. Most patients are instructed
to rest or choose exercises that put less stress on their
feet, at least until the misalignment is corrected.
Persons with bunions should wear shoes that have
enough room in the toe box to accommodate the bunion.
High-heeled shoes and tight-fitting socks or stockings
should be avoided. Sandals are a good choice. Shoes
may be stretched to provide more comfort or customized
to relieve pressure on the affected area. Shoes should be
removed periodically during the day to give feet a break.
Dressings and pads help protect the bunion from addi-
tional shoe pressure. Arch supports can reduce the pres-
sure on the bunion. The application of splints or cus-
tomized shoe inserts (orthotics) to correct the alignment
of the big toe joint is effective for many bunions. These
can correct the excessive pronation (turning inward) so
that the pressure is not continually on the big toe.
Deep friction massage techniques by a physical or
massage therapist can be helpful to increase circulation,
reduce inflammation, and prevent soft tissue build-up.
Physical therapy also provides useful approaches, such
as ultrasound, to help retard or reverse the formation of
the bunion.
One study found that using an extract from marigold
( Tagetes patula ) with a protective pad led to a reduction
in the size and pain of bunions. A used chamomile tea
bag applied to a bunion may be helpful. Massaging with
essential oil of chamomile or with a cream containing
chamomile may provide relief. The homeopathic remedy
Calcarea phosphorica can be useful in balancing the
bone formation and remodeling.
Soaking the affected foot in warm water may reduce
pain. Elevating the affected foot and applying ice and
compression to the bunion can be helpful, especially
after exercise.
Dietary supplements and dietary changes may help
to treat bunions. Vitamins which may be helpful in treat-
ing the bursitis associated with bunions include A, B
complex, C, and E. Increasing the intake of protein may
also be beneficial.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Woman’s right foot with bunion on big toe. (Photograph by
Wedgworth, Custom Medical Stock Photo. Reproduced by
permission.)
Acupuncture can be useful in treating the symp-
toms as the spleen meridian is roughly where the pain
occurs. Other treatments may help stabilize the foot.
Allopathic treatment
Nonsteroidal anti-inflammatory drugs (NSAIDs)
such as ibuprofen (Advil, Motrin), acetaminophen
(Tylenol), or naproxen sodium (Aleve) may be taken to
help reduce bunion pain. Physicians may also use steroid
injections with local anesthetic around the bunion to re-
duce inflammation. Other drugs may be necessary
should an infection occur.
If conservative treatments are not successful, surgi-
cal removal of the bunion may be necessary to correct
the deformity. This procedure is called a bunionectomy,
and there are many variations on the operation, which is
usually performed by a surgeon who specializes in treat-
ing bone conditions (orthopedics) or by one who special-
izes in treating the foot (podiatry). The procedure chosen
depends upon the angle of the bone misalignment, con-
dition of the bursa, and strength of the bones. Most
bunionectomies involve the removal of a section of bone
and the insertion of pins to rejoin the bone. Sometimes
the surgeons may move ligaments (which connect bone
to bone in the joint) or tendons (which connect bone to
muscle) in order to realign the bones.
Expected results
Often, modifications in footwear allow a good re-
covery without a need for surgery. If surgery is neces-
sary, complete healing without complications requires
approximately four to six weeks. Even after surgery cor-
rects the bone misalignment, patients are usually in-
structed to continue wearing low-heeled, roomy shoes to
319
Bunion
Burdock root
KEY TERMS
Bursitis — Inflammation of the bursa.
Orthopedics — A medical specialty concerned
with treating diseases, injuries, and malformations
of the bones and supporting structures, such as
tendons, ligaments, and muscles.
Orthotic — A device or brace used to control, cor-
rect, or compensate for a bone deformity.
Podiatry — A medical specialty concerned with
treating diseases, injuries, and malformations of
the feet.
prevent the bunion from reforming. Complications of
bunions include infection of the bunion and inflamma-
tion and arthritic changes in other joints as a result of
difficulty in walking.
Prevention
Prevention begins with proper foot wear. Shoes
with a wide and deep toe box are best. High-heeled
shoes should not be worn for longer than three hours at
a time. If a bunion is present and becomes inflamed, the
foot should be elevated with the application of an ice
pack over the painful area for not more than 20 minutes
every other hour. Daily exercise strengthens the muscles
of the legs and feet and may prevent bunion formation.
Women who wear high-heeled shoes should do calf
stretches on a regular basis. Use of arch supports or cus-
tom made orthotics can help people whose feet rotate
inward as they walk or those with different leg lengths.
Stretching the Achilles tendon can counteract stresses
on the forefoot.
Resources
BOOKS
Richard B. Birrer, et al. Common Foot Problems in Primary
Care, 2nd ed. Philadelphia, PA: Hanley & Belfus, Inc.,
1998.
PERIODICALS
Cimons, Marlene. “Bothersome Bunions.” Runner’s World 34
(May 1999): 46+.
ORGANIZATIONS
American Orthopedic Foot and Ankle Society. 222 South Pros-
pect, Park Ridge, IL 60068.
American Podiatry Medical Association. 9312 Old Georgetown
Road. Bethesda, MD 20814.
320
OTHER
“Foot Pain.” WebMD. http://my.webmd.com/content/dmk/dmk_
article_40037.
Griffith, H. “Complete Guide to Symptoms, Illness & Surgery.”
The Putnam Berkley Group, Inc., 1995. Available at:
http://www.thriveonline.com.
Belinda Rowland
Bupleurum see Chinese thoroughwax
Burdock root
Description
Great burdock (. Arctium lappa) is a coarse biennial
herb native to Europe and Asia, and naturalized through-
out North America since its introduction by European
settlers. This massive herb is thought of as a tenacious
weed by many gardeners but it is valued by herbalists
worldwide as a medicinal and culinary storehouse. Great
burdock may grow as tall as 9 ft (3 m) in its second year.
Common burdock ( Articum minus) a smaller species, is
abundant in North America, growing to 5 ft ( 1 .5 m) tall.
There are about 10 species of burdock.
Over the centuries, the hardy burdock has acquired
many names, including beggar’s buttons, bardana, burr
seed, clot-bur, clothburr, cocklebur, cockle buttons, fox’s
clote, great burr, Gypsy rhubarb, happy major, hardock,
hareburr, love leaves, personata, philanthropium, thorny
burr, and turkey burrseed. In Japan the herb is known as
gobo and is cultivated for its somewhat sweet-tasting
root, an ingredient in numerous culinary dishes. Gobo has
been grown in the United States as a vegetable for soups
and salds since the 1980s. In Russia, a common name for
the herb is lapuh. Most common folk names for this
member of the Compositae family refer to the large and
prickly seed covers that adhere securely to passersby.
Burdock has a deep primary root producing a large
rosette of basal leaves in the first year that may grow as
large as 1.5 ft (0.45 m) long and nearly as wide. In the
second year of growth, burdock shoots upward with a
stout, grooved, branching stem. Leaf stalks are longer
than the leaves, and each has a purple hue at the base that
extends up the stalk along the inner groove and into the
leaf veins. Stalks are hollow in common burdock. Leaves
resemble those of rhubarb in size and shape. They are
dark green on top and a downy, pale green on the under-
side. Flower heads are round and thistle-like, with nu-
merous, small purple-hued, funnel-shaped blooms in
mid-summer to early fall. Blossoms are surrounded by
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
stiff, prickly, hook-tipped burrs that grasp and hold firm-
ly to clothing and fur.
General use
Burdock’s fibrous primary root and rhizome expand
to about 1 ft (0.3 m) underground. Most of the herb’s
medicinal constituents are stored in these underground
parts. The entire plant has both nutritive and medicinal
uses. The roots contain as much as 45% inulin, as well as
alkaloids, essential oil, flavonoids, glycosides, mucilage,
polyacetylenes, resin, tannins, and volatile oil. The seeds
are rich in vitamins A and B and essential fatty acids.
Both the seeds and the root have a demulcent quality that
is soothing to the mucous membranes of the body. The
leaves are generally less potent than the root and seed
when used in medicinal preparations.
Burdock is primarily a tonic and alterative herb. The
cumulative effect of its use is said to bring a subtle
strengthening and cleansing to the entire system. Though
most of the therapeutic benefits attributed to this stately
herb have not been clinically proven, burdock has been
long tested in folk use, and is a safe, if mild, herbal remedy.
Burdock has been traditionally used as a blood purifier. It
promotes perspiration and the release of toxins from the
body. It is helpful in clearing up such skin conditions as
psoriasis and dry, scaly eczema. It works best when used
over a period of time. The bitter properties of burdock, par-
ticularly noticeable in the dried leaf and seed, stimulate
bile secretions. It is a good digestive herb and liver remedy.
Burdock’s anti-microbial and fungistatic properties have
been traced to as many as 14 different poly acetylene com-
pounds in the root. Burdock has been used to treat boils,
canker sores, carbuncles, measles, and sties. It will help
restore friendly bacteria in the system after antibiotic use,
and may bring relief in cases of chronic arthritis and gout.
Burdock may also help reduce blood sugar levels.
In medieval times burdock was used for more seri-
ous problems, such as the treatment of syphilis and lep-
rosy. Hildegard of Bingen, a twelfth-century German
abbess, considered burdock a valuable remedy for can-
cerous tumors. Herbalists in other cultures and times, in-
cluding the Americas, China, India, and Russia have
turned to the root of this familiar herb for a folk treat-
ment of cancer. The oil of burdock, known as repeinoe
maslo , used over a period of six to eight months, was
said to help stimulate the growth of new hair. A drink
prepared with aged wine and fine-shredded, fresh bur-
dock leaves was taken after the bite of a mad dog. A
poultice of the fresh leaf, applied to the forehead was
used to relieve headache. Shredded leaves were also
combined with an egg white, beaten until stiff, and the
mixture was applied to burns to speed healing.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Burdock seeds have also been used in medicinal
preparations, particularly to treat psoriasis and to stimulate
the digestive process. In Chinese medicine seeds were
used as a treatment for feverish colds and sore throat.
Burdock has been recently shown to have significant
antibacterial and anticandidal activity, which helps to ex-
plain its place in folk medicine as a treatment for various
infectious diseases. In addition, a team of Asian re-
searchers reported in 2002 that burdock appears to coun-
teract the damaging effects of alcohol on the liver.
Preparations
Burdock root is harvested from the first-year plant
in the early fall. Roots are deep and may be difficult to
extract. The leaves are best used when fresh, as the dried
leaf is bitter. Harvesting is done before the plant flowers.
Decoction: Burdock’s medicinal properties, concen-
trated in the root, are best extracted by decoction. Add
about 1 tsp of thinly-sliced, fresh or dried burdock root
per 8 oz of cold water in a glass or ceramic pot. Bring to
a boil. Reduce heat and simmer for about 20 minutes.
Drink up to three cups daily.
Poultice: Simmer fresh, chopped burdock leaves for
up to five minutes. Drain, squeezing out the liquid. Cool
until warm. Apply to the affected area and secure with a
clean strip of cotton gauze. A little oil applied to the skin
first may keep the poultice from sticking when dry. Pre-
pare a fresh poultice every few hours until the desired re-
lief is obtained.
Tincture: Combine one part fresh herb to three parts
alcohol (50% alcohol/water solution) in glass container.
Set aside in dark place. Shake daily for two weeks.
Strain through muslin or cheesecloth, and store in dark
bottle. The tincture should maintain potency for two
years. Standard dosage, unless otherwise prescribed, is
1/2 tsp, three times daily.
Culinary: Fresh burdock roots are mild tasting and
somewhat sweet. They may be peeled and thinly sliced
to add to soups, salads, and in a mixture of stir-fried veg-
etables. The young leaves of the first year plant may be
eaten fresh or steamed as a nutritious potherb, and the
fresh stalks, peeled and steamed until tender, are also a
culinary treat. Burdock root, roasted and ground to a
powder, has been used as coffee additive or substitute.
Precautions
Some commercially available burdock leaves and
roots have been suspected of being adulterated, on occa-
sion, with the root of the deadly belladonna (Mr op a bel-
ladonna) with toxic consequences to unwary users. Con-
321
Burdock root
Burns
sumers of herbal remedies should find a reliable source
for medicinal herbs to avoid hazardous mistakes. Preg-
nant women should not use burdock, as it has a reported
action as a uterine stimulant.
Precautions
Medicinal preparations containing burdock should
not be used by pregnant or lactating women. Burdock
prepared as a vegetable, however, appears to be safe.
Side effects
Large doses of medicinal preparations containing
burdock may cause the level of potassium in the blood
to drop too low. There have also been case reports of
people developing an allergic skin rash from touching
the leaves and stems of the plant.
Interactions
Burdock has been reported to interact with medica-
tions given to control diabetes. Persons with diabetes
should consult a physician before taking any herbal
preparation containing burdock. In addition, burdock has
been reported to intensify the activity of diuretics (drugs
given to increase urine output) and lithium.
Burdock may also interfere with the absorption of
iron and other minerals in the diet. Persons who must
take supplemental iron or other dietary minerals should
consult their health practitioner before taking burdock.
Resources
BOOKS
Hoffmann, David. The New Holistic Herbal, 2nd ed. Boston,
MA: Element, 1986.
Hutchens, Alma R. A Handbook of Native American Herbs.
Boston, MA: Shambhala, 1992.
McIntyre, Anne. The Medicinal Garden. New York: Henry Holt
and Company, 1997.
PDR for Herbal Medicines. Montvale, NJ: Medical Economics
Company, 1998.
Polunin, Miriam, and Christopher Robbins. The Natural Phar-
macy. New York: Macmillan Publishing Company, 1992.
Prevention’ s 200 Herbal Remedies, 3rd ed. Emmaus, PA: Ro-
dale Press, Inc., 1997.
Tyler, Varro E., Ph.D. The Honest Herbal. New York: Pharma-
ceutical Products Press, 1993.
Weiss, Gaea and Shandor. Growing & Using The Healing
Herbs. New York: Wings Books, 1992.
PERIODICALS
Holetz, F. B., G. L. Pessini, N. R. Sanches, et al. "Screening of
Some Plants Used in the Brazilian Folk Medicine for the
Treatment of Infectious Diseases.” Memorias do Instituto
Oswaldo Cruz 91 (October 2002): 1027-1031.
322
KEY TERMS
Alterative — A medication that is given to gradual-
ly overcome a disorder or disease condition, or to
restore normal body functioning. Burdock has
been classified historically as an alterative.
Gobo — A variety of burdock that can be used as a
vegetable for soups and salads. It is sometimes
known as Japanese burdock.
Rhizome — A horizontal underground stem that
sends up shoots from its upper surface.
Tonic — A medication or herbal preparation that is
given to restore or increase muscle tone, or to
generally promote the vital functions of the body.
Lin, S. C., C. H. Lin, C. C. Lin, et al. “Hepatoprotective Effects
of Arctium lappa Linne on Liver Injuries Induced by
Chronic Ethanol Consumption and Potentiated by Carbon
Tetrachloride.” Journal of Biomedical Science 9 (Septern-
ber-October 2002): 401-409.
Rodriguez, P., J. Blanco, S. Juste, et al. “Allergic Contact Der-
matitis Due to Burdock ( Arctium lappa).” Contact Der-
matitis 33 (August 1995): 134-135.
Strauch, Betsy. "An Herb To Know — Burdock.” The Herb
Companion (Oct./Nov. 1999).
ORGANIZATIONS
American Herbalists Guild. 1931 Gaddis Road, Canton, GA
30115. (770) 751-6021. <www.americanherbalistsguild.
com>.
Herb Research Foundation. 1007 Pearl Street, Boulder, CO
80302.(303) 449-2265.
Clare Hanrahan
Rebecca J. Frey, PhD
Burns
Definition
Bums are injuries to the tissues caused by heat, fric-
tion, electricity, radiation, or chemicals. Such injuries
cause the breakdown of body proteins, death of cells,
loss of body fluids, and edema.
Description
Burns vary depending on the cause, the intensity,
and the body parts involved. They are classified by de-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
gree, based on the severity of the tissue damage: A first-
degree burn causes redness and swelling in the outer-
most layers of skin called the epidermis. A second-de-
gree burn involves redness, swelling, and blistering. The
damage extends beneath the epidermis to the deeper lay-
ers of skin, the dermis. A third-degree burn, also called a
full-thickness burn, destroys the entire depth of skin,
causing significant scarring. Damage also may extend to
the underlying fat, muscle, or bone. Third-degree burns
require immediate medical attention. Burns are the third
leading cause of accidental death in North America.
The severity of a burn is judged by the amount of
body surface area (BSA) involved as well as the depth of
the burn. A burn is considered to be critical, or major, if a
person has third-degree burns on more than 10% of the
BSA or second-degree burns covering more than 25% of
an adult’s BSA, and more than 20% of a child’s BSA.
Such burns are serious and should be treated in a special-
ized hospital burn unit. Burns involving the hands, feet,
face, eyes, ears, or genitals are considered critical, as
well. Moderate bums are defined as first- or second-de-
gree burns covering 15%-25% of an adult’s body or 10%-
20% of a child’s body, or a third-degree bum on 2%-10%
BSA. These burns also require medical attention.
Causes & symptoms
Burns may be caused by any encounter, however
brief, with heat greater than 120°F (49°C). The source of
this heat may be the sun, hot liquids, steam, fire, electric-
ity, friction (rug burns and rope burns,) and chemicals.
Signs that the skin has been burned are localized red-
ness, swelling, and pain. A blister may develop. The skin
may peel, appear white or charred, and feel numb. A
burn may trigger a headache or fever, and extensive
burns may induce shock.
Thermal burns are caused by heat sources such as
fire, hot liquids, gases or other objects. Radiation burns
are usually due to excess exposure to the sun’s rays, tan-
ning beds, or x rays. Chemical burns are most likely to
come from strong acids, alkalis, phenols, or phosphorus.
Electrical burns may be quite severe due to the high heat
generated by electric currents.
Diagnosis
A physician will diagnose a bum based upon visual
examination, and will ask questions to determine the his-
tory of contact with possible sources of damage. De-
pending on the circumstances, there should be an evalua-
tion of the condition of the lungs and breathing, related
injuries, evidence of any suspected child abuse, and the
extent and location of the burn. Shock and infection are
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
There are three classifications of burns: first-degree, sec-
ond-degree, and third-degree burns. (Illustration by Electron-
ic Illustrators Group. The Gale Group.)
often the results of moderate and major burns, and
should be included in any evaluation.
Treatment
A number of herbal remedies, applied topically, can
help mild burns heal. These include aloe (Aloe bar-
badensis or Aloe vera ), St. John’s wort, ( Hypericum
perforatum ) Calendula officinalis, comfrey root (Sym-
phytum officinale), and tea tree oil ( Melaleuca spp.)
Nutritional support is particularly important for burn
victims. Supplementing the diet with vitamins A, C, and
E, zinc and B-complex, essential fatty acids (omega-3
and omego-6) and eating foods high in these nutrients
can be very beneficial to the healing process. Proteins
and fluid intake should be increased to replace losses.
The traditional Chinese medicine (TCM) approach
recommends foods that remove heat and toxins, nourish
yin, and promote the production of body fluids. These
foods include mung beans, kidney beans, lima beans,
soybeans, cucumbers, potatoes, summer squash, sweet
potatoes, and barley. In addition, freshly juiced ginger,
potatoes, and cucumbers can be applied to burns to re-
duce pain and swelling. The pulp of fresh pumpkin can
be used as a poultice (soft compress applied to the affect-
ed area). Chamomile tea decreases anxiety.
Homeopathic treatment should be given as soon as
possible after the onset of the burn injury. Cantharis 30c
is the most noteworthy remedy for burns. It is recom-
323
Burns
Burns
mended to keep blisters from forming. A dose can be
taken every 15 minutes for up to six doses.
Homeopathic calendula mother tincture can be use-
ful to promote the healing of burns. Ten drops should be
added to one ounce of water and applied to the burn
three times daily. Arnica montana 30c can help prevent
shock. Urtica mens 6c and Causticum 6c may also be
useful for burns. Urtica may be applied to the skin as an
ointment as well.
Guided imagery can assist with pain control.
Allopathic treatment
Burn treatment usually consists of relieving pain,
preventing infection, and maintaining body fluids, elec-
trolytes, and calorie intake while the body heals. Chil-
dren and the elderly are more vulnerable to complica-
tions from burn injuries and require more intensive care.
Other factors that influence treatment include associated
injuries such as bone fractures and smoke inhalation,
presence of a chronic disease, a history of abuse, and the
occurrence of shock or infection. Moderate and major
burns should always be treated by a medical practitioner.
The first act of treating a burn is to stop the burning
process. Small thermal burns should be immediately
placed in cold water if possible. To avoid infection, the
wound should be cleaned with soap and water, and all dirt
should be carefully removed. Butter, shortening, or simi-
lar salve should never be applied to the burn since it pre-
vents heat from escaping and drives the burning process
deeper into the skin. Minor burns should be cleaned gen-
tly with soap and water. If the skin is broken or apt to be
disturbed, the burned area should be coated lightly with
an antibacterial ointment and covered with a sterile ban-
dage. Pain relievers such as aspirin or non-steroidal anti-
inflammatory drugs (NSAIDs) may be used as needed. A
doctor should be consulted if signs of infection appear:
increased warmth, redness, pain, or swelling; pus or simi-
lar drainage from the wound; swollen lymph nodes; or
red streaks spreading from the burn.
At an accident site, the victim should be immediate-
ly removed from the burning process. Clothing should be
removed from all affected areas. Any clothing embedded
in the bum should not be disturbed. Dry chemicals
should be brushed from the skin; burns caused by acids,
alkalis, phosphorus, or organic compounds, such as phe-
nols and cresols, should be flushed with water continu-
ously over an extended time.
In cases of moderate and major burn damage, fur-
ther medical treatment may include assessment of
breathing and treatment if the patient’s airways or lungs
have been damaged; a flush of any chemicals; and the
324
administering of intravenous fluids, since burns may dra-
matically deplete body fluids. Antibiotic ointments are
usually applied to burns, and the patient is also given an-
tibiotics intravenously to prevent infection. A tetanus
shot may also be given. Dead tissue is surgically re-
moved, or debrided. Once the burned area is cleaned and
treated, it is usually covered with sterile bandages. Oral
narcotics such as codeine may be required for pain relief.
The burn patient may have to undergo physical and oc-
cupational therapy. If there is extensive scarring, a skin
graft is usually performed.
Expected results
Prognosis is dependent upon the degree of the burn,
the amount of body surface covered, whether critical
body parts are affected, any additional injuries or com-
plications, and the promptness of medical treatment. The
epidermis in first-degree burns regenerates rapidly; not
much scarring results unless infection develops. With
deeper burns, the process of healing is slow, and scars
often develop. This may limit mobility and function,
making physical therapy necessary. In some cases,
surgery may be advisable to remove scar tissue and re-
store appearance. Some people, especially young women
and people with dark skin, may develop keloids.
Secondary infections are common, and may be a
major cause of loss of function, disfigurement, and
death. Patients with burns over more than 40% BSA,
those older than 60 years old, and those with inhalation
injuries are at risk for burn injuries that result in death.
Prevention
Burns are commonly received from fires in the
home. Properly placed and working smoke detectors in
combination with rapid evacuation plans will minimize a
person’s exposure to smoke and flames in the event of a
fire. Children must be taught never to play with matches,
lighters, fireworks, gasoline or cleaning fluids.
Burns from scalding with hot water or other liquids
may be prevented by setting the water heater thermostat
no higher than 120°F (49°C), checking the temperature
of bath water before getting into the tub, and turning pot
handles on the stove out of the reach of children. Care
should be used when removing covers from pans of
steaming foods and when uncovering or opening foods
heated in a microwave oven.
Sunburns may be avoided by the liberal use of sun-
screen. Hats, loose clothing, and umbrellas also provide
protection, especially between 10 a.m. and 3 p.m., when
the most damaging ultraviolet rays are present.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Debride — To surgically remove dead tissue.
Intravenous fluids — Nutrients and medicines that
can be fed quickly and directly into the veins.
Keloid — An overgrowth of scar tissue that does
not resolve.
Mother tincture — An alcohol and water mixture
used to extract homeopathic substances. The tinc-
ture is then diluted to make a homeopathic reme-
dy.
Shock — An abnormal condition resulting from
low blood volume. Signs of shock include rapid
pulse and breathing; cool, moist, pale skin; and
bluish lips and fingernails.
Skin graft — Surgery used to cover burned or in-
jured areas of the body with new skin.
Thermal burn — Tissue injury caused by extreme
heat.
Nourish yin — In TCM, to cool the body and re-
plenish its fluids.
Burns are often received from electrical appliances.
Care should be exercised around stoves, space heaters,
irons, and curling irons. Electrical burns may be prevent-
ed by covering unused outlets with safety plugs and
keeping electrical cords away from infants and toddlers
who might chew on them.
Chemical burns may be prevented by wearing pro-
tective clothing, including gloves and eye shields. Chem-
icals should always be used according to the manufactur-
er’s instructions and properly stored when not in use.
Resources
BOOKS
The Burton Goldberg Group. Alternative Medicine: The Defin-
itive Guide. Washington: Future Medicine Publishing,
1995.
Lininger, D.C., Skye, editor-in-chief, et al. The Natural Phar-
macy. California: Prima Health, 1998.
Lockie, Dr. Andrew and Dr. Nicola Geddes. The Complete
Guide to homeopathy: The principles and Practice of
Treatment with a Comprehensive Range of Self-Help
Remedies for Common Ailments. London: Dorling
Kindersley, Ltd., 1995.
ORGANIZATIONS
Shriners Hospitals for Children. 2900 Rocky Point Drive,
Tampa, FL 33607-1435.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
OTHER
Health Answers, http://www.healthanswers.com (January 17,
2001).
The Merck Manual, http://www.merck.com/pubs/mmanual/
section20/ chapter276/276a.htm (January 17, 2001).
Patience Paradox
Bursitis
Definition
Bursitis is the painful inflammation of one or more
bursae, which are padlike sacs found in parts of the body
that are subject to friction. Bursae cushion the move-
ments between the bones, tendons and muscles near the
joints. Bursitis is most often caused by repetitive move-
ment and is known by several common names, including
weaver’s bottom, clergyman’s knee, housemaid’s knee,
and miner’s elbow, depending on the area of injury.
Description
There are over 150 bursae in the human body. Usual-
ly bursae are present from birth, but they may form in re-
sponse to repeated pressure. Each sac contains a small
amount of synovial fluid, a clear liquid that acts as a lubri-
cant. The bursae may become inflamed through traumatic
injury, infection, or the development of arthritis. The in-
flammation then causes pain whenever the joint is moved.
The most common site for bursitis to occur is the shoulder
joint (subdeltoid), but it also is seen in the elbows (olecra-
non), hips (trochanteric), knees, heels (Achilles), and toes.
The affected area may be referred to as “frozen,” because
movement is so limited. In the knee there are four bursae,
and all can become inflamed with overuse.
Causes & symptoms
The most common cause of bursitis is repeated
physical activity, but it can flare up for no known reason.
It can also be caused by trauma, rheumatoid arthritis,
gout, and acute or chronic infection.
Pain and tenderness are common symptoms of bur-
sitis. If the affected joint is close to the skin, as with the
shoulder, knee, elbow, or Achilles tendon, swelling and
redness are seen and the area may feel warm to the
touch. The bursae around the hip joint are deeper, and
swelling is not as obvious. Movement may be limited
and is painful. In the shoulder, it may be difficult to raise
325
Bursitis
Bursitis
An x-ray image of the knees of a patient with cysts caused
by rheumatoid arthritis. The cysts appear as dark areas just
below the knee joints. (Custom Medical Stock Photo. Repro-
duced by permission.)
the arm outward from the side of the body. Putting on a
jacket or combing the hair, for example, become trouble-
some activities.
in acute bursitis symptoms appear suddenly; with
chronic bursitis, pain, tenderness, and limited movement
reappear after exercise or strain.
Diagnosis
When a patient has pain in a specific joint, a careful
physical examination is needed to determine what type
of movement is affected and if there is any swelling pre-
sent. Bursitis will not show up on x rays, although some-
times there are also calcium deposits in the joint that can
be seen. Inserting a thin needle into the affected bursa
and removing (aspirating) some of the synovial fluid for
examination can confirm the diagnosis. In most cases,
the fluid will not be clear. It can be tested for the pres-
ence of microorganisms, which would indicate an infec-
tion, and for crystals, which could indicate gout. In in-
stances where the diagnosis is difficult, a local anesthetic
(a drug that numbs the area) is injected into the painful
spot. If the discomfort stops temporarily, then bursitis is
probably the correct diagnosis.
Treatment
Nutritional therapy
Naturopaths and nutritionists emphasize the role of
diet as underlying causes of bursitis. They believe that
the faulty use of calcium by the body, magnesium defi-
ciencies, and food allergies may play a role. Their rec-
ommended diet may include the following:
• fresh fruits, vegetables and whole grains
326
• avoidance of foods that may cause allergies or digestive
problems.
• multivitamin and mineral supplements
• vitamins A, C and E, selenium, and zinc supplements
Herbal therapy
Herbalists have recommended the following herbs
or plant products for treatment of bursitis:
• curcumin (turmeric)
• bromelain (an enzyme found in pineapple)
• ginger
• grape-seed extract
• pine-bark extract
• citrus bioflavonoids
Homeopathy
Homeopathic remedies for bursitis include Bel-
ladonna, Bryonia and Rhus toxicodendron.
Hydrotherapy
The application of ice soon after an injury helps de-
crease the inflammation of acute bursitis. After two days
of treatment with ice, however, heat instead of ice is
more helpful. A warm heating pad or hot showers or
baths can also relieve the symptoms of bursitis.
Acupuncture
Acupuncture has been proven effective in treating
hip and shoulder pain caused by bursitis and other condi-
tions.
Chiropractic
Spinal manipulation by a chiropractor may help im-
prove movement in the affected joints by relieving some
of the pressure on them.
Body work
Body work starts with adequate rest and massage of
the bursitic area. Massage can increase blood circulation
in the area, reducing the inflammation and pain. Follow-
ing the initial phase of body work, patients may partici-
pate in yoga exercises that help to improve joint mobility
and strengthen the muscles surrounding the joints.
Allopathic treatment
Conservative treatment of bursitis is usually effec-
tive. The application of heat, rest, and immobilization
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
of the affected joint area is the first step. A sling can be
used for a shoulder injury; a cane is helpful for hip
problems. The patient can take nonsteroidal anti-in-
flammatory drugs (NSAIDs) like aspirin, ibuprofen,
and naproxen to relieve the pain and inflammation.
Once the pain decreases, exercises of the affected area
can begin. If the nearby muscles have become weak be-
cause of the disease or prolonged immobility, then ex-
ercises to build strength and improve movement are
best. A doctor or physical therapist can prescribe an ef-
fective regimen.
If the bursitis is related to an inflammatory condi-
tion like arthritis or gout, then management of that dis-
ease is needed to control the bursitis.
When bursitis does not respond to conservative
treatment, an injection into the joint of a long-acting cor-
ticosteroid preparation like prednisone can bring imme-
diate and lasting relief. The drug is mixed with a local
anesthetic and works on the joint within five minutes.
Usually one injection is all that is needed.
Surgery to remove the damaged bursa may be per-
formed in extreme cases.
If the bursitis is caused by an infection, then addi-
tional treatment is needed. Septic bursitis is caused by
the presence of a pus-forming organism, usually Staphy-
lococcus aureus. Septic bursitis requires treatment with
antibiotics, which can be taken by mouth, injected into a
muscle, or injected directly into a vein (intravenously).
The bursa will also need to be drained by needle two or
three times over the first week of treatment.
Expected results
Bursitis usually responds well to treatment, but it
may develop into a chronic condition if the underlying
cause is not corrected.
Prevention
Aggravating factors should be eliminated to prevent
bursitis. Overexercising or the repetition of a movement
that triggers the condition should be avoided. Doing ex-
ercises to strengthen the muscles around the joint will
also help. When doing repetitive tasks, the patient should
take frequent breaks and alternate the repetitive activity
with others that use different parts of the body. To cush-
ion the joints, it is a good idea to use cushioned chairs
when sitting and foam kneeling pads for the knees.
Leaning on the elbows, kneeling, or sitting on a hard sur-
face for a long period of time should be avoided. Not
wearing high heels can help prevent bursitis in the heel,
as can changing to new running shoes as soon as the old
ones are worn out.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Arthritis — Inflammation of a joint that may lead to
changes in the joint's structure. It causes pain and
swelling. Rheumatoid arthritis is a chronic disease
that leads to crippling deformities.
Bursa — A sac that contains synovial fluid and
cushions the joints.
Gout — A hereditary metabolic disease that is a
form of arthritis and causes inflammation of the
joints. It is more common in men.
Kinesiology — The science or study of movement.
Synovia — A clear, somewhat sticky lubricating
fluid secreted by membranes that surround the
joints.
Resources
BOOKS
Bennett, J. Claude, and Fred Plum. Cecil’s Textbook of Medi-
cine. Philadelphia: W. B. Saunders Co., 1994.
Bennett, Robert M. “Bursitis, Tendinitis, Myofascial Pain, and
Fibromyalgia.” In Conn's Current Therapy. Edited by
Robert E. Rakel. Philadelphia: W. B. Saunders Co., 1998.
“Bursitis” In The Medical Advisor: The Complete Guide to Al-
ternative and Medical Treatments. Richmond, VA: Time-
Life Inc., 1997.
The Burton Goldberg Group. Alternative Medicine: The Defin-
itive Guide. Fife, WA: Future Medicine Publishing, 1995.
Murray, Michael, and Joseph Pizzorno. Encyclopedia of Natur-
al Medicine, revised 2nd ed., Rocklin, CA: Prima Health,
1998.
OTHER
Applied Medical Infomatics Inc., 1997. “Bursitis.” http://www.
healthanswers.com.
Mai Tran
Butcher's broom
Description
Butcher’s broom is the root of the plant Ruscus ac-
uleatus. R. aculeatus is a common evergreen shrub native
to Mediterranean countries. It is related to asparagus. The
shrub grows to less than 3 ft ( 1 m) in height and about the
same size in girth in shady, moist, uncultivated ground.
Its leaves are small and laced with brown membranes.
The root, which is the medicinal part, is fleshy. Butcher’s
327
Butcher's broom
Butcher's broom
Butcher’s broom. (© PlantaPhile, Germany. Reproduced by
permission.)
broom has a few small greenish white flowers that mature
into red, cherry-sized berries. This herb has spread to
many other parts of the world including Great Britain, the
United States, and western Asia. Other names for Butch-
er’s broom include kneeholm, knee holly, sweet broom,
Jew’s myrtle, pettigree, and box holly.
General use
Butcher’s broom has been used in folk medicine as
far back as the first century a.d. In the past, it was used
as a laxative and as a treatment for gout, jaundice, kid-
ney stones, and broken bones. It was also used as a di-
uretic to reduce swelling in the hands and feet, and to re-
duce inflammation due to arthritis. At one time, the plant
was eaten as a vegetable in the United States. The seeds
have been roasted and used as a coffee substitute.
Few of these uses survive today. Modern herbalists
primarily use butcher’s broom as supportive therapy for
poor circulation, hemorrhoids, varicose vein syndrome,
and other manifestations of leaky vein walls and poor ve-
nous blood return to the heart. For these conditions, it is
taken internally. Although butcher’s broom will not cure
these conditions, it is used to relieve symptoms such as leg
cramps, pain, heaviness in the legs, swelling of the legs
and feet, and it can strengthen vein walls. Butcher’s broom
is also used externally as an ointment or suppository to
treat itching and burning associated with hemorrhoids.
Butcher's broom had been in decline as a medicinal
herb until the 1950s. Then researchers discovered that an
extract of the root contained two compounds, ruscogenin
and neuorscogenin, that could constrict the veins in dogs
and other laboratory animals. This improves blood flow
and increases the strength and tone of those veins.
Interest in butcher’s broom increased. The herb was
included in many popular formulations for treating poor
leg circulation in Europe (and less so in the United
States). A few controlled human studies were conducted.
People showed some of the same reactions to the drug as
laboratory animals, but the improvements in blood flow
were slight, and little was known about the safety of the
drug. As a result, the United States Food and Drug Ad-
ministration (FDA) felt the study data was not conclu-
sive enough to approve butcher’s broom as a drug. How-
ever, the German Federal Health Agency’s Commission
E (established in 1978 to independently review and eval-
uate scientific literature and case studies on herb and
plant medications) has approved butcher’s broom for use
in alleviating the discomforts associated with chronic ve-
nous insufficiency.
There is less scientific data about treating hemor-
rhoids with butcher’s broom. Although there are com-
pounds in butcher’s broom that constrict blood vessels
and reduce inflammation, it isn’t clear whether these
compounds are effective in ointments and suppositories
applied externally to hemorrhoids. Recent research done
in Palestine also suggests that extracts of R. aculeatus
have a mild and selective antifungal property. Although
initial studies look promising, more controlled research
needs to be done on people to conclusively define the
role of butcher’s broom in healing.
Preparations
The root of butcher’s broom is harvested in the fall
and dried before use. It is available in commercial cap-
sules, tablets, and tinctures for internal use, and in oint-
ments and suppositories for external use. Tablets often
contain about 300 mg of the dried extract. However, pa-
tients should follow package directions or directions
from their healthcare provider in using this herb.
Precautions
Not much is known about the safety of butcher’s
broom, which is one reason why the FDA did not ap-
prove its use as a drug. However, no health problems are
known to result when this herb is used as directed, and it
has been used for centuries. People with high blood pres-
sure should not take butcher’s broom. Conditions for
which butcher’s broom is used can be serious. This herb
is intended as supportive therapy for these conditions.
People with chronic venous insufficiency should be
under the care of a trained doctor.
Side effects
In rare cases, butcher’s broom may cause nausea
and stomach upset. No other side effects have been re-
ported.
328
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Diuretic — Any substance that increases the pro-
duction of urine.
Gout — A painful inflammation of the joints, usual-
ly caused by excessive uric acid in the blood.
Interactions
It is not known how butcher’s broom interacts with
any other herbs or medicines. Few, if any, scientific stud-
ies have been done on its interactions with traditional
medications.
Resources
BOOKS
Pierce, Andrea. The American Pharmaceutical Association
Practical Guide to Natural Medicines. New York: William
Morrow and Company, 1999.
PDR for Herbal Medicines. Montvale, New Jersey: Medical
Economics Company, 1998.
OTHER
"Plants for the Future: Ruscus aculeatus.” http://www.metalab.
unc.edu.
Tish Davidson
Buteyko
Definition
Buteyko, also called the Buteyko method, is an
asthma management method based on breathing exer-
cises that reduce airway constriction e. The therapy is a
learned breathing technique that is designed to slow and
lessen the intake of air into the lungs, which if practiced
over time is proposed to to reduce the symptoms and
severity of respiratory problems.
Origins
The Buteyko method is named after its developer,
Russian scientist Konstantin Buteyko. In the 1950s in
Moscow, Buteyko was involved in studies of the breath-
ing patterns in sick and healthy people, and he came to
conclusions about the breath that went against medical
opinion at the time. Buteyko noticed that the breath tend-
ed to be deeper in patients who were very ill or ap-
proaching death, and concluded that long-term over-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
breathing was a cause of imbalance in the body. He
called this habit Hidden Hyperventilation, which he ob-
served to be prevalent. Professor Buteyko claimed to
cure patients of respiratory disorders by correcting their
breathing to more shallow and slower patterns. He also
did scientific studies to study the mechanisms of over-
breathing’s negative effects n the body.
Buteyko concluded that over-breathing causes an
imbalance in the carbon dioxide levels in the body (espe-
cially lungs and bloodstream), which in turn changes
blood oxygen levels and decreases the amount of oxygen
that cells receive. Body acidity/alkalinity balance can
also be influenced by breathing pattern, and C0 2 /0 2 con-
centrations. In time, over-breathing can stress the sys-
tems of the body including the respiratory, circulatory,
and nervous systems. According to Buteyko, breathing
difficulties such as asthma are believed to be symptoms
of over-breathing, and are in fact the body’s natural reac-
tion to reduce the intake of air into the lungs. For
Buteyko, many diseases were viewed as the body’s reac-
tion to over-breathing. Buteyko also believed that over-
breathing was a bad habit that people learned, citing the
prevailing beliefs in in Russian society that deep breath-
ing was good for the body and the nerves. He also identi-
fied improper breathing habits as being caused by the ex-
cess consumption of protein, which requires increased
metabolism for digestion and thus deeper breathing.
Other causes of improper breathing habits include stress
and a sedentary lifestyle
Buteyko claimed that many symptoms are caused by
over-breathing, including bronchial spasms, excess
mucus, nervous problems, dizziness, headaches, and al-
lergies. Buteyko also theorized that over-breathing is di-
rectly linked to many diseases including asthma, hyper-
tension, heart disease, strokes, hemorrhoids, and
eczema. Buteyko’s philosophy of medicine was, “Hav-
ing not found the reason [cause] of the disease, the
physician has no right to treat the patient. Only having
discovered the reason for the disease, is it possible to
guarantee recovery.’’ For Buteyko, deepbreathing was the
cause of many diseases, and the bad habit could be easily
replaced by a healthier pattern. He developed a tech-
nique to recondition breathing patterns, and demonstrat-
ed success in healing some diseases and conditions with
the breathing technique. Buteyko’s method was met with
resistance from the mainstream Russian medical system,
and his findings were resisted and suppressed, until other
doctors observed and agreed with its beneficial effects
for asthma sufferers. In the 1990s one of Buteyko’s
pupils, Alexander Stalmatski, went to Australia to train
practitioners in the Buteyko method. He stayed in Aus-
tralia for six years and then took his teachings to Eng-
land. In the early 2000s, Australia and England had the
329
Buteyko
Buteyko
largest number of trained Buteyko practitioners, while
the method was slowly making its way into the alterna-
tive health profession in the United States.
Benefits
The Buteyko method is used primarily as a natural
technique to reduce the symptoms and severity of asthma.
It is also used by asthma sufferers to reduce dependency
on medications. The method is also used for other respi-
ratory conditions including bronchitis and emphysema.
Description
During an attack, asthma sufferers breathe about
twice as fast as people without the condition, which is
known as hyperventilation The Buteyko method aims to
correct the breathing pattern, thereby maintaining bal-
ance body C0 2 and cellular oxygenation levels. With
careful and consistent practice of the technique, asthma
sufferers can retrain their breathing patterns and often
improve their symptoms of the disease.
The Buteyko method strives to remove the bad
habits of over-breathing and to replace them with new
habits of slower, shallower breathing, called “reduced
breathing.” Emphasis is placed on posture and relax-
ation in the upper body. Proper breathing technique is
one in which the navel and lower ribcage move out slow-
ly during inspiration and move inward during a relaxed
expiration. People are taught to avoid breathing through
the mouth as much as possible, taking breaths through
the nostrils even during exercise and sleep.
During training for reduced breathing, the pulse is
monitored as a feedback signal: shallow and efficient
breathing reduces the pulse and heart rate. During train-
ing, there is also attention to what is called a controlled
pause, in which breathing stops and the duration of paus-
ing the breath is recorded and extended through practice
. In correct Buteyko breathing, the body can maintain a
controlled pause of 40 to 60 seconds. For asthma suffer-
ers, the controlled pause is typically only 5 to 15 sec-
onds; through habituation to the technique the controlled
pause can be held for much longer.
When the technique is effectively practiced and re-
duced breathing becomes habitual, fewer allergens are
inhaled and the airways become less dehydrated and irri-
tated. Mucus and histamine production decreases, in-
flammation decreases, and breathing becomes easier.
Preparation
People seeking to learn the Buteyko method are en-
couraged to find a certified practitioner or class. Books
330
KEY TERMS
Allergen — A foreign substance that causes the air-
ways to narrow and produces symptoms of asth-
ma when inhaled.
Asthma — Respiratory disease characterized by
constriction of the airways in the lungs, causing
difficulty in breathing.
Bronchodilator — A type of medication that acts to
open up bronchial tubes that have constricted in
an asthmatic attack.
and videos are available that give step-by-step instruc-
tions in the technique.
Precautions
Asthma sufferers learning the technique should con-
tinue use of their asthma medication; but may taper
down with dosages under their doctors’ supervision.
Side Effects
No unfavorable side effects with the technique have
been observed.
Research & general acceptance
The Buteyko method has not gained widespread
popularity in the United States. The technique is more
prevalent in Australia and England. Conclusive scientific
studies of the method have yet to be conducted.
In Australia two studies have pointed to the effective-
ness of the technique for asthma. In Brisbane, a group of
asthma sufferers taught the Buteyko method were able to
reduce the use of bronchodilators by 90 percent after six
weeks, compared to 5 percent of the control group, and re-
duced the use of steroids by nearly 50 percent after 12
weeks. Another study at Victoria University showed that,
12 weeks after learning the Buteyko method, asthma suf-
fers were able to reduce medication by 92 percent. Two
clinical trials in Russia pointed to the method’s success for
asthma treatment. Finally, the link between asthma and
hyperventilation, a central idea to the Buteyko method,
has been documented in medical studies since the 1940s.
Training & certification
Trained instructors may lead individual and group
training sessions. Certification classes are available in
large cities throughout the United States, although class-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
es and trained teachers are more readily available in Aus-
tralia and England.
Resources
BOOKS
Bradley, Dinah. Self-Help for Hyperventilation Syndrome. Pub-
lishers Group West, 2001.
Hale, Teresa. Breathing Free: The Revolutionary 5-Day Pro-
gram to Heal Asthma, Emphysema, Bronchitis, and other
Respiratory Ailments. Three Rivers Press, 2000.
OTHER
Buteyko Health Center, http://www.buteyko.com.
Buteyko Institute of Health and Breathing, http://www.bibh.org.
Douglas Dupler
Butternut see Black walnut
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
331
Buteyko
c
Cadmium poisoning
Definition
Cadmium is a metal with an atomic weight of
112.41. In the Periodic Table of the Elements, cadmium
is located between zinc and mercury. It is used in a large
number of industrial applications. In the United States,
over 10 million pounds of cadmium are used industrially
every year.
The uses for cadmium include:
• component of several metal alloys
• component of solder (metallic cement), particularly
solder for aluminum
• electroplating
• nickel plating
• engraving
• cadmium vapor lamps
• nickel-cadmium batteries
• treatment of parasites in pigs and poultry
Cadmium can be very toxic, and is dangerous if it is
swallowed or inhaled. While spontaneous recovery from
mild cadmium exposure is common, doses as low as 10
milligrams can cause symptoms of poisoning. There is
no accepted fatal dose amount.
Description
The symptoms of ingested cadmium poisoning are:
• increased salivation
• choking
• vomiting
• abdominal pain
• anemia
• painful spasms of the anal sphincter
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
When cadmium dust or powder is inhaled, the first
symptoms are a sweet or metallic taste, followed by
throat irritation. Other symptoms that may appear in
three to five hours include:
• dry throat
• cough
• headache
• vomiting
• chest pain
• pulmonary edema, a congestive lung condition
• bronchospasm, the abnormal tightening of airways that
may be accompanied by wheezing and coughing
• pneumonitis, inflammation of the lung
• muscle weakness
• leg pain
When a person has exposure to cadmium in low
doses over a long period of time, symptoms may include
loss of sense of smell, cough, shortness of breath, weight
loss, and tooth staining. Chronic cadmium exposure may
cause damage to the liver and kidneys.
Causes & symptoms
The most common cause of cadmium poisoning is a
lack of proper precautions in places where cadmium is
used. In such industries, air quality should be regularly
monitored. Cadmium-plated containers should never be
used to store acidic foods such as fruit juices or vinegar.
Fossil fuels, such as coal and oil, release cadmium
fumes into the air. Chronic cadmium poisoning is also
possible through soil or water contamination. This prob-
lem may occur with improper disposal of nickel-cadmium
batteries used in items such as cameras. Cadmium poison-
ing has been associated with Itai-Itai disease in Japan.
Diagnosis
Cadmium poisoning is usually diagnosed by its symp-
toms, particularly if there is reason to believe that the pa-
333
Caffeine
KEY TERMS
Chelating — A chemical term denoting a com-
pound that has a central metallic ion attached via
covalent bonds to two or more non-metallic
atoms in the same molecule.
Itai-ltai disease — The first reported cases of cad-
mium poisoning in the world, seen in Japan circa
1950. The name means "ouch-ouch" and repre-
sents the sufferers' screams of pain. The disease
caused bone and kidney defects. It was caused by
cadmium pollution from mines.
Pneumonitis — Inflammation of lung tissue.
Hemodialysis — A procedure for removing meta-
bolic waste products or toxic substances from the
bloodstream.
Osteoporosis — A disease in which the bones be-
come extremely porous, are subject to fracture,
and heal slowly.
tient has been exposed to cadmium. Because patients may
not request treatment for up to a day following cadmium
exposure, diagnosticians should carefully question any pa-
tient who shows symptoms consistent with this condition.
Treatment
Other than symptomatic treatment, there are no
good options for dealing with cadmium poisoning. He-
modialysis may be used to remove circulating cadmium
from the bloodstream, although the literature on the sub-
ject is scarce. Addition of a chelating agent, particularly
ethylenediamine tetraacetic acid (EDTA), will increase
the amount of cadmium removed by the dialysate (the
fluid used in dialysis to carry substances to or remove
from the kidney during hemodialysis).
These treatments are only effective for oral poison-
ing, and have no demonstrated benefit in cadmium fume
inhalation.
Allopathic treatment
There are no generally accepted treatments for the acute
effects of cadmium poisoning. Other than dialysis, dimer-
captosuccinic acid (DMSA) (an oral chelating agent), has
been recommended for removal of cadmium from the blood.
Expected results
The prognosis depends on the nature and severity of
the cadmium load. Most cases of mild exposure resolve
334
spontaneously after a few days. In other cases, cadmium
can lead to permanent damage with shortened lifespan,
or even death.
Cadmium may be carcinogenic.
Long-term exposure may also result in bone defects
including osteoporosis.
Prevention
All work done in areas where there may be cadmi-
um fumes should be well ventilated. Ground water and
soil should be checked for cadmium. Cadmium-coated
containers should, in general, be avoided. They should
never be used with acidic liquids such as fruit juices.
Coal and oil-burning utilities should be monitored for
cadmium discharge. Nickel-cadmium batteries should be
recycled or disposed of as toxic waste.
Resources
BOOKS
Driesbach, R. M. Handbook of Poisoning. 7th ed. Lange, 1971.
Ford, M. D. Toxicology. 1st ed. Philadelphia, PA: W. B. Saun-
ders, 2001.
Goldman, L., and J. C. Bennet. Cecil Textbook of Medicine.
21st ed. Philadelphia. PA: W. B. Saunders, 2000.
Murray J. F., and J.A. Nadel. Textbook of Respiratory Medicine.
3rd ed. Philadelphia, PA: W. B. Saunders Company, 2000.
PERIODICALS
Davis, R. D. “Cadmium - A Complex Environmental Problem.
Part II. Cadmium in Sludges Used as Fertilizer.” Experi-
entia (February 15, 1984): 1 17-26.
ORGANIZATIONS
Canadian Centre for Occupational Health and Safety. 135
Hunter Street, East Hamilton, ON Canada L8N 1M5.
Samuel Uretsky, Pharm.D.
Caffeine
Description
Caffeine is a drug that stimulates the central nervous
system (CNS). Caffeine is found naturally in coffee. Kola
seed kernels or nuts ( Cola nidtida), and a variety of teas.
Other foods and beverages, such as chocolate and soft
drinks, also contain caffeine, and the drug can be pur-
chased in over-the-counter tablet and capsule form (No
Doz, Overtime, Pep-Back, Quick-Pep, Caffedrine, and Vi-
varin). Some prescription pain relievers, medicines for mi-
graine headaches, and antihistamines also contain caffeine.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
General use
Caffeine makes people more alert, less drowsy, and
improves coordination. It is sometimes included in ath-
letes’ diets to improve physical performance. In addi-
tion, one recent study found that older people who were
given a cup of caffeinated coffee in the morning had
fewer late-day memory problems than those who were
given decaffeinated coffee. Combined with certain pain
relievers or medicines for treating migraine headache,
caffeine makes those drugs work more quickly and ef-
fectively. Caffeine alone can also help relieve headaches.
Antihistamines are sometimes combined with caffeine to
counteract the drowsiness caused by those drugs. Caf-
feine is also sometimes used to treat other conditions, in-
cluding breathing problems in newborns and in young
babies after surgery.
Preparations
Kola can be prepared in decoction or tincture form.
To prepare a decoction, mix 1-2 tsp of powdered kola
nut in a cup of water. After bringing the water to a boil,
simmer the decoction on low heat for 10-15 minutes.
Tinctures of kola nut can be purchased at many health
food stores or mail order suppliers. A tincture is an
herbal preparation made by diluting the herb in alcohol,
glycerin, or vinegar. Dosage of kola tincture varies by
formula and the symptoms or illness it is supposed to
treat, but an average recommended dosage might be 1-4
ml three times daily. Powdered kola nut and kola tinc-
tures should be stored in airtight containers away from
direct light to maintain potency.
For over-the-counter caffeine preparations, adults
and children age 12 years and older should take 100-200
mg no more than every 3-4 hours. In timed-release form,
the dose is 200-250 mg once a day. Timed-release forms
should not be taken less than 6 hours before bedtime.
Caffeine pills or tablets are typically not recommended
for children under 12 years of age.
Precautions
If caffeine is administered in a kola preparation,
kola should always be obtained from a reputable source
that observes stringent quality control procedures and in-
dustry-accepted good manufacturing practices. Con-
sumers should look for the designations “U.S.P.” (U.S.
Pharmacopeia) or “NF” (National Formulary) on kola
nut labeling. Herbal preparations prepared under USP or
NF guidelines meet nationally recognized strength, qual-
ity, purity, packaging, and labeling standards as recom-
mended by the United States Food and Drug Administra-
tion (FDA).
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Source Standard amount
in milligrams (mg)
Bottled beverages (12 oz)
Red bull
115.5
Jolt
72
Mountain Dew
55
Diet Coke
45
Dr. Pepper
41
Coca Cola Classic
34
Coffee (8 oz)
Brewed
80-135
Instant
65-100
Decaf brew
3-4
Tea (8 oz)
Iced
47
Brewed
40-60
Instant
30
Green
15
Chocolate
Hot cocoa (8 oz)
14
Chocolate milk (6 oz)
4
Chocolate bar (1 oz)
3-6
Medications (per tablet)
Vivarin
200
No-Doz
100
Midol, Maximum Strength
65
Anacin
32
Dristan
30
Avoid taking too much caffeine when it is being
taken as an over-the-counter drug. Consider how much
caffeine is being taken in from coffee, tea, chocolate,
soft drinks, and other foods that contain caffeine. Check
with a pharmacist or healthcare professional to find out
how much caffeine is safe to use.
335
Caffeine
Caffeine
Caffeine cannot replace sleep and should not be
used regularly to stay awake as the drug can lead to more
serious sleep disorders, like insomnia.
People who use large amounts of caffeine over long
periods build up a tolerance to it. When that happens,
they have to use more and more caffeine to get the same
effects. Heavy caffeine use can also lead to dependence.
If an individual stops using caffeine abruptly, withdrawal
symptoms may occur, including headache, fatigue,
drowsiness, yawning, irritability, restlessness, vomiting,
or runny nose. These symptoms can go on for as long as
a week. In addition, caffeine dependence is not confined
to the adult population. A study published in 2002 found
that American teenagers have a high rate of caffeine de-
pendence, partly because they consume large amounts of
carbonated beverages that contain caffeine.
If taken too close to bedtime, caffeine can interfere
with sleep. Even if it does not prevent a person from
falling asleep, it may disturb sleep during the night.
The notion that caffeine helps people sober up after
drinking too much alcohol is a myth. In fact, using caffeine
and alcohol together is not a good idea. The combination
can lead to an upset stomach, nausea, and vomiting.
Older people may be more sensitive to caffeine and
thus more likely to have certain side effects, such as irri-
tability, nervousness, anxiety, and sleep problems. Re-
cent findings also suggest that people with insulin-de-
pendent diabetes should monitor their caffeine intake.
One study published in 2002 found that caffeine appears
to decrease insulin sensitivity by about 15%.
Allergies
Anyone with allergies to foods, dyes, preservatives,
or to the compounds aminophylline, dyphylline, oxtri-
phylline, theobromine, or theophylline should check
with a physician before using caffeine. Anyone who has
ever had an unusual reaction to caffeine should also
check with a physician before using it again.
Pregnancy
Caffeine can pass from a pregnant woman’s body
into the developing fetus. Although there is no evidence
that caffeine causes birth defects in people, it does cause
such effects in laboratory animals given very large doses
(equal to human doses of 12-24 cups of coffee a day). In
humans, evidence exists that doses of more than 300 mg
of caffeine a day (about the amount of caffeine in 2-3
cups of coffee) may cause miscarriage or problems with
the baby’s heart rhythm. Women who take more than
300 mg of caffeine a day during pregnancy are also
more likely to have babies with low birth weights. Any
336
woman who is pregnant or planning to become pregnant
should check with her physician before using caffeine.
Breast-feeding
Caffeine passes into breast milk and can affect the
nursing baby. Nursing babies whose mothers use 600 mg
or more of caffeine a day may be irritable and have trou-
ble sleeping. Women who are breast-feeding should
check with their physicians before using caffeine.
Other medical conditions
Caffeine may cause problems for people with these
medical conditions:
• peptic ulcer
• heart arrhythmias or palpitations
• heart disease or recent heart attack (within a few
weeks)
• high blood pressure
• liver disease
• insomnia (trouble sleeping)
• anxiety or panic attacks
• agoraphobia (fear of being in open places)
• premenstrual syndrome (PMS)
Side effects
At recommended doses, caffeine can cause restless-
ness, irritability, nervousness, shakiness, headache, light-
headedness, sleeplessness, nausea, vomiting, and upset
stomach. At higher than recommended doses, caffeine
can cause excitement, agitation, anxiety, confusion, a
sensation of light flashing before the eyes, unusual sensi-
tivity to touch, unusual sensitivity of other senses, ring-
ing in the ears, frequent urination, muscle twitches or
tremors, heart arrhythmias, rapid heartbeat, flushing,
and convulsions.
Interactions
Using caffeine with certain other drugs may inter-
fere with the effects of the drugs or cause unwanted —
and possibly serious — side effects. Certain drugs inter-
fere with the breakdown of caffeine in the body. These
include oral contraceptives that contain estrogen, the an-
tiarrhythmia drug mexiletine (Mexitil), the ulcer drug
cimetidine (Tagamet), and the drug disulfiram
(Antabuse), used to treat alcoholism.
Caffeine interferes with drugs that regulate heart
rhythm, such as quinidine and propranolol (Inderal). Caf-
feine may also interfere with the body’s absorption of iron.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Anyone who takes iron supplements should take them at
least an hour before or two hours after using caffeine.
Serious side effects are possible when caffeine is
combined with certain drugs. For example, taking caf-
feine with the decongestant phenylpropanolamine can
raise blood pressure. Very serious heart problems may
occur if caffeine and monoamine oxidase inhibitors
(MAO) are taken together. These drugs are used to treat
Parkinson’s disease, depression, and other psychiatric
conditions. Consult with a pharmacist or physician about
which drugs can interact with caffeine.
Because caffeine stimulates the nervous system,
anyone taking other central nervous system stimulants
should be careful about using caffeine.
Resources
BOOKS
Hoffman, David. The Complete Illustrated Herbal. New York:
Barnes & Noble Books, 1999.
Medical Economics Corporation. The P DR for Herbal Medicines.
Montvale, NJ: Medical Economics Corporation, 1998.
PERIODICALS
Bernstein, G. A., M. E. Carroll, P. D. Thuras, et al. “Caffeine
Dependence in Teenagers.” Drug and Alcohol Depen-
dence 66 (March 2002): 1-6.
Keijzers, G. B., B. E. De Galan, et al. “Caffeine Can Decrease
Insulin Sensitivity in Humans.” Diabetes Care 25 (Febru-
ary 2002): 399-400.
Maughan, R."The Athlete's Diet: Nutritional Goals and Dietary
Strategies.” Proceedings of the Nutrition Society 61 (Feb-
ruary 2002): 87-96.
Ryan L., C. Hatfield, and M. Hostetter. “Caffeine Reduces
Time-of-Day Effects on Memory Performance in Older
Adults.” Psychological Science 13 (January 2002): 68-71.
ORGANIZATIONS
Office of Dietary Supplements. National Institutes of Health.
Building 31. Room 1B25, 31 Center Drive, MSC 2086,
Bethesda, MD 20892-2086. (301) 435-2920. Fax: (301)
480-1845. http://odp.od.nih.gov/ods/ (Includes on-line ac-
cess to International Bibliographic Information on Dietary
Supplements (IBIDS), a database of published, international
scientific literature on dietary supplements and botanicals).
Paula Ford-Martin
Rebecca J. Frey, PhD
Calcarea carbonica
Description
Calcarea carbonica, abbreviated as Calcarea carb.,
is a homeopathic remedy made from the middle layer of
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Arrhythmia — Abnormal heart rhythm.
Central nervous system (CNS) — The brain, spinal
cord, and nerves throughout the body.
Decoction — An herbal extract produced by mix-
ing an herb in cold water, bringing the mixture to
a boil, and letting it simmer to evaporate the ex-
cess water. The decoction is then strained and
drank hot or cold. Decoctions are usually chosen
over infusion when the botanical or herb in ques-
tion is a root, seed, or berry.
Palpitation — Rapid, forceful, throbbing, or flutter-
ing heartbeat.
Tinctures — A liquid extract of an herb prepared by
steeping the herb in an alcohol and water mixture.
Tinctures can also be prepared using vinegar or
glycerin, instead of alcohol.
Withdrawal symptoms — A group of physical or
mental symptoms that may occur when a person
suddenly stops using a drug to which he or she
has become dependent.
shells. In chemical terms, Calcarea carbonica is impure
calcium carbonate, CaC0 3 . Unlike most homeopathic
remedies, which are made from substances soluble in
water or alcohol, Calcarea carbonica must be prepared
by a process called trituration. Triturated material is
ground or pounded until it is reduced to a fine powder.
According to one homeopath, the discovery of trituration
is a tribute to the genius of Samuel Hahnemann, the
founder of homeopathy. “His method of preparing in-
soluble substances brought to light in this instance a
whole world of therapeutic power formerly unknown.”
General use
Calcarea carbonica is a remedy that is given more
frequently in so-called constitutional prescribing than to
treat acute conditions. In constitutional prescribing, the
homeopathic practitioner selects a remedy to treat the
patient’s complete symptomatology, based on a careful
evaluation of his or her overall health. In homeopathy,
constitution includes a person’s heredity and life history
as well as present lifestyle, environment, and medical
history in the narrow sense. Constitutional treatment is
based on the assumption that chronic or recurrent illness-
es reflect a specific weakness or vulnerability in the pa-
tient’s total constitution. It is intended to stimulate heal-
ing at the deepest levels of the person’s emotions and
psyche as well as physical characteristics.
337
Calcarea carbonica
Calcarea carbonica
Calcarea carbonica is one of the three most impor-
tant remedies, along with Lycopodium and Sulphur in the
traditional homeopath’s medicine chest because all three
are antipsoric remedies. The term antipsoric is derived
from Hahnemann’s theory of miasms. In homeopathy, a
miasm is an inherited fundamental weakness or predis-
position to chronic diseases. Hahnemann thought that the
most ancient and universal miasm, the one that underlay
the majority of the chronic illnesses that afflict humans,
is the psoric miasm, or Psora. To define a remedy as an-
tipsoric is to say that it is capable of healing a basic
source of constitutional vulnerability to disease. Because
Calcarea carbonica is an antipsoric remedy, it is also a
polychrest remedy. Polychrest is the term used in home-
opathy for a remedy that has many uses. Calcarea car-
bonica is used to treat a variety of diseases and disorders
such as acne, arthritis, vaginal discharges in women,
night terrors in children, and ringworm on the scalp.
Calcarea carbonica is in general considered a
“chilly” remedy, appropriate for people who suffer keen-
ly from the cold and have difficulty keeping warm. A
homeopathic practitioner who is asking a patient about
symptoms will inquire about the circumstances (e.g.,
light or dark, heat or cold, rest or activity, etc.) that make
the patient feel better or worse. These factors are called
modalities in homeopathy. In terms of modalities, pa-
tients who need Calcarea carbonica feel worse when
they are cold. They may complain of a cold sensation in
the abdomen and cold, clammy feet at night. Dampness,
activity, and fright also make them feel worse. They feel
better when they are warm and lying down.
Other aspects of Calcarea carbonica patients that
are noted in the homeopathic literature are their tendency
to tire easily, to move slowly and sluggishly, to sweat
readily, and to have poor muscle tone and swollen lymph
nodes. As a rule, they are passive, overweight people
with fair or chalky complexions, large heads, and large
puffy abdomens. They appear to be bloated rather than
solidly muscular. Their perspiration and other body dis-
charges often have a sour smell. Women may have ex-
cessively heavy menstrual periods (menorrhagia) and
sore breasts before the flow begins. Calcarea carbonica
patients often crave cold or iced drinks even when they
do not have much appetite. On the other hand, they may
have cravings for indigestible nonfood items, such as
coal or chalk. They may dislike milk or meat, and com-
plain of headaches and nausea after meals.
The intellectual constitution of Calcarea carbonica
patients is marked by the same slowness and lack of en-
ergy that characterizes their physical movements. They
may complain of heaviness or sensations of pressure in
the head when they are asked to do anything requiring
intellectual effort. Children with a Calcarea carbonica
338
constitution are slow to teethe and to walk, but they are
also likely to be stubborn and strong-willed. Emotional-
ly, Calcarea carbonica patients tend to be afraid of the
dark, of isolation, of getting sick, and of going insane.
Preparations
Calcarea carbonica is available in tablet form as a
single remedy, and in a number of combination reme-
dies. Since it is a polychrest remedy, it is manufactured
by all major suppliers of homeopathic medicines, and
can be easily purchased from homeopathic pharmacies
or over the Internet.
Precautions
In homeopathy, most precautions about the remedies
concern proper storage and administration rather than
excluding certain types of patients. Homeopathic practi-
tioners believe that remedies lose their power from expo-
sure to heat, light, or other substances. Guidelines for
proper storage of homeopathic remedies include keeping
them away from strong sunlight and high temperatures,
keeping them in their original containers, and not storing
them near perfumes, bleach, or other strong-smelling
substances. In addition, patients under care of a home-
opath are instructed to avoid coffee or products contain-
ing camphor (lip balms, chest rubs, etc.) during a period
of homeopathic treatment and for two days after the last
dose. Homeopaths believe that these substances counter-
act or “antidote” the effects of homeopathic remedies.
Precautions regarding homeopathic remedies also in-
clude avoiding contamination of the medicine. The patient
should not touch the medicine; it should be dispensed into
a cup and tipped directly into the mouth. Homeopathic
remedies are not taken with water but allowed to dissolve
in the mouth. Patients are asked not to eat or drink for
about 20 minutes before and after each dose.
Side effects
Calcarea carbonica , like other homeopathic reme-
dies, has so little of the original substance in the tablets
that it is highly unlikely to produce side effects in the
usual sense. In addition, because Calcarea carbonica is
given more often for constitutional treatment than for
acute illnesses, it is not as likely to produce the tempo-
rary worsening of the patient’s symptoms known as ag-
gravation.
Interactions
Homeopathic remedies are so dilute that they are
highly unlikely to interact with allopathic medications.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Aggravation — In homeopathy, a temporary wors-
ening or intensification of the patient's symptoms
prior to improvement and healing.
Antipsoric — A homeopathic remedy that is an ef-
fective constitutional treatment for the psoric
miasm. Calcarea carbonica is one of three major
antipsoric remedies.
Constitutional prescribing — Homeopathic treat-
ment based on a total assessment of the person's
life history, heredity, lifestyle, and present environ-
ment, as distinct from prescribing based on imme-
diate acute symptoms.
Materia medica — A Latin phrase that means "the
materials of medicine." In homeopathy, a materia
medica is a book that lists the various homeopath-
ic remedies together with the symptoms that they
treat.
Miasm — In homeopathy, a hereditary weakness of
the constitution and a corresponding predisposi-
tion to chronic disease.
Modality — A factor or circumstance that makes a
patient's symptoms better or worse. Modalities in-
clude such factors as time of day, room temperature,
the patient's level of activity, sleep patterns, etc.
Polychrest — A homeopathic remedy that can be
given for a wide variety of diseases and conditions.
Psora — According to Hahnemann, the oldest and
most universal miasm, responsible for human vul-
nerability to the majority of non-venereal chronic
diseases.
Trituration — A method of preparing a homeopath-
ic remedy from an insoluble substance by grind-
ing or pounding it into a fine powder. Calcarea
carbonica is prepared from shells by trituration.
On the other hand, the homeopathic materia medica in-
dicate that the remedies can be complementary or in-
compatible with one another. According to Hahnemann,
Calcarea carbonica should not be given before Sulphur.
Calcarea carbonica is complementary with belladonna
but incompatible with bryonia.
Resources
BOOKS
Cummings, Stephen. MD, and Dana Ullman, MPH. Every-
body’s Guide to Homeopathic Medicines. New York: G. P.
Putnam's Sons, 1991.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
MacEoin, Beth. Homeopathy. New York: HarperCollins Pub-
lishers, 1994.
Stein, Diane. “Homeopathy.” AH Women Are Heaters: A Com-
prehensive Guide to Natural Healing. Freedom, CA: The
Crossing Press, 1996.
Vithoulkas, George. Homeopathy: Medicine of the New Man.
New York: Fireside Books, 1992.
ORGANIZATIONS
Boiron Research Foundation. 1208 Amosland Road, Norwood,
PA 19074.
Homeopathic Educational Services. 2124 Kittredge Street,
Berkeley, CA 94704. (510) 649-0294 or (800) 359-9051.
International Foundation for the Promotion of Homeopathy.
2366 Eastlake Avenue, East. Suite 301, Seattle, WA
98102. (206) 324-8230.
National Center for Homeopathy (NCH). 801 North Fairfax
Street, Suite 306, Alexandria, VA 22314. (703) 548-7790.
Fax: (703) 548-7792.
Rebecca J. Frey, PhD
Calcium
Description
As the most plentiful mineral in the body, calcium
plays a key role in the development and maintenance of
bones and teeth. Calcium enables the contraction of
muscles, including the function of the body’s most im-
portant muscle, the heart. It is also essential for normal
blood clotting, proper nerve impulse transmission, and
the appropriate support of connective tissue.
Almost every segment of the population — women,
children, teenagers, men, unborn babies, and the elder-
ly — benefit from calcium in their daily diet. The mineral
is an important dietary supplement for those who are un-
dergoing significant periods of bone growth, such as in
childhood, during pregnancy, and while breast-feeding.
Calcium is an effective weapon for the aging popu-
lation as they combat osteoporosis. A condition that
simply means “porous bones,” osteoporosis attacks
bones when they are their most vulnerable. As the body
ages, bones lose more calcium, and it becomes vital to
supplement the diet with calcium in order to encourage
bone growth and prevent or slow down the process of os-
teoporosis.
General use
While the body relies on the presence of calcium for
many of its everyday functions, the number of reasons
339
Calcium
Calcium
why the mineral should be supplemented in the diet are
numerous. Calcium is beneficial to everyone, but re-
search has shown that women may benefit more than
others. A study in the October 1999 issue of the journal
Obstetrics & Gynecology found that pregnant women
who do not get enough calcium in their diet can increase
the bone mineral content of their fetus by about 15% by
taking 1,300 mg of a calcium supplement per day during
their second and third trimesters. For those women who
already consume enough calcium, the additional supple-
ments do not have this effect. Additional research shows
that calcium deficiencies lead to preeclampsia during
pregnancy, causing high blood pressure, swelling, and
weight gain greater than 1 lb (0.5 kg) per day. The risk of
preeclampsia developing lowers by 45-75% for women
who receive calcium supplementation.
Premenstrual syndrome (PMS) is another condition
women face that may be alleviated by the use of calcium
supplements. Researchers at the National Institute of Men-
tal Health (NIMH) concluded that those women who took
1,200 mg of calcium per day reduced their overall PMS
symptoms by more than 50%. In the study, calcium supple-
mentation led to the reduction of psychological PMS
symptoms (such as mood swings) by 45%, food cravings
by 54%, and bloating and water retention by 36%.
A 1999 study reported that researchers have found
that increasing the amount of daily calcium consumed by
women may reduce their risk of stroke. Those women in
the Nurses’ Health Study who took more than 400 mg of
calcium daily were at the lowest risk for a stroke, while
those who consumed more than 600 mg each day did not
have an increased benefit. Researchers believe that the
risk of stroke is reduced by calcium from decreased cho-
lesterol levels, or by stopping the formation of blood
clots that cause strokes.
For elderly postmenopausal women, the prevention
of osteoporosis becomes critical. In order to maintain
bone mass during this time, a study conducted in 1999
concluded that a low-dose hormone replacement therapy
(HRT) combined with calcium and vitamin D supple-
mentation is an effective therapeutic option for preven-
tion of osteoporosis. Estriol, which is used in HRT, ap-
pears to be helpful in controlling menopausal symptoms.
Results from research regarding this use of estriol on
bone density have been contradictory, according to the
Alternative Medicine Review, with the results showing
the most effectiveness coming from lapanese studies.
Calcium alone is frequently prescribed with estro-
gen at the beginning of menopause to treat or prevent
osteoporosis. This therapy is recommended to guard
against the increased loss of calcium in the bones due to
increasing age. As bones lose more calcium they become
340
dense and brittle, and more vulnerable to the attack of
osteoporosis. This condition is most common in people
over 70, and in women after menopause, where it may
increase the risk of broken hips, ribs, and pelvis, and the
weakening of other bones, increased physical exercise is
also important for bone strengthening.
On the other hand, although calcium supplementation
is useful in lowering the risk of osteoporosis in Western
women, more research is needed to determine why the
rates of osteoporosis are low in some Eastern societies
with low-calcium diets. There is evidence that osteoporo-
sis, like coronary artery disease, is primarily a problem in
Western societies. In addition, accumulating evidence that
a diet high in fruits and vegetables helps to prevent frac-
tures suggests that the level of calcium in the diet is not
the only nutritional factor involved in osteoporosis.
Calcium has been shown to be beneficial to the
colon. Among those people taking calcium supplements,
research points to a modest reduction in the recurrence of
polyps in their colons. Colon polyps are benign tumors
that often turn cancerous. Researchers think that calcium
binds to carcinogens, preventing abnormal cell growth.
Stemming from its active role in building bone den-
sity throughout the body, calcium may prove particularly
beneficial for strengthening of the jawbone. Dental re-
searchers at the State University of New York at Buffalo
report that calcium supplementation may prevent peri-
odontal disease as it builds a strong jawbone. Periodon-
tal, or gum, disease is an infection caused by bacteria
that deposits in pockets between the teeth and gums, and
is the leading cause of tooth loss in the United States. As
the infection progresses, the jawbone that holds a tooth
in place is eventually destroyed, causing the tooth to
loosen and fall out. The researchers contend that calci-
um’s overall bone-building role would equal a stronger
jawbone that would better fight off gum disease.
While supplements of calcium can be found in many
forms, research has shown a promising benefit if it is ob-
tained from dairy foods, rather than supplements or leafy
greens — calcium in the form of dairy may actually pre-
vent weight gain. Those in the study who consumed at
least 1,000 mg of calcium a day (equaling about 3 cups,
or 750 ml of skim milk), gained 6-7 lb (2. 7-3. 2 kg) less
over two years than those with low-calcium diets. Re-
searchers of Purdue University speculate that calcium
probably prevents weight gain by increasing the break-
down of body fat and decreasing its formation. It is im-
portant to note, however, that dairy products should be
consumed in moderation, as other research conducted
has indicated that dairy products are not necessarily a
good source of absorbable calcium. In addition, other
studies indicate that women are often reluctant to in-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
crease their intake of dairy products because they dislike
milk, suffer from lactose intolerance, or fear that they
will gain too much weight.
Calcium is proving essential to those children around
the world who are stricken by rickets. Rickets is a defi-
ciency condition in children that affects developing carti-
lage and newly formed bone throughout the body, causing
severe deformities. Often thought to be a result of the in-
adequate intake of vitamin D from dietary sources or lack
of exposure to sunlight, research reported in 2000 has
found that children with rickets respond well to calcium
supplementation. While rickets is still rare in most devel-
oped countries, it is becoming more common in the Unit-
ed States due to lower milk consumption by children; and
it remains a problem in many other parts of the world. Re-
searchers conclude that effective treatment for the condi-
tion is calcium supplementation alone, or in combination
with vitamin D. Osteomalacia, or the adult form of rickets,
also responds to calcium supplementation.
Evidence is accumulating in the United States that
women are not the only group at risk for insufficient di-
etary levels of calcium. Children and adolescents are
also at risk, according to a 2001 report from the National
Institutes of Health. Researchers found that “only 13.5%
of girls and 36.3% of boys ages 12 to 19 in the United
States get the recommended daily amount (RDA) of cal-
cium, placing them at serious risk for osteoporosis and
other bone diseases” in their adult years. The report list-
ed increased consumption of soft drinks and decreased
consumption of milk as contributing to the problem.
Preparations
Calcium may be supplemented in the diet in a vari-
ety of ways. Numerous foods are rich in calcium, includ-
ing dairy products (such as milk, yogurt, and cheese) and
leafy green vegetables like turnip greens, broccoli, kale,
and collards. Canned salmon, sardines, shrimp, and tofu
are also high in calcium. More foods are being fortified
with calcium, making it easier to ensure the proper
amount of the mineral is consumed. Calcium-fortified
foods range from cranberry juice cocktail, cereal and
waffles, to orange juice and flour. With almost every seg-
ment of the population consuming too little calcium, re-
searchers recommend calcium-fortified foods to increase
daily calcium intake.
While the types of food calcium may be obtained
from continues to increase, most people still lack enough
of the essential mineral. For those who are not getting
enough calcium from foods, supplements are an accept-
able alternative. The chemical form of calcium supple-
ments come in five varieties: carbonate, citrate, lactate,
phosphate, chelate, and citrate malate. The supplements
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
are available as tablets, syrup, or suspension form. Calci-
um supplements should be stored at room temperature
and away from moisture and sunlight. It should not be
stored in the bathroom, and the liquid forms should not
be frozen.
Experts state that calcium is best absorbed from the
citrate malate form, or the type of calcium found in some
juices, but they recommend calcium carbonate for the
overall amount of calcium it offers and its affordability.
Calcium carbonate can be found in antacids, and it is ab-
sorbed better when taken with meals. Food slows down
the time it takes substances to travel through the gut, giv-
ing the calcium more time to be absorbed. Absorption is
key for the proper functioning of calcium. Sufficient lev-
els of vitamin D and hydrochloric acid in the stomach,
and the presence of other minerals, such as magnesium
and phosphorous are essential for quick absorption.
The body may also be better able to absorb calcium
when taken along with ingredients extracted from chico-
ry root. Research indicates that Raftilin inulin and
Raftilose oligofructose, both extracts from chicory root,
are dietary fibers that are not digested in the stomach or
the small intestine. Instead, they are fermented by Bifi-
dobacteria in the colon — beneficially leading to in-
creased calcium absorption throughout the body, with
emphasis on bone tissue. Additionally, Oligofructose im-
proves the texture and mouthfeel while improving taste
and fruit flavors in low-fat yogurts. Inulin is used for fat
replacement and fiber enrichment of reduced-fat and fat-
free sour cream and whipped topping.
There are many ways to ensure calcium is part of a
daily diet, but it is important that the recommended daily
allowance (RDA), or appropriate dosage of the mineral
be followed. The RDA of calcium for adults is 800 mg;
pregnant women and young adults should be certain
their intake equals 1,200 mg per day. Adults over 50
should increase their intake to 1,000 mg per day with
supplements that include vitamin D.
Calcium supplements may be taken with a large
glass of water during or after a meal. Tablets in chewable
form must be chewed thoroughly before swallowing, and
effervescent tablets should be diluted in cold water or
juice before taking. It is recommended that other med-
ications be taken two hours after any calcium supple-
ment. The simultaneous intake of calcium may interfere
with the absorption of other drugs. Do not take more
than 500 mg of calcium at one time for the best absorp-
tion of the mineral.
Precautions
When adding calcium supplements to the diet, it is
recommended that it not be taken within one to two hours
341
Calcium
Calcium
of eating bran, or whole grain cereals or breads. Large
amounts of alcohol or caffeine containing beverages or
tobacco should be avoided. Large amounts of calcium,
phosphates, magnesium, or vitamin D in medication or
dietary supplements should not be taken unless directed
by a physician. Those with diarrhea, stomach trouble,
parathyroid disease, sarcoidosis, or kidney stones should
consult with their physician before taking calcium.
Side effects
Calcium is typically well tolerated by those who add
it to their diets, but if the mineral is taken in high levels it
can cause several side effects, including: nausea, vomit-
ing, loss of appetite, constipation, stomach pain, thirst,
dry mouth, increased urination, and weakness. While
these side effects are rare, it is even more unlikely to ex-
perience the life-threatening symptoms of an irregular or
very slow heart beat. If these dangerous symptoms appear
while taking calcium, use of the mineral should be dis-
continued and emergency treatment should be sought. An
overdose of a calcium supplement may lead to confusion,
irregular heartbeat, depression, bone pain, or coma.
Interactions
It is important that all over-the-counter (OTC) or
prescription medications are reviewed with a physician
before beginning calcium supplement.
According to the Complete Guide to Prescription &
Nonprescription Drugs, the following are some of the
drugs that may cause possible interactions if taken with
calcium:
• alendronate
• anticoagulants
• calcitonin
• calcium-containing medicines
• chlorpromazine
• oral contraceptives
• corticosteroids
• digitalis preparations
• diuretics, thiazide
• estrogens
• etidronate
• iron supplements
• meperidine
• mexiletine
• nalidixic acid
342
KEY TERMS
Carcinogen — Any substance or agent that pro-
duces or instigates cancer.
Preeclampsia — A toxemia of pregnancy that caus-
es increasing hypertension, headaches, and
swelling of the lower extremities.
Sarcoidosis — A disease of unknown etiology
which causes widespread lesions that may affect
any organ or tissue of the body.
Stroke — A hemorrhage into the brain, formation
of a clot in an artery, or rupture of an artery that
causes sudden loss of consciousness, followed by
paralysis.
• nicardipine
• nimodipine
• oxyphenbutazone
• para-aminosalicyclic acid (PAS)
• penicillins
• pentobarbital
• phenylbutazone
• phenytoin
• pseudoephedrine
• quinidine
• salicylates
Resources
BOOKS
The Editors of Time-Life Books. “Essential Vitamins and Min-
erals.” In The Medical Advisor: The Complete Guide to
Alternative & Conventional Treatments. Richmond, VA:
Time-Life Inc., 1996.
Griffith, H. Winter. “Calcium Supplements.” In Complete
Guide to Prescription & Nonprescription Drugs, 1999
Edition. New York: The Berkley Publishing Group, 1998.
PERIODICALS
“Calcium May Help Prevent Colon Polyps.” Environmental
Nutrition 22, no. 2 (February 1999): 1.
“Calcium May Help Prevent Gum Trouble.” Tufts University
Health & Nutrition Letter 17, no. 5 (July 1999): 6.
“Calcium May Reduce Stroke Risk in Women.” Stroke (Sep-
tember 1999).
“The Four Supplements You Can’t Live Without.” Prevention
51, no. 12 (December 1999): 1.
Gulliver, Pauline, and Caroline C. Horwath. "Assessing
Women’s Perceived Benefits, Barriers, and Stage of
Change for Meeting Milk Product Consumption Recom-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
mendations.” Journal of the American Dietetic Associa-
tion 101 (November 2001): 1354-1357.
Head, Kathleen A., n.d. “Estriol: Safety and Efficacy.” Alterna-
tive Medicine Review 3, no. 2 (April 1998). <http://www.
thorne.com>.
Hegsted. D. Mark. “Fractures, Calcium, and the Modern Diet.”
American Journal of Clinical Nutrition 74 (November
20011:571.
Liebman, Bonnie. “Calcium Supplements: The Way to Go.”
Nutrition Action Healthletter 25, no. 3(April 1998): 5.
Marion, Matt. “Health Bulletin.” Men’s Health 14, no. 10 (De-
cember 1999): 32.
“Using Calcium to Combat PMS Symptoms.” Medical Update
22, no. 5 (November 1998): 6.
Wallace, Phil. "NIH Says Calcium ‘Crisis’ is Affecting Young
People.” Food Chemical News 43 (December 17, 2001):
27.
ORGANIZATIONS
Food and Drug Administration, Office of Consumer Affairs,
HFE-88, Rockville, MD 20857.
Beth Kapes
Rebecca J. Frey, PhD
Calendula
Description
Calendula ( Calendula officinalis ) is also known as
garden marigold, holligold, goldbloom, golds, ruddes,
Mary bud, bull’s eyes, and pot marigold. It is a member
of the Asteraceae family. Other members of this plant
family include daisies, arnica, chamomile, and yarrow.
This bright, flowering herb opens its gold blossoms in
the morning and closes them at dusk, or when rain
threatens. Calendula is native to Asia and southern and
central Europe. Early settlers brought the herb to North
America where it has become a garden favorite. It is cul-
tivated throughout the world and valued for its culinary
and medicinal uses. The first name, Calendula , is from
the Latin kalendae, the word Romans used to indicate
that it bloomed throughout the year in their area. The
second name officinalis indicates that calendula was in-
cluded in official lists of medicinal herbs. The common
name marigold refers to the blossoms’ association with
the Virgin Mary.
Calendula is a familiar garden plant with yellow or
orange-gold blooms that have a strong and distinctive
scent. The plant likes sun and will re-seed from year to
year, even in poor soil. The erect, square and branching
stems emerge from a taproot to grow up to 2 ft (0.6 m)
high. The lower leaves are broad and spatula shaped.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Upper leaves may be oblong, are smooth at the edges,
and are arranged alternately along the stem. Blossoms
may be single or double, are 1-4 in (2.54-10.2 cm)
across, and are made of many small florets. The bushy
herb blooms continuously throughout the summer. Seeds
are crescent to horseshoe shaped with a rough exterior.
General use
Calendula has been used for centuries as a culinary,
medicinal, and magical herb. It was believed that calendu-
la could bring protection against dangerous influences.
The seventeenth century astrologer and doctor, Nicholas
Culpeper, taught that the marigolds were under the influ-
ence of the constellation Leo. The flowers, he said were “a
comforter of the heart and spirits.” The bright yellow blos-
som of this herb was used to make a dye to color cheese
and butter. In the kitchen, leaves and florets were added to
sauces, soups, porridge, and puddings for color and medi-
cinal benefit. The dried, powdered blossoms have also
been used as a substitute for saffron in cooking. During
the Civil War, calendula was used to stop the blood flow
from battle wounds. Calendula blossom preparations con-
tinue to be valued as an antiseptic for external application
to scrapes, burns, cuts, or wounds. Local application, in
the form of a plant poultice or an infusion soaked in a
cloth and applied to a wound, is an effective healing reme-
dy. The Romans valued the herb for its ability to break
fevers. During the Middle Ages, calendula used for pro-
tection against the plague. In early American Shaker med-
icine, calendula was a treatment for gangrene.
In addition to its first aid uses, calendula also acts as a
digestive remedy. An infusion or tincture of the flowers,
taken internally, is beneficial in the treatment of ulcers,
stomach cramps, colitis, herpes viruses, yeast infections,
and diarrhea. An infusion may also be used as an external
wash helpful in treating bee stings, eye inflammations,
boils and abscesses, varicose veins, eczema, acne, and as
a gargle for mouth sores or a rinse to relieve toothache.
The flowers have antispasmodic, antimicrobial, and antivi-
ral properties. They improve the circulation of the blood
and the lymphatic fluids and aid in elimination of toxins
from the body. The juice from the fresh flowers or stem is
said to help remove warts and help heal mucous mem-
branes and skin. An infusion or tincture of the herb is also
helpful in cases of painful or delayed menstruation, and
the herb is a beneficial ally in the transition to menopause.
The tincture also has many other uses, such as a topical
wash for diaper rash in infants, a mouth gargle for sores, a
vaginal douche for yeast, an internal soother for inflamed
lungs, a topical for hemorrhoids, etc.
Despite a large number of studies on the chemical
constituents of calendula flowers, the agents responsible
343
Calendula
Calendula
Calendula (marigold) flowers. (Photograph by Robert J. Huffman/Field Mark Publications. Reproduced by permission.)
for the herb’s healing properties haven’t been clearly de-
termined. Constituents include saponins, carotenoids,
resin, bitter principle, essential oil, sterols, flavonoids,
and mucilage.
Preparations
Calendula blossoms are harvested when fully open
throughout the flowering season. The flower heads are
picked on a sunny day after the morning dew has evapo-
rated. The blossoms are then spread on a paper-lined tray
to dry in a bright and airy room away from direct sun.
The temperature in the drying room should be at least
70°F (21°C). When the blossoms are completely dry, the
florets are removed, and the center part of the blossom is
thrown away. The dried florets are then be stored in a
dark glass container with an airtight lid. The dried herb
will maintain medicinal potency for 12 to 18 months. The
container should be clearly labeled with the name of the
herb, the date, and place harvested. The fresh juice of
calendula flowers is preserved with 20% alcohol; the tra-
ditional tincture contains 50% alcohol.
Infusions are made by placing 2 oz (56.7 g) of fresh
or half as much dried calendula blossom florets in a
344
warm glass container. Then 2.5 cups (0.56 kg) of fresh,
nonchlorinated water that has been boiled is added to the
herbs. The mixture is then covered and steeped for ten to
fifteen minutes. Next, the mixture is strained and the tea
is drunk warm. The prepared tea will store for about two
days in the refrigerator. Calendula blossom tea may be
drunk by the cupful up to three times a day, as needed, or
applied as an external skin wash.
An ointment is made by mixing dried and powdered
calendula florets with olive oil. The combination is then
mixed with melted beeswax. Then it is poured into dark
glass jars while still warm. The mixture is sealed tightly
with a lid when cool.
Precautions
Calendula shouldn’t be used during pregnancy. It also
should not be confused with the French marigold Tagetes
patula, sometimes grown in gardens as an insect repellant.
Side effects
Calendula is a relatively mild, nontoxic herbal medi-
cine with no known side effects reported.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Interactions
None reported.
Resources
BOOKS
Ody, Penelope. The Complete Medicinal Herbal. New York:
Dorling Kindersley, 1993.
PDRfor Herbal Medicines. New Jersey: Medical Economics
Company, 1998.
Phillips, Roger, and Nicky Foy. The Random House Book of
Herbs. New York: Random House, 1990.
Tyler, Varro E., Ph.D. Herbs Of Choice, The Therapeutic Use
of Phytomedicinals. New York: The Haworth Press, Inc.,
1994.
Tyler, Varro E., Ph.D. The Honest Herbal. New York: Pharma-
ceutical Products Press, 1993.
Weiss, Gaea, and Shandor Weiss. Growing & Using the Heal-
ing Herbs. New York: Wings Books, 1992.
Clare Hanrahan
Calluses see Corns and calluses
Camellia sinensis see Green tea
Canadensis see Elder
Cancer
Definition
Cancer is not just one disease, but a large group of
almost 100 diseases. It is a genetic disease, with two
main characteristics of uncontrolled growth of the cells
in the human body and the ability of those cells to mi-
grate from the original site and spread to distant sites.
Description
One out of every four deaths in the United States is
from cancer. It is second only to heart disease as a cause
of death in the United States. About 1.2 million Ameri-
cans are expected to be diagnosed with cancer each year,
of which more than 500,000 are diagnosed as terminally
ill. Cancer can attack anyone. Since the occurrence of
cancer increases as people age, most cases are seen in
adults, middle-aged or older. The most common cancers
are skin cancer, lung cancer, colon cancer, breast can-
cer (in women), and prostate cancer (in men). In addi-
tion, cancer of the kidneys, ovaries, uterus, pancreas,
bladder, rectum, blood (leukemia), and lymph nodes
(lymphoma) are also included among the 12 major can-
cers that affect most Americans.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Cancer, by definition, is a disease of the genes. A
gene is a small part of DNA, which is the master mole-
cule of the cell. Genes make proteins, which are the ulti-
mate workhorses of the cells. It is these proteins, along
with other substances, that allow our bodies to carry out
the many processes that permit people to breathe, think,
move, etc. Many genes produce proteins that are in-
volved in controlling the processes of cell growth and di-
vision. An alteration, or mutation, to the DNA molecule
can disrupt the genes and produce faulty proteins. This
causes the cell to become abnormal and lose its restraints
on growth. The abnormal cell begins to divide uncontrol-
lably and eventually forms a new growth known as a
tumor or neoplasm (medical term for cancer meaning
“new growth”). In a healthy individual, the immune sys-
tem can recognize the neoplastic cells and destroy them
before they get a chance to divide. However, some mu-
tant cells may escape immune detection and survive to
become tumors or cancers.
Tumors are of two types, benign or malignant. A be-
nign tumor is slow growing, does not spread or invade
surrounding tissue, and once removed, it does not usual-
ly recur. A malignant tumor, on the other hand, invades
surrounding tissue and has the capacity to spread to other
parts of the body. If the cancer cells have spread to the
surrounding tissues, then, even after the primary malig-
nant tumor is removed, it generally recurs either locally
or to a distant site. A majority of cancers are caused by
changes in the cell’s DNA because of damage due to the
cell’s environment. Environmental factors that are re-
sponsible for causing the initial mutation in the DNA are
called carcinogens , and there are many types. Some can-
cers also have a genetic basis. In other words, an individ-
ual could inherit faulty DNA from a patient’s parents,
which could predispose the patient to getting cancer.
There is also the two “hit” theory, where there is a com-
bination of a genetic mutation and a stimulation of cell
division and/or replication, due to environmental circum-
stances. While this scientific evidence points to both fac-
tors (environmental and genetic) playing a role, less than
10% of all cancers are purely hereditary. Cancers that are
known to have a hereditary link are breast cancer, colon
cancer, ovarian cancer, and uterine cancer. In late
2001, scientists took one step closer to identifying genet-
ic markers that indicate cancer susceptibility. Called
“low penetrance genes,” these markers are believed to
combine to increase risk for cancer.
There are several different types of cancers. Carci-
nomas are cancers that arise in the epithelium (the layer
of cells covering the body’s surface and lining the inter-
nal organs and various glands). Ninety percent of human
cancers fall into this category. Melanomas are cancers
that originate in the skin, usually in the pigment cells
345
Cancer
Cancer
Illustration of invading cancer of the pancreas. The malig-
nant tumor is located at the bottom center of illustration.
(Illustration by John Bavosi, Custom Medical Stock Photo. Re-
produced by permission.)
(melanocytes). Sarcomas are cancers of the supporting
tissues of the body, such as bone, muscle, and blood ves-
sels. Cancers of the blood and lymph glands are called
leukemias and lymphomas respectively. Gliomas are can-
cers of the nerve tissue.
Causes & symptoms
Causes & risk factors
The major risk factors for cancer are: tobacco, alco-
hol, diet, sexual and reproductive behavior, infectious
agents, family history, occupation, environment, and pol-
lution. According to the estimates of the American Can-
cer Society (ACS), approximately 40% of the cancer
deaths in 2003 were due to tobacco and excessive alco-
hol use. An additional one-third of the deaths were relat-
ed to diet and nutrition. Many of the one million skin
cancer cases were due to overexposure to ultraviolet
light from the sun’s rays. It should be noted that medical
science has not been able to pinpoint many of the exact
causes of cancer, but has been able to estimate risk fac-
tors and occurrence associated with various agents.
Tobacco. Eighty to ninety percent of lung cancer
cases occur in smokers. Smoking has also been shown to
be a contributory factor in cancers of the upper respiratory
tract, esophagus, larynx, bladder, pancreas, and probably
liver, stomach, breast, and kidney, as well. Recently, scien-
tists have also shown that second-hand smoke (or passive
smoking) can increase one’s risk of developing cancer.
Alcohol. Excessive consumption of alcohol is a risk
factor in certain cancers, such as liver cancer. Alcohol, in
combination with tobacco, significantly increases the
chances that an individual will develop mouth, pharynx,
larynx, and esophageal cancers.
Diet. Thirty five percent of all cancers are estimated
to be due to dietary causes. Excessive intake of fat lead-
ing to obesity has been associated with cancers of the
breast, colon, rectum, pancreas, prostate, gall bladder,
ovaries, and uterus.
Sexual and reproductive behavior. The human papil-
lomavirus, which is sexually transmitted, has been impli-
cated to cause cancer of the cervix. In addition, it has
also been shown that women who have not had children
or have children late in life have an increased risk for
both ovarian and breast cancer.
Infectious agents. In the last 20 years, scientists
have obtained evidence to estimate that 15% of the
world’s cancer deaths may be traced to viruses, bacteria,
or parasites.
Family history. Certain cancers like breast, colon,
ovarian, and uterine cancer, recur generation after gener-
ation in some families. A few cancers, such as the eye
cancer “retinoblastoma,” a type of colon cancer, and a
type of breast cancer known as “early-onset breast can-
cer,” have been shown to be linked to certain genes that
can be tracked within a family. It is therefore possible
that inheriting particular genes makes a person suscepti-
ble to certain cancers.
Occupational hazards. There is evidence to estimate
that certain occupational hazards account for 4% of all
cancer deaths. For example, asbestos workers have an in-
creased incidence of lung cancer. Similarly, a higher
likelihood of getting bladder cancer is associated with
dye, rubber, and gas workers; skin and lung cancer with
smelters, gold miners, and arsenic workers; leukemia
with glue and varnish workers; liver cancer with PVC
manufacturers; and lung, bone, and bone marrow cancer
with radiologists and uranium miners.
Environmental radiation. Exposure is believed to
cause 1-2% of all cancer deaths. Ultra-violet radiation
346
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
from the sun accounts for a majority of melanoma
deaths. Other sources of radiation are x rays, radon gas,
and ionizing radiation from nuclear material.
Pollution. Several studies have shown that there is a
well established link between asbestos and cancer. Chlo-
rination of water may account for a small rise in cancer
risk. Studies released in 2003 showed that cadmium, a
natural metal found in food, water, and cigarette smoke,
disturbs a system in our cells essential to preventing can-
cer. The main danger from pollution occurs when dan-
gerous chemicals from the industries escape into the sur-
rounding environment. It has been estimated that 1% of
cancer deaths are due to air, land, and water pollution.
Alternative medicine tends to disagree with conven-
tional medicine about the causes of cancer, claiming that
environmental pollution and emotional and psychologi-
cal factors are major influences upon the disease. Samuel
S. Epstein, a professor of Occupational and Environmen-
tal Medicine at the University of Illinois and the chair-
man of the Cancer Prevention Coalition, is one of the
strongest critics of the National Cancer Institute and the
American Cancer Society (ACS). Epstein tends to echo
many of the beliefs of alternative practitioners. He
claims that mainstream medicine, driven by politics,
profits, and pharmaceutical sales, is not discussing or
sufficiently researching some major factors behind can-
cer, or researching ways of preventing those causes. Ep-
stein asserts that a primary cause of cancer is the massive
pollution of the air, water, food, and workplace. For in-
stance, since the 1940s over 100,000 new chemicals
have been added to the environment, and each year in the
United States alone, over 10 lb (4.5 kg) of pesticides and
herbicides per person are used on the food supply, chem-
icals that are proven to be carcinogenic. Epstein believes
that the human immune system simply cannot handle all
the new carcinogens and stresses in the environment, and
cancer represents this breakdown of the immune system.
He is also a critic of some conventional cancer therapies
like radiation and chemotherapy, claiming that the thera-
pies themselves are highly carcinogenic and are often re-
sponsible for recurrent cancer. Epstein points out that de-
spite the “war on cancer’’ by mainstream medicine, mor-
tality rates have not been significantly improved by its
methods, and more research needs to be dedicated to
preventative and alternative measures instead of pharma-
ceuticals and invasive treatments.
Symptoms
Cancer is a progressive disease, and goes through
several stages with varying symptoms. Some symptoms
are produced early and may occur due to a tumor that is
growing within an organ or a gland. As the tumor grows,
it may press on the nearby nerves, organs, and blood ves-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
A transmission electron micrograph (TEM) of two spindle
cell nuclei from a human sarcoma. Sarcomas are cancers of
the connective (Photograph by Dr. Brian Eyden, Photo Re-
searchers, Inc. Reproduced by permission.)
sels. This causes pain and some pressure that may be the
earliest warning signs of cancer. Despite the fact that
there are several hundred different types of cancers, pro-
ducing very different symptoms, the ACS has established
the following seven symptoms as possible warning sig-
nals of cancer:
• changes in the size, color, or shape of a wart or a mole
• a sore that does not heal
• persistent cough, hoarseness, or sore throat
• a lump or thickening in the breast or elsewhere
• unusual bleeding or discharge
• chronic indigestion or difficulty in swallowing
• any change in bowel or bladder habits
Many other diseases besides cancer, could produce
the same symptoms. However, it is important to have
these symptoms checked as soon as possible, especially
if they linger. The earlier a cancer is diagnosed and treat-
ed, the better the chance of it being cured. Many cancers,
such as breast cancer, may not have any early symptoms.
Therefore, it is important to undergo routine screening
tests, such as breast self-exams and mammograms.
Diagnosis
Diagnosis begins with a thorough physical examina-
tion and a complete medical history. The doctor will ob-
347
Cancer
Cancer
serve, feel, and palpate (apply pressure by touch) differ-
ent parts of the body in order to identify any variations
from the normal size, feel, and texture of the organ or tis-
sue. As part of the physical exam, the doctor will inspect
the oral cavity, or the mouth. By focusing a light into the
mouth, he or she will look for abnormalities in color,
moisture, surface texture, or presence of any thickening
or soreness in the lips, tongue, gums, the hard palate on
the roof of the mouth, and the throat.
To detect thyroid cancer, the doctor will observe the
front of the neck for swelling. He may gently manipulate
the neck and palpate the front and side surfaces of the
thyroid gland (located at the base of the neck) to detect
any nodules or tenderness. As part of the physical exami-
nation, the doctor will also palpate the lymph nodes in
the neck, under the arms, and in the groin. Many illness-
es and cancers cause a swelling of the lymph nodes.
The doctor may conduct a thorough examination of
the skin to look for sores that have been present for more
than three weeks and that bleed, ooze, or crust; irritated
patches that may itch or hurt, and any change in the size of
a wart or a mole. Examination of the female pelvis is used
to detect cancers of the ovaries, uterus, cervix, and vagina.
In the visual examination, the doctor looks for abnormal
discharges or the presence of sores. Then, using gloved
hands the physician palpates the internal pelvic organs
such as the uterus and ovaries to detect any abnormal
masses. Breast examination includes visual observation
where the doctor looks for any discharge, unevenness, dis-
coloration, or scaling. The doctor palpates both breasts to
feel for masses or lumps. For males, inspection of the rec-
tum and the prostate is also included in the physical exam-
ination. The doctor inserts a gloved finger into the rectum
and rotates it slowly to feel for any growths, tumors, or
other abnormalities. The doctor also conducts an examina-
tion of the testes, where the doctor observes the genital
area and looks for swelling or other abnormalities. The
testicles are palpated to identify any lumps, thickening, or
differences in the size, weight, and firmness.
If the doctor detects an abnormality on physical ex-
amination, or the patient has some symptom that could
be indicative of cancer, the doctor may order diagnostic
tests. Laboratory studies of sputum (sputum cytology),
blood, urine, and stool can detect abnormalities that may
indicate cancer. Sputum cytology is a test where the
phlegm that is coughed up from the lungs is microscopi-
cally examined. It is often used to detect lung cancer.
A blood test for cancer is easy to perform, usually
inexpensive and risk- free. Blood tests can be either spe-
cific or nonspecific. Often times, in certain cancers, the
cancer cells release particular proteins (called tumor
markers) and blood tests can be used to detect the pres-
348
ence of these tumor markers. However, with a few ex-
ceptions, tumor markers are not used for routine screen-
ing of cancers, because several noncancerous conditions
also produce positive results. Blood tests are generally
more useful in monitoring the effectiveness of the treat-
ment, or in following the course of the disease and de-
tecting recurrent disease.
Imaging tests such as computed tomography scans
(CT scans), magnetic resonance imaging (MRI), ultra-
sound, and fiberoptic scope examinations help doctors
determine the location of the tumor even if it is deep
within the body. Conventional x rays are often used for
initial evaluation, because they are relatively cheap,
painless, and easily accessible. In order to increase the
information obtained from a conventional x ray, air or a
dye (such as barium or iodine) may be used as a contrast
medium to outline or highlight parts of the body.
The most definitive diagnostic test is the biopsy,
wherein a piece of tissue is surgically removed for mi-
croscope examination. Besides confirming a cancer, the
biopsy also provides information about the type of can-
cer, the stage it has reached, the aggressiveness of the
cancer, and the extent of its spread. Since a biopsy pro-
vides the most accurate analysis, it is considered the gold
standard of diagnostic tests. Screening examinations,
conducted regularly by healthcare professionals, can re-
sult in the detection of cancers of the breast, colon, rec-
tum, cervix, prostate, testes, tongue, mouth, and skin at
early stages, when treatment is more likely to be suc-
cessful. Some of the routine screening tests recommend-
ed by the ACS are sigmoidoscopy (for colorectal
cancer), mammography (for breast cancer), pap smear
(for cervical cancer), and the PSA test (for prostate can-
cer). Self-examinations for cancers of the breast, testes,
mouth, and skin can also help in detecting the tumors be-
fore the symptoms become serious.
Diagnosis in alternative treatment often relies on
conventional diagnostic tools for determining the type
and stage of cancer, but will supplement those tools with
diagnostic techniques that strive to evaluate the overall
health of a person, in order to treat a person holistically.
For instance. Ayurvedic medicine and traditional Chi-
nese medicine place high priorities during diagnosis on
the patient’s emotional and psychological history, as well
as considerations like lifestyle, relationships, and the de-
gree of social and spiritual support, in order to have in-
sight into the cause and proper treatment of a particular
cancer. These alternative practices also have highly de-
veloped diagnostic techniques for the body, including
pulse diagnosis; methods of analyzing the tongue, eyes,
skin, hair, and fingernails; palpating and finding prob-
lems in the organs and abdomen; and listening to the
breath for clues to the internal environment.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Treatment
Choosing an alternative cancer treatment
There are a multitude of alternative treatments avail-
able to help a person with cancer. They are usually inte-
grated with allopathic treatments like surgery, chemother-
apy, and radiation therapy, where only an estimated 4%
exclusively use alternative medicine. Chemotherapy and
radiation treatments are some of the most painful and
toxic of conventional treatments, and often have unpre-
dictable results. As a rule, alternative treatments are less
invasive, nontoxic, and have minimal side effects. When
used as adjuncts to conventional treatment, some alterna-
tive treatments have been shown to decrease pain and
side effects, aid in the recovery process, and improve the
quality of life of cancer patients.
Alternative treatment of cancer is a complicated
arena and choosing one from the many can seem a diffi-
cult task, as can choosing an alternative practitioner. Pa-
tients should consult as many trained health practitioners
as feasible when choosing alternative therapies. If pa-
tients are willing to ask questions and thoroughly re-
search their options, they can increase their chances of
getting the best possible alternative support for the diffi-
cult task of treating cancer.
When choosing alternative treatment, individuals
should evaluate practitioners, therapies, and services de-
livered by clinics or practitioners, as well as the extent of
documentation and published literature regarding these
concerns. When looking for practitioners, patients
should evaluate their training and credentials and their
reputations in the healing community. Referrals from
other patients should be requested. Furthermore, they
should seek practitioners who are knowledgeable and fa-
miliar with a broad spectrum of options of treating can-
cer, including those used by conventional medicine, and
who are willing to work in conjunction with convention-
al doctors if the patient and treatment requires it. Con-
versely, if patients choose a physician who employs and
recommends conventional, allopathic methods, that
physician should be willing to communicate with pa-
tients, as well as communicate with an alternate
provider. Another major consideration when choosing a
practitioner is whether he or she seems trustworthy, ethi-
cal, and compassionate.
Patients should also evaluate the particular therapy
offered by a practitioner or clinic. They should find out
exactly how the therapy works and the principles behind
it; whether it is harmless or potentially damaging, and
the positive benefits it offers; what literature and scien-
tific studies exist for the therapy; and what other patients
say about the treatment.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Finally, patients should evaluate the quality of ser-
vice that the practitioner or clinic offers. Cost, reputa-
tion, quality of support personnel, and attention to indi-
vidual needs are important considerations when evaluat-
ing the service dimension of a treatment.
Types of alternative treatment
Alternative medicine generally views cancer as a
holistic problem. That is, cancer represents a problem
with the body’s overall health and immunity. As such,
treatment is holistic as well, striving to strengthen and
heal the physical, mental, and spiritual aspects of pa-
tients. Alternative cancer treatments may emphasize dif-
ferent basic approaches, which include traditional medi-
cines, psychological approaches, nutritional and dietary
approaches, physical approaches, integrated approaches,
and experimental programs.
TRADITIONAL MEDICINES. Traditional Chinese
medicine uses acupuncture, acupressure massage,
herbal remedies, and movement therapies like t’ai chi
and qigong to treat cancer. Traditional Chinese herbal
remedies have already contributed a significant number
of anticancer drugs, as studies have shown their anti-
cancer properties and immune stimulants. A 2001 report
noted that the ancient compound artemisinin (worm-
wood) appears surprisingly effective in targeting certain
cancer cells and helping to destroy them. The therapy is
much less expensive than many traditional options, but
further study was underway. Acupuncture has been
shown to reduce some tumors and significantly reduce
pain and improve immune system activity.
Ayurvedic medicine utilizes detoxification, herbal
remedies, massage, exercise, yoga, breathing techniques,
and meditation as part of its cancer treatment. Pan-
chakarma is an extensive detoxification and strengthen-
ing program that is recommended for cancer sufferers
and those undergoing chemotherapy and radiation. Pan-
chakarma uses fasting, special vegetarian diets, enemas,
massage, herbal medicines, and other techniques to rid
the body of excess toxins that are believed to contribute
to chronic diseases like cancer, and to strengthen the im-
mune system. Ayurvedic herbs are also being demonstrat-
ed to have significant anticancer properties.
Naturopathy and homeopathy are traditional West-
ern healing systems using herbal medicines and other
techniques to strengthen the immune system and reduce
the pain of cancer treatment. Western herbalism is also
beginning to compile studies of many herbs that have an-
ticancer and immune strengthening properties.
PSYCHOLOGICAL APPROACHES. Alternative treat-
ments that seek to help patients with the mental and spir-
itual challenges that cancer poses include psychothera-
349
Cancer
Cancer
py, support groups, guided imagery, meditation,
biofeedback, and hypnosis.
Psychological approaches work with the idea that
the mind and emotions can profoundly influence the
health of the body and diseases like cancer. Many studies
have acknowledged that mind and emotions play a key
role in cancer and immune functioning, and psychologi-
cal approaches are being used by many conventional
programs, including Harvard Medical School. A new
field of academic medicine called psychoneuroimmunol-
ogy has begun that studies the interactions between men-
tal states and immune response.
Studies have shown that patients who approach their
cancer with positive attitudes and peaceful acceptance
have higher survival rates than those patients who react
with negative emotions, like depression, cynicism, or
helplessness. Alternative treatments use psychological
approaches to help patients overcome the mental and
emotional barriers to healing.
PHYSICAL APPROACHES. Physical approaches to
cancer include exercise; massage therapies; movement
therapies like yoga, t’ai chi and qigong; breathing tech-
niques; and relaxation techniques. These therapies strive
to increase immune system response, promote relaxation
and stress reduction, and reduce side effects of conven-
tional treatments such as pain, nausea, weakness, and
physical immobility.
NUTRITIONAL AND DIETARY APPROACHES. Diet is
now recognized by scientists to play a major role in re-
ducing the risk of some cancers. A 1992 report in Oncol-
ogy claimed that nutritional factors may account for up to
70% of avoidable cancer mortality in this country. Many
nutritionists also state that cancer patients have height-
ened needs for diets free of toxic chemicals and full of
cancer-fighting nutrients. Diet and nutrition can improve
both a cancer patient’s chances for recovery and quality
of life during treatment. In laboratory studies, vitamins
such as A, C, and E, as well as compounds such as isoth-
iocyanates and dithiolthiones found in broccoli, cauli-
flower, and cabbage, and the antioxidant beta-carotene
found in carrots, have been shown to protect against can-
cer. Additionally, bioflavonoids and lycophene found in
green tea help in the prevention of cancer.
Dietary approaches for cancer include vegetarian-
ism, raw food diets, macrobiotics, the Gerson diet, and
the Livingston- Wheeler nutritional program, discussed
below. Cancer diets generally emphasize fresh fruits,
vegetables, whole grains, and legumes, and restrict in-
take of fat, meat, dairy products, sugar, processed foods,
and other foods believed to tax cancer patients. Nutri-
tional approaches to cancer include antioxidant and vita-
min supplementation and the use of numerous herbal ex-
350
tracts. There are many herbs that have been shown to
have anticancer, immune enhancing, and symptom re-
ducing properties, and patients are recommended to con-
sult competent herbalists for herbal support.
INTEGRATED APPROACHES. Keith Block is a con-
ventional physician and oncologist who is integrating
many alternative practices into his cancer treatment cen-
ter affiliated with the Chicago Medical School in Illinois.
His program seeks to provide individualized cancer
treatment using conventional therapies while integrating
alternative healing techniques. Block advocates a special
diet (based on vegetarianism and macrobiotics), exercise,
psychological support, and herbal and nutritional supple-
ments. Block’s program has received acclaim for both
treatment success and satisfaction of patients.
EXPERIMENTAL PROGRAMS. Antineoplaston therapy
was developed by Stanislaw Burzynski, a Polish physi-
cian who began practicing in Houston, Texas. Burzynski
has isolated a chemical, deficient in those with cancer,
which he believes stops cancer growth, and his treatment
has shown some promise.
Dr. Joseph Gold, the director of the Syracuse Cancer
Research Institute, discovered that the chemical hy-
drazine sulfate has many positive effects in cancer pa-
tients, including stopping weight loss, shrinking tumors,
and increasing survival rates.
The Livingston therapy was developed by the late
Dr. Virginia Livingston, an American physician. She as-
serted that cancer is caused by certain bacteria that she
claimed are present in all tumors. She advocated a detox-
ification program and special diet that emphasized raw
or lightly cooked and primarily vegetarian foods, with
special vitamin and nutritional supplements.
The Gerson therapy was for years the best known
nutritional therapy for cancer. It is available in two clin-
ics in California and Mexico. It consists of a basic vege-
tarian diet low in salt and fat, with high doses of particu-
lar nutrients using raw fruit and vegetable juices. The
Gerson therapy also requires patients to drink raw calf’s
liver juice, believed to aid the liver, and advocates fre-
quent coffee enemas, which are claimed to help the body
evacuate toxins.
Allopathic treatment
The aim of allopathic (conventional) cancer treatment
is to remove all or as much of the tumor as possible and to
prevent the recurrence or spread of the primary tumor.
While devising a conventional treatment plan for cancer,
the likelihood of curing the cancer has to be weighed
against the side effects of the treatment. If the cancer is
very aggressive and a cure is not possible, then the treat-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
ment should be aimed at relieving symptoms and control-
ling the cancer for as long as possible. Cancer treatment
can take many different forms, and it is always tailored to
the individual patient. The decision on which type of treat-
ment is the most appropriate depends on the type and lo-
cation of cancer, the extent to which it has already spread,
the patient’s age, sex, general health status, and personal
treatment preferences. The major types of treatment are:
surgery, radiation, chemotherapy, immunotherapy, hor-
mone therapy, and bone marrow transplantation.
Surgery
Surgery is the removal of a visible tumor and is the
most frequently used cancer treatment. It is most effec-
tive when a cancer is small and confined to one area of
the body. Surgery can be used for many purposes. Treat-
ment of cancer by surgery involves removal of the tumor
to cure the disease. Along with the cancer, some part of
the normal surrounding tissue may also be removed to
ensure that no cancer cells remain in the area. Since can-
cer usually spreads via the lymphatic system, adjoining
lymph nodes may be examined and sometimes removed,
as well. Preventive or prophylactic surgery involves re-
moval of an abnormal looking area that is likely to be-
come malignant over time. The most definitive tool for
diagnosing cancer is a biopsy. Sometimes a biopsy can
be performed by inserting a needle through the skin.
However, at other times, the only way to obtain tissue
sample for biopsy is by performing a surgical operation.
Radiation
Radiation kills tumor cells. Radiation is used alone in
cases where a tumor is unsuitable for surgery. More often,
it is used in conjunction with surgery and chemotherapy.
Radiation can be either external or internal. In the external
form, the radiation is aimed at the tumor from outside the
body. In internal radiation (also known as brachy therapy),
a radioactive substance in the form of pellets or liquid is
placed at the cancerous site by means of a pill, injection,
or insertion in a sealed container.
Chemotherapy
Chemotherapy is the use of drugs to kill cancer
cells. It destroys the hard-to-detect cancer cells that have
spread and are circulating in the body. Chemotherapeutic
drugs can be taken either orally or intravenously, and
may be given alone or in conjunction with surgery, radia-
tion, or both. The toxic effects of chemotherapy are se-
vere. In 2003, a new technique was developed to stream-
line identification of drug compounds that are toxic to
cancerous cells but not to healthy cells. The technique
identified nine drugs, one of which had never before
been identified for use in cancer treatment. Researchers
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
began looking into developing the new drug for possible
use. In addition, it may make the body less tolerant to the
side effects of other treatments that follow, such as radia-
tion therapy. The more common use of chemotherapy is
adjuvant therapy, which is given to enhance the effec-
tiveness of other treatments. For example, after surgery,
adjuvant chemotherapy is given to destroy any cancerous
cells that still remain in the body.
Immunotherapy
Immunotherapy uses the body’s own immune sys-
tem to destroy cancer cells. This form of treatment is
being intensively studied in clinical trials and is not yet
widely available to most cancer patients. The various im-
munological agents being tested include substances pro-
duced by the body (such as the interferons, interleukins,
and growth factors), monoclonal antibodies, and vac-
cines. Unlike traditional vaccines, cancer vaccines do not
prevent cancer. Instead, they are designed to treat people
who already have the disease. Cancer vaccines work by
boosting the body’s immune system and training the im-
mune cells to specifically destroy cancer cells.
Hormone therapy
Hormone therapy is standard treatment for some
types of cancers that are hormone-dependent and grow
faster in the presence of particular hormones. These in-
clude cancer of the prostate, breast, and uterus. Hormone
therapy involves blocking the production or action of
these hormones. As a result, the growth of the tumor
slows down and survival may be extended for several
months or years. However, in 2003, the Women’s Health
Initiative found that even relatively short-term use of es-
trogen plus progestin is associated with increased risk of
breast cancer, diagnosis at a more advanced stage of the
disease, and a higher number of abnormal mammo-
grams. The longer a woman used HRT, the more her risk
increased. This contradicted earlier beliefs that HRT
could prevent breast cancer. So checking with a physi-
cian for the latest information is advised.
Bone marrow transplantation
The bone marrow is the tissue within the bone cavi-
ties that contains blood-forming cells. Healthy bone mar-
row tissue constantly replenishes the blood supply and is
essential to life. Sometimes, the amount of drugs or radi-
ation needed to destroy cancer cells also unfortunately
destroys bone marrow. Replacing the bone marrow with
healthy cells counteracts this adverse effect. A bone mar-
row transplant is the removal of marrow from one person
and the transplant of the blood-forming cells either to the
same person or to someone else. Bone marrow transplan-
tation, while not a therapy in itself, is often used to res-
351
Cancer
Cancer
cue a patient, by allowing those with cancer to undergo
very aggressive therapy.
in 2001, interest grew in adding hyperthermia to
conventional therapy such as radiation. By raising tu-
mors to high fever temperatures, the performance of cer-
tain cancer drugs was noted. Hyperthermia is thought to
destroy cancer cells much the same way that the body
uses fever to naturally combat other forms of disease.
Many different specialists generally work together
as a team to treat cancer patients. An oncologist is a
physician who specializes in cancer care. The oncologist
provides chemotherapy, hormone therapy, and any other
non-surgical treatment that does not involve radiation.
The oncologist often serves as the primary physician and
coordinates the patient’s treatment plan. There are many
other specialists involved in cancer treatment, and virtu-
ally any type of medical or surgical specialist may be-
come involved with care of the cancer patient, should it
become necessary.
Expected results
Lifetime risk is the term that cancer researchers use to
refer to the probability that an individual, over the course
of a lifetime, will develop cancer or die from it. In the
United States, men have a one in two lifetime risk of de-
veloping cancer, and for women the risk is one in three.
Overall, African Americans are more likely to develop
cancer than Caucasians. African Americans are also 30%
more likely to die of cancer than Caucasians. Many can-
cers are curable if detected and treated at their early
stages. A cancer patient’s prognosis is affected by many
factors, particularly the type of cancer the patient has, the
stage of the cancer, the extent to which it has metasta-
sized, and the aggressiveness of the cancer. In addition,
the patient’s age, general health status, and the effective-
ness of the treatment being pursued are also important fac-
tors. To help predict the future course and outcome of the
disease and the likelihood of recovery from the disease,
doctors often use statistics. The five-year survival rates are
the most common measures used. The number refers to
the proportion of people with cancer who are expected to
be alive five years after initial diagnosis, compared with a
similar population that is free of cancer. It is important to
note that while statistics can give some information about
the average survival experience of cancer patients in a
given population, they cannot be used to indicate individ-
ual prognosis, because no two patients or cancers are ex-
actly alike. The unpredictability of cancer can be seen as
positive, as well as negative — some patients have experi-
enced recoveries in cases that were deemed incurable.
Alternative medicine rarely claims to be able to cure
cancer on a regular basis, but many treatments seem to
352
help with controlling symptoms, controlling the pain and
side effects of conventional treatments, and increasing the
quality of life for cancer sufferers. Alternative therapies
have also shown unexpected results and cures. Alternative
therapies may be strongest as preventative measures, be-
fore major problems like cancer occur in the body.
Prevention
Most practitioners agree that the best treatment for
cancer is prevention. Having sound physical and mental
health can significantly reduce the chances of getting
cancer. The following guidelines are generally recom-
mended by doctors, nutritionists, and alternative practi-
tioners for cancer prevention and recovery:
• Refraining from smoking.
• Not drinking alcohol excessively.
• Exercising regularly, at least 20 minutes per day,
preferably outdoors in the fresh air.
• Avoiding exposure to radiation. This includes avoiding
unnecessary x rays, not residing near sources of natural
or human-made radiation, and avoiding occupational
exposure to radiation.
• Avoiding exposure to harmful chemicals in food, the
home, and workplace.
• Maintaining proper body weight, particularly avoiding
obesity.
• Practicing safe sex.
• Protecting the skin from overexposure to sunlight.
Avoiding the midday sun between 1 1 a.m. and 3 p.m.
and never allowing the skin to become sunburned help
with prevention.
• Eating a healthy diet. Becoming educated on and prac-
ticing dietary principles reduces the risk of cancer.
These principles include eating plenty of fresh fruits,
vegetables, beans, and whole grains and consuming or-
ganically grown foods when possible. Minimizing
overeating and reducing intake of meat and dairy prod-
ucts while increasing fiber are recommended. Avoiding
processed and canned foods, including soft drinks, and
avoiding sugar and refined starch products like white
flour also helps. Reducing the intake of fat, avoiding
hydrogenated vegetable oils like margarine and short-
ening, and drinking filtered or spring water have been
recommended.
• Striving to maintain sound mental and emotional health
is believed to help prevent cancer. Learning a technique
like yoga, t’ai chi, meditation, or others can reduce
stress and promote relaxation. Maintaining healthy rela-
tionships and social support systems also relieves stress.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Benign — A growth that does not spread to other
parts of the body.
Biopsy — The surgical removal and microscopic ex-
amination of living tissue for diagnostic purposes.
Carcinogen — Any substance capable of causing
cancer by mutating the cell's DNA.
Chemotherapy — Treatment with drugs that are an-
ticancer.
Holistic — The sum of physical, mental, and emo-
tional dimensions of a person.
Macrobiotics — Special vegetarian diet based on
wholegrains, legumes, fruits, and vegetables.
Malignant — A general term for cells that can dis-
lodge from the original tumor, invade, and destroy
other tissues and organs.
Metastastis — The spread of cancer from one part
of the body to another.
Oncologist — Conventional physician specializing
in cancer.
Resources
BOOKS
Galland, Leo, m.d. The Four Pillars of Healing. New York:
Random House, 1997.
Lerner, Michael. Choices in Healing: Integrating the Best of
the Conventional and Complementary Approaches to
Cancer. Cambridge, Massachusetts: MIT Press, 1994.
Walters. Richard. Options: The Alternative Cancer Therapy
Book. New York: Avery Publishing Group, 1993.
Weil, Andrew, m.d. Natural Health, Natural Medicine. New
York: Houghton Mifflin, 1995.
Yance, Donald R. Herbal Medicine, Healing and Cancer.
Chicago: Keats Publishing, 1999.
PERIODICALS
Alternative Therapies Magazine. PO Box 17969, Durham, NC
27715. (919) 668-8825. http://www.alternative-therapies.
com.
“Cadmium Studies Suggest New Pathway to Human Cancer.”
Drug Week (July 4, 2003): 77.
“HRT Linked to Higher Breast Cancer Risk, Later Diagnosis,
Abnormal Mammograms.” Women’s Health Weekly (July
17, 2003):2.
“Hyperthermia and Hypoxia Spell Cancer Destruction.” Can-
cer Weekly, November 27, 2001: 20.
“Ancient Chinese Folk Remedy may hold Key to Nontoxic
Cancer Treatment.” Cancer Weekly, December 18, 2001:
12 .
"Genetic Identification Techniques Yield Clues to Cancer Sus-
ceptibility.” Cancer Weekly November 13, 2001: 19.
“Technique Streamlines Search for Anticancer Drugs.” Cancer
Weekly (April 15, 2003): 62.
ORGANIZATIONS
The Alliance for Alternative Medicine. PO Box 59, Liberty
Lake, WA 99019.
American Cancer Society, National Headquarters. 1599 Clifton
Road, N.E. Atlanta, Georgia 30329 (800) 227-2345.
<http ://www. cancer. org> .
Cancer Prevention Coalition, c/o University of Illinois School
of Public Health, 2121 West Taylor Street Chicago, IL
60612 . (312) 996-2297 epstein@uic.edu. <http://www.
preventcancer.com>.
The Health Resource. 209 Katherine Drive, Conway, AR
72032. (501) 329-5272.
National Cancer Institute. 9000 Rockville Pike, Building 31,
room 10A16, Bethesda, MD 20892. (800) 422-6237.
<http://www.cancer.gov>.
OTHER
Cancer Nutrition Center, [cited October 2002]. <http://www.
cancemutrition.com>.
Douglas Dupler
Teresa G. Odle
Cancer, bladder see Bladder cancer
Cancer, breast see Breast cancer
Cancer, colorectal see Colorectal cancer
Cancer, ovarian see Ovarian cancer
Cancer, uterine see Uterine cancer
Cancer treatments, biological
Definition
Biological cancer treatments, also known as meta-
bolic treatments, work by detoxifying and strengthening
the body so that it can overcome cancer cells and metab-
olize them. This is almost always done nutritionally, pos-
sibly with the aid of nutritional supplements and/or
herbs, or by employing detoxification procedures such
as enemas and colonic irrigation.
Origins
It is thought that Paracelsus and Hippocrates cured
cancer with biological cures (through food) but it is diffi-
cult to verify that they were actually treating cancer,
which is commonly regarded as an affliction of modern
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
353
Cancer treatments, biological
Cancer treatments, biological
man. Modem biological cancer therapies began to ap-
pear at the beginning of the twentieth century.
Dr. Max Gerson’s therapy is probably foremost
among the early ones, although he had some equally em-
inent contemporaries. However, there are now many al-
ternative health practitioners specializing in the treat-
ment of cancer to be considered, although success varies.
Benefits
Biological cancer treatments are non-invasive and
do not have the drawbacks associated with chemothera-
py and radiation therapy. Unlike biological treatments,
both deplete or completely destroy the body’s immune
system and can leave patients in a very weakened state.
Biological treatments work by actually strengthen-
ing the immune system so that it can overcome any ab-
normal situation. A successful biological cancer treat-
ment will leave patients feeling better than they did be-
fore they became ill, with all bodily functions effectively
harmonized and energy levels raised.
Description
All biological cancer therapies focus on strengthen-
ing the human organism so that it can kill the cancer,
rather than focusing on the cancer alone, as is the case
with allopathic medicine. Therefore, all these therapies
have in common that healthy lifestyle must be practiced.
In particular, this means abstaining from processed, de-
natured foods, and ensuring the absence of pollution and
toxins from diet and living environment.
Natural hygiene and other alternative therapies pre-
scribe fresh fruit and vegetables in abundance. The Ger-
son therapy uses fresh juices from organic sources. Es-
pecially in the beginning a vital aspect of the treatment is
detoxification. This is the process of encouraging, and
sometimes forcing, the body to eliminate toxins stored in
the body cells and gastrointestinal tract. In the case of
cancer patients, this can involve a considerable quantity
of toxic waste that must be flushed out of the system.
Concurrently with the detoxification process the
treatment will aim to provide the organism with plentiful
supplies of fresh enzymes and nutrients that will allow
the body to rebuild itself, and renew systems such as the
endocrine system and immune system.
When treating most disorders and diseases with nat-
ural therapies, the patient is encouraged to undertake a
program of exercise to enhance the effectiveness of the
treatment. This is not so in the case of cancer patients,
however, as generally they may not be strong enough for
such activities, and as their bodies will need every ounce
354
of strength to fight the cancer. Instead, they are advised to
undertake an exercise program once they are well enough.
Practitioners
All the practitioners who have been successful with
the treatment of serious disease, particularly cancer, have
a reputation for being very tough on their patients, in fact
some have been described as Hitler-like in their attitudes.
When questioned, many say that unless a cancer patient
is prepared to tackle the problem of detoxification seri-
ously and follow the diet without diversification, then
there is little hope that they will be able to overcome the
disease. Often patients who are in a weakened state of
health need the support of a therapist who is prepared to
be firm with them.
DR. MAX GERSON (?-1 959). Dr. Gerson’s therapy
probably can be considered the original biological can-
cer treatment. In his book entitled A Cancer Therapy,
Results of Fifty Cases, Gerson documented 50 success-
fully treated cancer patients. He explained to readers that
the cases in his book were the most extensively docu-
mented and therefore most suitable for the purposes of
demonstrating his cure.
This therapy relies mainly on fresh organic juices,
but includes supplements and strict instructions for
lifestyle. A vital aspect of his treatment are the coffee en-
emas he devised to achieve thorough detoxification.
DR. LINUS PAULING (1901-1994). Nobel Prize laure-
ate, Dr. Linus Pauling, researched the properties of nutri-
tional supplements in treating disease for many years,
and he is generally accepted as the foremost authority on
the subject. In 1979, he published a work with co-author
Ewan Cameron titled Cancer and Vitamin C. Pauling ad-
vocated supplements, in particular megadoses of vita-
min C, for the treatment of cancer and other degenera-
tive diseases.
DR. ANN WIGMORE (1909-1993). Wheatgrass juice
and sprouts are the basis for Wigmore’s regimen, which
she originally devised to cure her own chronic diseases
including cancer, and has been successfully helping peo-
ple for decades. The Wigmore diet focuses primarily on
live foods. Wigmore felt that raw vegetables held more
nutrition than when cooked and were without the chem-
ical additives that processed foods hold. Her therapy is
still practiced at the Hippocrates Institute and has been
adopted by a number of alternative health care practi-
tioners as the basis for their treatment.
DR. RANDOLPH STONE (1890-1981). Stone devel-
oped a system known as Polarity therapy during his ca-
reer, which spanned 60 years. He felt that health should
be measured by an assessment of the human energy
field. This is affected by daily life, nutrition, exercise,
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
touch, sound, etc. Stone recommended a comprehensive
regimen consisting of touch therapy (where the praction-
er’s hands are conduits of energy), diet (a vegetarian diet
is emphasized because foods collected in a non-violent
way hold more energy), and yoga (to tune the patient
into his or her own body). This will balance health, and
so produce satisfactory energy fields.
DR. MICHIO KUSHI. Microbiotics is the belief that
people are influenced by everything around them, in-
cluding the environment, foods they eat, and even where
they live. Promoting a positive lifestyle is also encour-
aged in order to keep a good outlook and mental attitude.
Possibly the most famous teacher of macrobiotics in the
United States, Michio Kushi, in collaboration with Alex
Jack, wrote The Cancer Prevention Diet in 1993. It is a
comprehensive guide to the prevention and treatment of
cancer with a macrobiotic diet.
Therapies
BOTANICAL MEDICINE. There are several different
therapies that fit into this category, which encompasses
general herbal medicine, Chinese herbalism and several
other ethnic herbal disciplines.
NATURAL EIYGIENE. Natural hygiene practitioners
have a long history of successfully treating such serious
diseases as cancer. This diet is a vegetarian diet focused
around maintaining a healthy and happy out look. Rest,
fresh air, grains, fruits, and vegetables are encouraged.
The American Natural Hygiene Society is a good source
of information regarding treatment and practitioners.
AYURVEDIC MEDICINE. This centuries old system of
natural medicine originated in India. Arvada has a con-
cept of life force, which is similar to the Chinese chi. It
aims to purge the body of undesirable matter, and then
rebuild it with good nutrition, while at the same time at-
tending to all aspects of the patient’s life both physical
and spiritual. This system is recognized by the World
Health Organization.
MACROBIOTICS. A diet of largely whole grains and
vegetables, combined with a unique philosophy is the
essence of the macrobiotic diet. Classes are available
lasting a weekend, one week, or one month, costing
$350, $1,250, and $2,900 respectively.
In general, the charge for various clinics and practi-
tioners varies widely, so it is essential for the patient to
discuss fees with the practitioner before treatment.
Preparations
Without exception, the above practitioners advocat-
ed the use of fresh natural produce, preferably organic,
for cancer patients and anyone else who wishes to im-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
prove their health. Where herbal remedies or other sup-
plements are prescribed, it is important to ensure that the
original formula is purchased, and not just a copy. Un-
scrupulous individuals have been known to pass off
unauthentic remedies using the names of well-known
practitioners.
Precautions
None of the therapies will be effective if the regimen
is not followed in its entirety. No matter how good the
quality of organic produce, no benefits will be felt if the
patient is still being exposed to environmental pollution,
or if detoxification procedures are inadequate. It is for
this reason that most practitioners recommend that a cure
be taken in the setting of a clinic, because all of these de-
tails can then become the responsibility of the staff, free-
ing the patient to concentrate on the business of becom-
ing well.
In fact many practitioners who treat cancer take
their cure so seriously, that they will refuse to treat pa-
tients who are not prepared to take all the necessary steps
and truly commit themselves to becoming well. They
warn that natural cures for cancer are not easy, cancer is
a sign that the integrity of the body system has been seri-
ously compromised, and nothing but the strictest regi-
men is likely to facilitate a return to health. Even so,
these therapies are very experimental and there are no
guarantees of a cure.
Side effects
Side effects associated with natural therapies are
very mild compared to those commonly experienced
with allopathic treatments. Cost is one of the main in-
hibitors of these treatments.
However, in the case of cancer treatment, a healing
crisis can be an unpleasant experience. Alternative medi-
cine practitioners believe that all illness is a result of a
toxic condition in the body, and cancer, being one of the
most serious conditions, is an indication of more serious
levels of toxicity. This means that when the body starts
to throw off these toxins, the blood system becomes
overloaded and the patient will experience headaches,
fevers, nausea, and in some cases extreme sensitivity to
stimuli such as sound and light. It is highly advisable to
seek a practitioner to help with detoxification therefore.
Research & general acceptance
Treatments for cancer are one of the areas where allo-
pathic medicine disapproves most strongly of alternative
medicine, and consequently these natural treatments are
the subject of much adverse publicity. Alternative practi-
355
Cancer treatments, biological
Canker sores
KEY TERMS
Denatured — Food which has been processed and
is no longer of benefit to the body.
Detoxification — The process of cleansing the sys-
tem of accumulated toxins.
Oncologist — Cancer specialist.
tioners assert that cancer patients should at least have the
option of choosing a biological cure for their illness.
Many alternative medicine practitioners recommend
that patients compare statistics when deciding on the
mode of treatment that is best for them, and ask to see
documentation.
Training & certification
All of the above practitioners hold medical qualifi-
cations, some of them to an M.D. or Ph.D. level. The or-
ganization People Against Cancer, specializes in helping
people find suitable practitioners and therapies. They
also provide practical help regarding the implementation
of therapies, can advise on books and so on.
Resources
BOOKS
Gerson, Max, M.D. A Cancer Therapy , Results of Fifty Cases.
Del Mar, California: Totality Books, 1977.
Jensen, Bernard, M.D. Foods That Heal. Garden City. New
York: Avery Publishing Group, 1993.
Shealy, Norman, M.D. Alternative Medicine, An Illustrated En-
cyclopedia of Natural Healing. Shaftsbury, Dorset: Ele-
ment Books, 1996.
ORGANIZATIONS
American Holistic Medicine Association. http://www.holistic
medicine.org/index.html.
The American Natural Hygiene Society. P.O. Box 30630,
Tampa, FL 33630. (813)855-6607. anhs@anhs.orgANHS.
http://www.anhs.org/.
American Polarity Therapy Association. P.O. Box 19858 Boul-
der, CO 80308. (303)545-2080. Hq@polaritytherapy.org.
http://www.polaritytherapy.org/polarity/index.html.
Kushi Institute. P.O. Box 7, Becket, MA 01223, Tel.: (413)
623-5741. kushi@macrobiotics.org. http://www.macro
biotics.org.
Linus Pauling Institute. Oregon State University 571 Weniger
Hall Corvalis OR 97331-6512. (541)737-5075. Lpi@orst.
edu. http://osu.orst.edu/dept/lpi/resagenda/timehne.html.
Max Gerson Memorial Cancer Center, http://www.1999.com/
gerson.
356
People Against Cancer. 604 East Street, PO Box 10, Otho, IA
50569. (515)972-4444. nocancer@ix.netcom.com. http://
www.dodgenet.com/nocancer.
OTHER
Dr. Govallo. http://home.earthlink.net/~emptherapies/vginet.
html.
Holistic medicine website, http://www.holisticmed.com/whatis.
html.
Patricia Skinner
Canker sores
Definition
Canker sores are small sores or ulcers that appear in-
side the mouth. They are painful and often recur from once
every few years to almost continually. Canker sores are
known medically as apthous ulcers or apthous stomatitis.
Description
Canker sores occur on the inside of the mouth, usu-
ally on the inside of the lips, cheeks, and/or soft palate.
They can also occur on the tongue and in the throat.
Often, several canker sores will appear at the same time
and may be grouped in clusters. They are painful and
sensitive to touch. The average canker sore is about one-
quarter inch in size, although they can occasionally be
larger. The sores may last for weeks at a time and leave a
scar. The initial symptom is a tingling or mildly painful
itching sensation in the area where the sore will appear.
After one to several days, a small red swelling appears,
which eventually becomes a grayish ulcer with a red ring
of inflammation surrounding the sore. Canker sores can
be very painful, especially if they are touched repeatedly
(e.g., by the tongue). They last for one to three weeks.
Approximately 20% of the United States population
is affected with recurring canker sores, and more women
than men get them. Women are more likely to have
canker sores during their premenstrual time.
Canker sores may be confused with cold sores
caused by the herpes simplex virus because the appear-
ance of both is similar. However, herpes infections occur
most commonly on the outside of the lips, on the hard
palate, and on the gums, whereas canker sores usually
occur on the soft tissues inside the mouth. Unlike canker
sores, herpes cold sores are infectious.
Causes & symptoms
The exact cause of canker sores is unknown. There
seems to be at least some link to immune reactions.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
There may also be a genetic tendency to develop canker
sores. Accidental injuries to the mouth from vigorous
toothbrush scrapes, poorly fitted dentures, braces, or
self-inflicted bites may give rise to canker sores. They
can also be triggered by stress, dietary deficiencies, hor-
monal changes, and food allergies. Sodium lauryl sul-
fate, which is an ingredient in many toothpastes, may
contribute to the development of canker sores by strip-
ping the mucous coating inside the mouth.
Diagnosis
Canker sores are diagnosed by observation of the
sore. A distinction between canker sores and cold sores
should be made because the latter is infectious. Other dis-
orders of the mouth may need to be ruled out as well; a
skin lesion biopsy may be required for further diagnosis.
Treatment
Many alternative therapies for canker sores try to
heal the existing sores and prevent their recurrence. Sev-
eral herbal remedies may be helpful in the treatment of
existing sores. These include:
• calendula ( Calendula officinalis)
• chamomile (, Matricaria recutita)
• goldenseal ( Hydrastis canadensis)
• licorice (Glycyrrhiza glabra)
• myrrh ( Commiphora molmol)
• peppermint (Mentha peperita)
• slippery elm (Ulmus fulva)
The herbs can be made into a strong tea. Compresses
soaked in the tea can be applied directly to the mouth, or
the tea can be swished in the mouth for several minutes.
The deglycyrrhizinated (DGL) form of licorice root,
Glycyrrhiza glabra, is soothing to the mucous mem-
branes of the mouth and can shorten the healing time for
canker sores. The powdered DGL should be mixed with
warm water to make a thin paste that can be used twice
daily. It should be swirled in the mouth for several min-
utes and then spit out.
B -complex vitamins, folic acid, and iron (taken sep-
arately or combined in a multivitamin) can help prevent
recurrent outbreaks, since canker sores are often associ-
ated with deficiencies in these nutrients.
Canker sores often occur during stressful times. Re-
laxation techniques such as meditation, guided im-
agery, and acupressure may help prevent or lessen the
severity of outbreaks.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
This patient is afflicted with stomatitis, a common inflam-
matory disease of the mouth. (Photograph by Edward H. Gill,
Custom Medical Stock Photo. Reproduced by permission.)
Allopathic treatment
Since canker sores heal themselves in most cases,
treatment usually isn’t necessary. Topical anesthetics,
such as lidocaine and similar remedies, may be used for
pain relief. Corticosteroid ointments may be used to re-
duce inflammation and speed healing. A protective paste,
like Orabase, can be used to prevent irritation of the
sores by teeth, dental appliances, or fluid intake.
Severe cases may be treated with the antibiotic
tetracycline. This is not recommended for children,
however, because it may permanently discolor any teeth
that are still forming. Chemical or physical cautery or
low-powered laser treatments may also be used to de-
crease severe pain. Ulcers tend not to recur where a
laser has been used.
Expected results
Canker sores tend to heal spontaneously. The pain
usually decreases within a few days, and other symptoms
resolve in one or two weeks. If symptoms last longer, if
there are increasing numbers of outbreaks, or if the pain
is severe, a doctor should be consulted.
Prevention
Good oral hygiene is necessary to prevent recurrent
outbreaks as well as secondary bacterial infections dur-
ing an outbreak. This includes regular brushing, floss-
ing, and regular trips to the dentist. Dentures, braces,
and fillings should be rechecked and possibly refitted.
Toothpastes containing sodium lauryl sulfate should
not be used.
Identifying food allergens and making dietary
changes may help prevent outbreaks. Spicy foods should
also be avoided because they may serve as irritants.
357
Canker sores
Cantharis
KEY TERMS
Inflammation — A localized reaction to tissue in-
jury or damage, usually characterized by pain,
swelling, and redness.
Skin lesion biopsy — A procedure in which a sliver
of tissue from the skin is removed in order to ex-
amine it and establish a diagnosis.
Ulcer — A site of damage to the skin or mucous
membranes characterized by the formation of pus
and the death of tissue. It is frequently accompa-
nied by inflammation.
Resources
BOOKS
Larsen, D.E., ed. Mayo Clinic Family Health Book. New York:
William Morrow, 1996.
Schlossberg, D. Current Therapy of Infectious Disease. St.
Louis: Mosby, 1996.
OTHER
DrKoop.com. http://www.drkoop.com/conditions/ency/article/
000998.htm (January 17, 2001).
The Merck Manual, http://www.merck.com/pubs/mmanual/
section9/chapterl05/105b.htm (January 17, 2001).
MotherNature.com. http://www.mothemature.com/ency/concem/
canker_sores.asp (January 17, 2001).
Patience Paradox
Cannabis sativa see Marijuana
Cantharis
Description
Cantharis is a homeopathic remedy obtained from the
insect Lytta vesicatoria ; common names are Spanish fly or
blister beetle. This beetle lives on honeysuckle and olive
trees in western Asia and southern Europe. It is bright green
and about 0.5 in ( 1 .3 cm) in length. Other names for cantharis
include: Cantharis vesicator, N.O. Insecta, and coleoptera.
The Spanish fly produces a toxic substance called
cantharidin. Cantharidin is a strong poison that primarily
affects the urinary tract and causes burning pain and
vomiting. Cantharidian is caustic and causes skin blis-
tering. Since homeopathy is based on the Law of Simi-
lars, a doctrine that says to treat a symptom with a dilut-
ed remedy that produces the same symptom is stronger
amounts, this homeopathic remedy is used for illnesses
that have burning pain as a symptom. Because cantharis
is a member of the animal kingdom, its activity excites
the passions of animals. As such, cantharis is indicated
for anger that is very severe with fits of rage. Likewise,
cantharis is indicated for conditions of the body that are
extreme, ie. pain that is stabbing, burning, and sharp.
General use
Homeopathic remedies are chosen based upon the
specific set of symptoms and traits displayed by each pa-
tient. In general, cantharis is used to treat conditions
characterized by burning pain and strong thirst but no
urge to drink. Conditions for which cantharis is indicated
will typically worsen rapidly.
Cantharis is primarily used to treat cystitis, which is
inflammation of the urinary bladder because of infection
or irritation. It is also used to treat burns and blisters.
Spanish fly was traditionally used as an aphrodisiac (in-
creases sexual desire). It was also used to remove warts,
treat baldness, increase loss of fluids (acting as a diuret-
ic), and for rheumatic problems (inflammation and de-
generation of the joints).
Mental symptoms treated with cantharis
Homeopathy treats a person’s whole being, mental
and physical. The patient who needs cantharis can be
confused and have odd ideas, may be maniacal and
demonstrate raging fury or sexual frenzy, or may loose
consciousness. The cantharis patient may be restless and
excitable. He or she may be extremely thirsty but have
difficulty swallowing. Also, the patient may have no ap-
petite and a strong avoidance of food. Other mental
problems that can be treated with cantharis include: ex-
cessive desire for sex (nymphomania), severe anxiety,
screaming, querulousness (constant complaining), and
insolence (being overbearing).
Physical symptoms treated with cantharis
The intense urge to urinate and burning pain are key
symptoms for cantharis. Cantharis is indicated for the
patient who experiences rapid and intense inflammation
of the urinary system. There is lower abdominal and
lower back pain. The severe burning pain associated with
the urinary tract makes the patient afraid to urinate.
There is a frequent and urgent need to urinate, however,
only small amounts (drops) of urine are passed. The
urine may contain blood. The patient may experience hy-
drophobia (fear of water) and, although extremely
thirsty, cannot drink water or even tolerate seeing or
hearing water. A severe, stabbing headache may be pre-
sent and the patient may avoid bright light.
358
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Cantharis is also used to treat bums or skin condi-
tions that resemble burns. It is used for sunburn, blis-
ters, skin eruptions, and insect bites. Symptoms associat-
ed with burns for which cantharis is indicated include
blister formation, searing pain, and relief upon applica-
tion of a cold compress. This remedy can relieve the pain
associated with second or third degree burns. Cantharis
is indicated for blisters that are burning and itching and
feel better upon application of a cold compress.
The patient feels better at night and in the morning.
Also, warmth, gentle massage, and lying flat on the back
make the patient feel better. Passing gas and burping
make the patient feel better. The patient feels worse in
the afternoon, during movement, and by drinking cold
water or coffee.
Other physical symptoms or conditions treated with
cantharis include:
• irritation of the digestive system causing a bloated
stomach
• burning diarrhea
• colitis (inflammation of the colon)
• loss of appetite
• burning feeling in the throat
• considerable thirst without the desire to drink
• pleurisy (inflammation of the membrane surrounding
the lungs)
• nighttime burning feeling on the bottom of the feet
• ice-cold hands with hot, red fingernails
• swelling and rash with pus on the hands
• stings with black centers
• erysipelas (infection of lymph ducts)
• fast spreading skin infection
• eczema
• dandruff
• shingles (herpes zoster)
• eye inflammation
• tongue inflammation
• neuralgia (nerve pain)
Preparations
Homeopathic canthous is prepared from the entire
beetle, dried and powdered. It is commercially available
as a homeopathic liquid or tablet. Because of the toxic
nature of cantharis, the tincture (an alcoholic extract) re-
quires a doctor’s prescription.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Cantharidin — The irritating poison produced by
Spanish fly that serves as the active ingredient in
cantharis. Because of cantharidin, high doses of
cantharis are highly toxic.
Cystitis — Painful inflammation of the urinary blad-
der caused by infection, irritation, allergy, or other
causes.
Homeopathy — A therapeutic system in which dis-
eases are treated with agents that cause a similar
set of symptoms in healthy persons. A "like treats
like" philosophy.
Cystitis is treated with 30C of homeopathic can-
tharis every half hour, with up to six doses. Minor burns
are treated with 30C of cantharis every 15 minutes for
four doses. Blisters are treated with 6C of cantharis four
times a day until the pain disappears. Burns may be
treated locally with water containing a few drops of can-
tharis tincture. Shingles may be treated with an ointment
made with 3X of cantharis.
Precautions
Large doses of cantharidin (the poison produced by
the Spanish fly found in cantharis) can cause a burning
pain in the stomach and throat, difficulty swallowing, vi-
olent vomiting, diarrhea, frequent urges to urinate, and
possibly convulsions and coma.
Side effects
Excessive doses of cantharis may cause symptoms
of cantharidin toxicity including burning pain, vomiting,
and frequent urge to urinate.
Interactions
The belladonna, phosphorus, mercurius, sepia,
and sulphur homeopathic remedies may be used to com-
plement the activity of cantharis. Homeopathic remedies
that serve as antidotes are aconite, apis, camphora, kali
nit., and pulsatilla. Cantharis serves as an antidote for
the homeopathic remedies alcohol, camphora, and vine-
gar. Homeopathic coffea and cantharis are incompatible.
Resources
BOOKS
Lodkie, Andrew, and Nicola Geddes. The Women s Guide to
Homeopathy: The Natural Way to a Healthier Life for
Women. New York: St. Martin’s Press, 1994.
359
Cantharis
Carnitine
Lockie, Andrew, and Nicola Geddes. The Complete Guide to
Homeopathy: The Principles and Practice of Treatment
with a Comprehensive Range of Self-Help Remedies for
Common Ailments. New York: Dorling Kindersley, 1995.
ORGANIZATIONS
Homeopathy Educational Services. 2124B Kittredge Street,
Berkeley, CA 94704. (510)649-0294. mail@ homeopathic,
com.
American Foundation for Homeopathy. 1508 S. Garfield, Al-
hambra, CA 91801.
National Center for Homeopathy. 801 N. Fairfax Street, Suites
306, Alexandria, VA 223 14.
OTHER
Clarke, John Henry. “Cantharis.” A Dictionary of Practical
Materia Medica. http://www.homeoint.Org/clarke/c/canth.
htm.
Belinda Rowland
Car sickness see Motion sickness
Carbuncles see Boils
Cardamom see Grains-of-paradise fruit
Carnitine
Description
Carnitine is an amino acid that is essential for babies
and nonessential for others. In this context, essential
means it must be obtained in the diet. Nonessential types
of amino acids can be synthesized to some extent within
the body. The kidney is able to form carnitine from the
amino acids lysine and methionine, in addition to iron
and vitamins B 6 , niacin, and C. The function of carnitine
is to mobilize long-chain fatty acids into the powerhouse
of the cell, where they are used for energy. Carnitine is
necessary for infants to grow and develop normally.
General use
The strongest indication for supplemental carnitine
is a genetic defect that causes a deficiency. It may also
be inadequately manufactured by babies, particularly
those who are premature or have a low birth weight.
Abnormally low levels of carnitine are most com-
monly associated with a few rare genetic diseases.
Symptoms of inadequate carnitine can include confu-
sion, heart pain, muscle weakness, and obesity. Poor
consumption of the nutrients required in order to synthe-
size carnitine also sometimes results in deficiency. These
360
nutrients include lysine, methionine, vitamin C, iron,
niacin, and vitamin B 6 (pyridoxine). Anyone with a pro-
tein deficient diet may have inadequate levels of the
building blocks for carnitine. Lysine and methionine are
likely to be lacking in a strict vegan diet, although some
fortified grains are available. Those who are under severe
or chronic health stress are also at higher risk. People
who have had surgery, severe burns, or wasting illnesses
require higher protein levels, and might benefit from a
supplement. The use of supplements containing D-carni-
tine has the potential to cause L-carnitine deficiency.
The heart is the most carnitine-rich organ in the
body, and there are several heart or circulatory condi-
tions that may benefit from more carnitine than is nor-
mally in the diet. Carnitine appears to help the heart, a
muscle that requires a lot of energy, function better. One
of the primary heart problems that can be helped by car-
nitine supplementation is angina (heart pain due to de-
creased oxygen because of coronary artery disease). Two
studies using L-carnitine, and one using L-propionyl-
carnitine, have demonstrated a reduction in symptoms of
this condition. When carnitine is added to the treatment
plan, it can potentially reduce some of the other medica-
tions used to control angina. However, reducing medica-
tion for angina patients should be supervised and guided
by a healthcare provider.
Intermittent claudication is a condition that develops
in some people with severe atherosclerosis. Walking be-
comes painful as a result of decreased blood flow to the
legs. Most studies have shown significant improvement
in the distance walked without pain when a supplement
of L-propionyl-carnitine was used. The dose used in one
study was 0.07 oz (2 g) per day.
When used along with traditionally prescribed med-
ications, carnitine may improve survival rates after a
heart attack. Other benefits, including lowering the
heart rate, blood pressure, and lipid levels occurred in
treated groups. The dose and type used in one study was
0.14 oz (4 g) per day of L-carnitine.
Most studies of carnitine used to improve athletic
performance have not shown any benefit. Supplementa-
tion may have some minimal effects on Alzheimer’s pa-
tients; some study groups had slightly slower rates of de-
terioration. These results remain questionable and fur-
ther study is needed.
There is some evidence that the use of supplemental
L-carnitine, at a dose of approximately 500-1000 mg
three times per day, may help to lower levels of serum
cholesterol. However, this regimen would be expensive,
and there are other effective and less expensive supple-
ments available. These include garlic, red yeast rice,
niacin, high fiber diets, and soy proteins.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
A condition known as chronic fatigue syndrome
(CFS) causes a number of potentially debilitating symp-
toms, including severe fatigue, muscle pain, and depres-
sion. Carnitine may prove helpful in alleviating the
symptoms of CFS, perhaps by increasing the efficiency
of energy production. One small study used a dose of 0. 1
oz (3 g) of L-carnitine per day.
Undocumented claims for the health benefits of car-
nitine include treatment of Down’s syndrome, muscular
dystrophy, some forms of male infertility, chronic ob-
structive pulmonary disease (COPD), and alcoholic fatty
liver disease. Carnitine has also been said to reduce the
toxicity of AZT, a medication for AIDS.
Preparations
Carnitine is found primarily in meats, but may also
be found in avocados, breast milk, dairy products, and
tempeh. In the body, it can be synthesized in the kidney
from lysine and methionine. Supplements are available
in capsules, but are generally quite expensive.
Several forms of oral carnitine are available, includ-
ing L-carnitine, D-camitine, and DL-carnitine. The latter
two forms are often found in over-the-counter nutritional
products and supplements. They are associated with more
adverse effects. Products containing D-carnitine and DL-
carnitine should be avoided. L-acetyl-carnitine and L-
propionyl-carnitine are acceptable alternative formula-
tions that may be recommended for specific conditions.
Precautions
Women who are pregnant or may become pregnant
should not take carnitine supplements. Breastfeeding
mothers should also avoid them, since they may not be
safe for infants in this situation. Babies requiring a supple-
ment due to low birth weight or pre-term conditions
should have it prescribed and monitored by a healthcare
provider. Those with food allergies to proteins are at risk
of adverse reactions to carnitine. People who have chronic
liver disease are at risk of having high carnitine levels due
to their illness and should not take carnitine supplements.
Side effects
L-carnitine taken by mouth has been known to cause
gastrointestinal symptoms, including nausea, vomiting,
cramps, and diarrhea. DL-carnitine is sometimes asso-
ciated with a syndrome of severe weakness and wasting
of muscle, particularly in patients with kidney disease
who have been on long-term hemodialysis.
Interactions
Valproic acid, a drug sometimes used to treat
seizures, is more likely to cause toxicity if the patient
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Amino acids — Building block units that compose
proteins.
Anticoagulant — Substance that inhibits blood
clotting, used therapeutically for such things as
stroke prevention in susceptible people.
Atherosclerosis — Deposition of fatty plaque on
the inner wall of arteries, hindering blood flow.
Vegan — A person who doesn't eat any meat or an-
imal products, including dairy and eggs.
under treatment has a carnitine deficiency. The drug may
cause decreased carnitine levels. A healthcare provider
should be consulted regarding the advisability of taking
supplemental carnitine under those circumstances. Sup-
plements of carnitine may increase the effects of the an-
ticoagulant medication warfarin.
Resources
BOOKS
Balch, James, and Phyllis Balch. Prescription for Nutritional
Healing. New York: Avery Publishing Group, 1997.
Bratman, Steven, and David Kroll. Natural Health Bible. Prima
Publishing, 1999.
Griffith, H. Winter. Vitamins, Herbs, Minerals & Supplements:
The complete guide. Arizona: Fisher Books, 1998.
Jellin, Jeff, Forrest Batz, and Kathy Hitchens. Pharmacist’ s
Letter/ Prescribe!'’ s Letter Natural Medicines Comprehen-
sive Database. California: Therapeutic Research Faculty,
1999.
Pressman, Alan H., and Sheila Buff. The Complete Idiot’s Guide
to Vitamins and Minerals. New York: Alpha books, 1997.
Judith Turner
Carotenoids
Description
The term carotenoid refers to a family of about 600
different plant pigments that function as antioxidants.
The yellow, orange, and many of the red pigments in
fruits, vegetables, and plant materials are usually
carotenoids. In fall, when deciduous trees prepare for
winter and stop their chlorophyll production, the green
color of the leaves fade and the orange, yellow, and red
colors of the carotenoids in the leaves are revealed before
361
Carotenoids
Carotenoids
the leaves die and fall to the ground. Plants appear to pro-
duce carotenoids to protect their stems and leaves from
the energy of the sun. Ultraviolet (UV) wavelengths can
generate molecules called free radicals that can damage
living cells. Free radicals are molecules, or fragments of
molecules, that are unstable and highly reactive. Free rad-
icals are produced as the result of a normal molecule los-
ing or gaining an electron. In normal, stable molecules,
electrons associate in pairs. However, radiation from the
sun can result in the removal of an electron from a mole-
cule and the formation of free radical. Carotenoids as an-
tioxidants limit free radical damage by donating electrons
to quench, or neutralize, the oxidant radicals.
In human nutrition, carotenoids, as antioxidants,
serve to protect cells from the danger of free radicals that
may be produced by the body during metabolism or by
cigarette smoke, sunlight, radiation, pollutants, or even
stress. Tens of thousands of free radicals are created in
the body every second. When a free radical captures an
electron from another molecule, a new free radical is cre-
ated as the second molecule has a lone, unpaired electron.
This new free radical seeks to capture another electron
and become normal again. This continual process of
forming free radicals becomes a chain reaction. Unless
quenched, these free radicals can damage DNA, fats, and
proteins. However, the body has a defense against these
free radicals. With proper nourishment, the body can
make sufficient quantities of antioxidant enzymes and
substrates for those enzymes that can facilitate the
quenching of free radical reactions by antioxidants. These
enzymes include superoxide dismutase, catalase, and glu-
tathione peroxidase. In addition to these enzymes pro-
duced by the body, antioxidant nutrients taken into the
body through foods or through dietary supplements also
can surrender electrons to the free radicals without
adding to the chain reaction, thus terminating the free
radical reactions. Antioxidant nutrients include vitamins
A, C, and E, bioflavonoids, lipoic acid, and carotenoids.
Despite the large number of carotenoids in nature,
only about 50 are present in foods that people in the
United States eat, and only about 14 of those have been
identified in blood, an indication of what is absorbed in
the human body. All carotenoids are fat-soluble com-
pounds, meaning that they can dissolve in fats and oils,
but not in water. The carotenoid family consists of
smaller families of pigments called carotenes and xan-
thophylls. Carotenes are hydrocarbons, containing only
carbon and hydrogen atoms, while xanthophylls also
contain oxygen. The carotenes have been studied more
than the other carotenoids. The ones of most interest in
human nutrition are beta-carotene, alpha-carotene, and
lycopene. Important xanthophylls include lutein, astax-
anthin, zeaxanthin, and cryptoxanthin.
362
As acceptance of the many health benefits of
carotenoids increases and continues to be proven, the ad-
dition of five individual carotenoids (alpha-carotene,
beta-carotene, lutein, lycopene, and beta-cryptoxanthin)
were added to the National Cancer Institute’s Diet Histo-
ry Questionnaire. The carotenoids appear to have many
health benefits, but more research is required to confirm
many of the health effects seen so far and to identify ad-
ditional benefits.
As one of the most common carotenoids, beta-
carotene is the most well-known and well-studied
carotenoid. It is found in carrots, pumpkins, peaches, and
sweet potatoes. Beta-carotene is the primary precursor to
vitamin A. With the aid of dioxygenase enzymes, the
human body can split one molecule of beta-carotene into
two vitamin A molecules. Vitamin A has many vital
functions in the human body, including being involved
in: (1) the growth and repair of body tissues, (2) the for-
mation of bones and teeth, (3) the resistance of the body
to infection, and (4) the development of healthy eye tis-
sues. Vitamin A deficiency symptoms include night
blindness, dry eyes, dry, rough skin, impaired bone
growth, and susceptibility to respiratory infections. Vita-
min A, is a fat soluble vitamin, can be stored in the body
long-term and can reach toxic levels over time if
amounts above recommended levels (10,000 IU for
adults and only 6,000 IU for pregnant women) are in-
gested. Too much vitamin A can cause headaches, vision
problems, nausea, vomiting, an enlarged liver or spleen,
birth defects, and even death at very high levels. Beta-
carotene is a better source of vitamin A than vitamin A
supplements because it is only converted to vitamin A on
an as-needed basis; excess beta-carotene is stored in the
body and unlike vitamin A, is not toxic when taken in
amounts in excess of body needs. Beta-carotene also im-
proves immune function, increases lung capacity, re-
duces DNA damage, may provide protection from the
sun, and may lessen the risks of some types of cancer.
However, for people who drink and smoke excessively,
beta-carotene may increase their risk of lung cancer.
Alpha-carotene, another common carotenoid, is nor-
mally found in the same foods as beta-carotene. It is sim-
ilar to beta-carotene in structure, with one of the ring
structures being beta-ionone. However, the other ring is
different, so one molecule of alpha-carotene yields only
one molecule of vitamin A. Alpha-carotene has been
found to have powerful anticancer properties in cell-cul-
ture studies.
Lycopene is often the most common carotenoid in
the American diet because it is found in tomato products,
including pizza and spaghetti sauce. It is also present in
lesser amounts in watermelon, pink grapefruit, guava,
and apricots. Lycopene does not produce vitamin A.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
However, lycopene in tomato juice and spaghetti and
pizza sauces has been associated with a lower risk of
prostate cancer in men. In late 2001, the first clinical
trial showed that lycopene supplementation could even
slow progression of prostate cancer growths.
Cooked tomato sauces were to found to be associat-
ed with greater health benefits, compared to uncooked
tomatoes, because the lycopene in the cooked tomatoes
was more easily absorbed. Also, since lycopene is fat-
soluble, absorption increased when it was mixed with oil
in the sauces. Uncooked tomatoes also demonstrated
health benefits, though to a lesser degree, especially
when they were used in a salad with a oil-based dressing
or in a sandwich with fat-containing meat. Lycopene
may help in the prevention of other cancers as well as
protect against heart attacks. A study late in 2001 indi-
cated that lycopene may also help patients with exercise-
induced asthma. Research is continuing on the potential
health benefits of lycopene.
Lutein, which is almost as common as beta-carotene
in the American diet, and zeaxanthin are xanthophylls
found in kale, spinach, broccoli, corn, alfalfa, and egg
yolks. Both are components of the macula of the eye, a
small area in the center of the retina responsible for de-
tailed vision. These carotenoids may prevent and slow
macular degeneration, a leading cause of blindness in
the elderly. As antioxidants, they reduce the amount of
free radical damage to the macula. Lutein may also help
prevent the formation of cataracts, reduce the risk of
heart disease, and protect against breast cancer.
Astaxanthin is a minor carotenoid that serves as a
pigment in aquatic animals such salmon, trout, and
Antarctic krill (small shrimp-like crustaceans that feed
on algae and that serve as a food source for other sea ani-
mals such as whales). Astaxanthin is a strong antioxidant
that appears to enhance the immune system and protect
against cancer. It also may protect against UVA light, a
wavelength of ultraviolet light that can cause sunburn
and skin cancer.
Cryptoxanthin is a minor carotenoid found in peach-
es, papayas, tangerines, and oranges. Cryptoxanthin is
second to beta-carotene in the amount of dietary carotene
converted to vitamin A. Along with other carotenoids, it
forms an antioxidant barrier in the human skin. It also ap-
pears to protect women from cervical cancer.
There are many other minor dietary carotenoids that
most likely provide significant health benefits. A diet
that includes many types of fruits and vegetables is im-
portant for supplying those nutrients and their associated
health benefits.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
General use
Although not classified as essential nutrients,
carotenoids are important substances in human food
sources, especially in fruits, vegetables, and plant greens,
that provide many health benefits. In addition, some are
precursors to vitamin A. They are primarily consumed
through the diet; however the more common carotenoids
are available as dietary supplements.
Preparations
Beta-carotene, lutein, and lycopene are sold as indi-
vidual carotenoid supplements. Beta-carotene is avail-
able in two forms, natural and synthetic. The natural
form is preferred to the synthetic, as the natural form ap-
pears to be a stronger antioxidant. Algae are an abundant
source of beta-carotene and are used to produce supple-
ments. Their presence in a supplement is usually identi-
fied on the label as Dunaliella salina or as some related
type of algae. D. salina produces 10 to 100 times more
beta-carotene than carrots. It grows in areas with strong
sunlight, high temperatures, and salty water, environ-
ments where antioxidants are greatly needed for protec-
tion from free radicals. A dose for adults for beta-
carotene may range up to 10-15 mg, or 25,000 IU, daily.
Lutein is prepared from marigold petals as either free
lutein or lutein ester. Both forms are absorbed well by the
body, though preliminary research has shown that lutein
ester may be assimilated slightly better and be retained
slightly longer than free lutein. For general health, 4-6
mg of lutein should be satisfactory. For those at risk for
macular degeneration, 30-40 mg daily may be useful.
Lycopene supplements are prepared from tomatoes.
A typical daily dose is 4 mg, which is the amount in one
large ripe tomato. Zeaxanthin is not available as a sup-
plement. However, the body can convert some lutein to
zeaxanthin. Also lutein supplements usually contain
some zeaxanthin.
Mixed carotenoid supplements are available, with
different formulations. For example, one typical formula
contains mostly beta-carotene, with smaller amounts of
lutein, zeaxanthin, and cryptoxanthin. Another type con-
tains less beta-carotene but a higher percentage of alpha-
carotene. Mixed carotenes may also be included in some
multi-vitamin and multi-oxidant supplements. Labels of
supplements should be read carefully to determine the
types of carotenoids present and their dosages.
A person consuming the typical American diet ob-
tains only about 1.5 mg of carotenoids per day. The Rec-
ommended Dietary Allowance (RDA), as established by
the United States National Research Council for the pur-
pose of evaluating diets, for vitamin A is 1,000 RE
363
Carotenoids
Carpal tunnel syndrome
(retinol equivalents), or 6 mg of beta-carotene. The
USRDA, established by the United States Food and Drug
Administration as a consumer convenience for labeling
purposes, is 5,000 IU of vitamin A, or 3 mg of beta-
carotene. The United States Department of Agriculture
and the National Cancer Institute have suggested that per-
haps 5-6 mg of carotenoids should be a dietary target. A
study completed in 2001 found that the carotenoids pre-
sent in fruit increased as fruit ripened and that greater
concentrations can be found in the peels than in the pulp.
To enhance dietary health benefits, it may be useful
to supplement a diet high in fruits and vegetables with an
additional 10-15 mg of carotenoids per day. Those with
poor diets may consider supplementation with 25 mg of
supplementation per day. Since it is not possible to put
every beneficial carotenoid in a supplement, the best way
to obtain a wide variety of carotenoids is to eat a diet
containing an assortment of carotenoid-containing foods.
Research has not yet answered the question of
whether a person requires additional vitamin A if he is
taking beta-carotene supplements. Vitamin A is only
available in foods of animal origin, so vegetarians should
consider using vitamin A supplements. Persons with dis-
eases such as diabetes may not be as efficient in convert-
ing beta-carotene into vitamin A, so they need to get
some from their diet or from supplements.
Precautions
A study conducted to investigate the effects of vita-
min E and beta-carotene on the incidence of lung cancer
and other cancers in male smokers indicated that, in the
subjects who were heavy smokers and also were heavy
drinkers, beta-carotene supplements may result in in-
creased adverse health effects, including a slight increase
in cancer. Another study of smokers indicated that high
supplemental doses of beta-carotene and vitamin A in-
creased the risk of lung cancer (though in former smok-
ers, beta-carotene and vitamin A decreased the chances
of developing lung cancer). Additional studies are being
conducted to further investigate the effects of beta-
carotene supplementation. However, it would be prudent
for those who drink heavily or smoke to avoid the use of
beta-carotene supplements and vitamin A.
Side effects
A person taking high doses of beta-carotene and
other carotenoids may develop a yellowish color on his
feet and hands. There is no indication that this is a toxic
effect. If the color is undesirable, the individual should
stop taking the supplements for a month or so, and then
resume them at a lower dose.
364
Interactions
Carotenoids seem to work best together in a comple-
mentary and synergistic manner to provide antioxidant
and other health benefits; they also seem to work well
with other antioxidants. Therefore the use of a mixed
carotenoid supplement in combination with a multi-an-
tioxidant formula, along with a diet rich in a variety of
fruits and vegetables, is most desirable.
Carotenoid supplements are readily assimilated by
the body, but to optimize absorption, they should be
taken with the highest fat-content meal of the day.
Research has not yet determined how the consump-
tion of one type of carotenoid as a supplement may af-
fect the absorption of other carotenoids. One study
showed that beta-carotene reduced the absorption of can-
thaxanthin, another showed that beta-carotene reduced
the levels of lutein in the body, while other studies have
shown that beta-carotene actually increased levels of
other carotenoids in the body. This is an area that re-
searchers are continuing to investigate to gain a better
understanding of potential interactions.
Resources
BOOKS
Challem, Jack. All About Carotenoids. Garden City Park, NY:
Avery Publishing Group, 1999.
Passwater, Richard A. Beta-Carotene and Other Carotenoids.
New Canaan, CT: Keats Publishing, Inc., 1999.
PERIODICALS
Bauer, Jeff. “A Tomato Antioxidant May Relieve Asthma.” RN
(October 2001):21.
Carlson, Mike, et al. “Eat the Peel (Smart Nutrition)." Men’s
Fitness (October 2001):20.
“Clinical Intervention Trial Finds Benefit of Lycopene.” Can-
cer Weekly (November 27, 2001) :38.
Dixon. Lori Beth, AmyF. Subar, and Frances E. Thompson.
“Addition of Five Carotenoids to the National Cancer In-
stitute Diet History Questionnaire Database.” The Journal
of Nutrition (November, 2001)3133S.
Judith Sims
Teresa G. Odle
Carpal tunnel syndrome
Definition
Carpal tunnel syndrome is a disorder caused by
compression at the wrist of the median nerve supplying
the hand, causing numbness and tingling.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Description
The carpal tunnel is an area in the wrist where the
bones and ligaments create a small passageway for the
median nerve. The median nerve is responsible for both
sensation and movement in the hand, in particular the
thumb and first three fingers. When the median nerve is
compressed, an individual’s hand will feel as if it has
“gone to sleep.”
Women between the ages of 30 and 60 have the
highest rates of carpal tunnel syndrome. Research has
demonstrated that carpal tunnel syndrome is a significant
cause of missed work days due to pain. In 1995, about
$270 million was spent on sick days taken for pain from
repetitive motion injuries.
Causes & symptoms
Compression of the median nerve in the wrist can
occur during a number of different conditions, particu-
larly those conditions which lead to changes in fluid ac-
cumulation throughout the body. Because the area of the
wrist through which the median nerve passes is very nar-
row, any swelling in the area will lead to pressure on the
median nerve. This pressure will ultimately interfere
with the nerve’s ability to function normally. Pregnancy,
obesity, arthritis, certain thyroid conditions, diabetes,
and certain pituitary abnormalities all predispose to
carpal tunnel syndrome. Other conditions that increase
the risk for carpal tunnel syndrome include some forms
of arthritis and various injuries to the arm and wrist (in-
cluding fractures, sprains, and dislocations). Further-
more, activities which cause a person to repeatedly bend
the wrist inward toward the forearm can predispose to
carpal tunnel syndrome. Certain jobs that require repeat-
ed strong wrist motions carry a relatively high risk of
carpal tunnel syndrome. Injuries of this type are referred
to as “repetitive motion” injuries, and are more frequent
among secretaries who do a lot of typing, people work-
ing at computer keyboards or cash registers, factory
workers, and some musicians.
Symptoms of carpal tunnel syndrome include numb-
ness, burning, tingling, and a prickly pin-like sensation
over the palm surface of the hand, and into the thumb,
forefinger, middle finger, and half of the ring finger.
Some individuals notice a shooting pain which goes from
the wrist up the arm, or down into the hand and fingers.
With continued median nerve compression, an individual
may begin to experience muscle weakness, making it dif-
ficult to open jars and hold objects with the affected hand.
Eventually, the muscles of the hand served by the median
nerve may begin to grow noticeably smaller (atrophy),
especially the fleshy part of the thumb. Untreated, carpal
tunnel syndrome may eventually result in permanent
The most severe cases of carpal tunnel syndrome may require
surgery to decrease the compression of the median nerve and
restore its normal function. This procedure involves severing
the ligament which crosses the wrist, thus allowing the medi-
an nerve more room and decreasing compression. (Illustration
by Electronic Illustrators Group. The Gale Group.)
weakness, loss of sensation, or even paralysis of the
thumb and fingers of the affected hand.
Diagnosis
The diagnosis of carpal tunnel syndrome is made in
part by checking to see whether the patient’s symptoms
can be brought on by holding his or her hand with the
wrist bent for about a minute. Wrist x rays are often
taken to rule out the possibility of a tumor causing pres-
sure on the median nerve. A physician examining a pa-
tient suspected of having carpal tunnel syndrome will
perform a variety of simple tests to measure muscle
strength and sensation in the affected hand and arm. Fur-
ther testing might include electromyographic or nerve
conduction velocity testing to determine the exact severi-
ty of nerve damage. These tests involve stimulating the
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
365
Carpal tunnel syndrom
Carpal tunnel syndrome
median nerve with electricity and measuring the result-
ing speed and strength of the muscle response, as well as
recording the speed of nerve transmission across the
carpal tunnel. In 2002, a report stated that three medical
organizations had concluded that electrodiagnostic stud-
ies were the preferred methods of diagnosing carpal tun-
nel syndrome, offering the highest degrees of sensitivity
and specificity.
Treatment
Carpal tunnel syndrome is initially treated with
splints, which support the wrist and prevent it from flex-
ing inward into the position that exacerbates median
nerve compression. Some people get significant relief by
wearing such splints to sleep at night, while others will
need to wear the splints all day, especially if they are
performing jobs that stress the wrist.
The activity which caused the condition should be
avoided whenever possible. Also, the actions of making
a fist, holding objects, and typing should be reduced. The
patient’s work area should be modified to reduce stress
on the body. This may be achieved by correct positioning
and with ergonomically designed furniture. Performing
hand and wrist exercises periodically throughout the day
can be beneficial.
Researchers found that the carpal ligament can be
lengthened or released without surgery through osteo-
pathic manipulation and weight loading. Combining the
two gives additional benefit because manipulation length-
ens the ligament at one end and weight loading increases
the length at the other end. Patients can be taught a
stretching exercise for self-manipulation of the ligament.
A National Institute of Health (N1H) panel conclud-
ed that traditional acupuncture may be a useful alterna-
tive or complementary treatment for carpal tunnel syn-
drome. Studies have shown that both laser acupuncture
and microamp transcutaneous electrical nerve stimulation
(TENS) can significantly reduce the pain associated with
carpal tunnel syndrome. Both of these therapies are pain-
less. Greater than 90% of the patients treated reported no
pain or pain that had been reduced by more than half. Pa-
tients in this study were also using Chinese herbal medi-
cines, deep acupuncture (including needle acupuncture),
moxibustion, and omega-3 fish oil capsules. All patients
were able to return to work and the pain of most patients
remained stable for up to two years. Persons over the age
of 60 years had a poorer response.
Some studies have shown that persons with carpal
tunnel syndrome are deficient in vitamin B 6 (pyridoxine)
and that supplementation with this vitamin is beneficial.
Carpal tunnel syndrome should improve within two to
three months by taking 100 mg three times daily. The pa-
366
tient should consult with his or her physician when taking
high doses of this vitamin.
Chinese and homeopathic remedies include:
• arnica; 30c dose
• astra essence
• Rhus toxicodendron; 6c dose
• Ruta graveolens; 6c dose
Allopathic treatment
Ibuprofen or other nonsteroidal anti-inflammatory
drugs may be prescribed to decrease pain and swelling.
Diuretics may be used if the syndrome is related to the
menstrual cycle. When carpal tunnel syndrome is more
advanced, steroids may be injected into the wrist to de-
crease inflammation.
The most severe cases of carpal tunnel syndrome
may require surgery to decrease the compression of the
median nerve and restore its normal function. Such a re-
pair involves cutting that ligament that crosses the wrist,
thus allowing the median nerve more room and decreas-
ing compression. This surgery is done almost exclusively
on an outpatient basis and is often performed without the
patient having to be made unconscious. Careful injection
of numbing medicines (local anesthesia) or nerve blocks
(the injection of anesthetics directly into the nerve) cre-
ate sufficient numbness to allow the surgery to be per-
formed painlessly, without the risks associated with gen-
eral anesthesia. Recovery from this type of surgery is
usually quick and without complications.
In 2002, researchers in the Netherlands reported that
after studying about 80 patients over two years, surgery
proved more successful than nighttime splints in freeing
up compressed nerves of patients with carpal tunnel syn-
drome. Many patients in the splint group ended up
choosing the surgery option after several months of
wearing splints.
Expected results
Without treatment, continued pressure on the median
nerve puts the patient at risk for permanent disability in the
affected hand. Alternative medicines have been shown to
reduce pain. Most people are able to control the symptoms
of carpal tunnel syndrome with splinting and anti-inflam-
matory agents. For those who go on to require surgery,
about 95% will have complete cessation of symptoms.
Prevention
Avoiding or reducing the repetitive motions that put
the wrist into a bent position may help to prevent carpal
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Carpal tunnel — A passageway in the wrist, creat-
ed by the bones and ligaments of the wrist,
through which the median nerve passes.
Electromyography — A type of test in which a
nerve's function is tested by stimulating a nerve
with electricity, and then measuring the speed and
strength of the corresponding muscle's response.
Ergonomic — The science relating to a person and
his/her work which strives for the efficient use of
human energy.
Median nerve — A nerve which runs through the
wrist and into the hand. It provides sensation and
some movement to the hand, the thumb, the
index finger, the middle finger, and half of the ring
finger.
tunnel syndrome. People who must work long hours at a
computer keyboard, for example, may need to take ad-
vantage of recent advances in ergonomics and position
the keyboard and computer components in a way that in-
creases efficiency and decreases stress. Early use of a
splint may also be helpful for persons whose jobs put
them at risk of carpal tunnel syndrome.
Resources
BOOKS
Asbury, Arthur K. “Carpal Tunnel Syndrome.” In Harrison’s
Principles of Internal Medicine, edited by Anthony S.
Fauci, et al. New York: McGraw-Hill, 1998.
Crouch, Tammy. Carpal Tunnel Syndrome and Repetitive
Stress Injuries. Berkeley, CA: Frog, 1995.
PERIODICALS
Branco, Kenneth, and Margaret A. Naeser. “Carpal Tunnel
Syndrome: Clinical Outcome After Low-Level Laser
Acupuncture, Microamps Transcutaneous Electrical
Nerve Stimulation, and Other Alternative Therapies-An
Open Protocol Study.” The Journal of Alternative and
Complementary Medicine 5 (1999):5-26.
Brody, Jane E. “Experts on Carpal Tunnel Syndrome Say that
Conservative Treatment is the Best First Approach.” The
New York Times. 119 (February 28, 1996): B9+.
“Carpal Tunnel Syndrome.” Postgraduate Medicine 98 no. 3
(September 1995): 216.
Glazer, Sarah. “Repetitive Stress Injury: A Modern Malady.”
The Washington Post 110 (March 12, 1996): WH12.
“Guidelines Promote Electrodiagnostic Studies for CTS.” Case
Management Advisor (August 2002): SI.
Lucas, B. “Nonsurgical Technique for Carpal Tunnel Syn-
drome.” Patient Care 33(March 15, 1999): 12.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Seiler, John Gray. “Carpal Tunnel Syndrome: Update on Diag-
nostic Testing and Treatment Options” Consultant. "SI no.
5 (May 1997):1233+.
“Surgery Beats Splints for Wrist Syndrome.” Science News
(September 28, 2002): 205.
ORGANIZATIONS
Association for Repetitive Motion Syndromes. P.O. Box 514.
Santa Rosa, CA 95402. (707) 571-0397.
Belinda Rowland
Teresa G. Odle
Cartilage supplements
Description
Cartilage is a type of dense connective tissue found
in humans and other animals. Bluish-white or gray in
color, the semi-opaque tissue has no nerve or blood sup-
ply of its own. Cartilage supplements come from such
animal sources as cattle, sheep, sharks, and chickens,
with cows and sharks being the predominant sources.
Bovine cartilage supplements are derived from the wind-
pipes of cows, while the cartilage from the heads and
fins of sharks is used for shark supplements.
General use
Both shark and bovine cartilage supplements have
been proposed as treatments for cancer. In addition, a
compound derived from cartilage called chondroitin has
been publicized as a useful treatment for osteoarthritis.
Cartilage preparations are available as pills, powders, or
liquids for oral dosage. They can also be given as ene-
mas, topical applications, or intravenous or intramuscu-
lar injections.
Bovine cartilage supplements
Beginning in the 1950s, a physician named John F.
Prudden noticed that bovine cartilage could enhance
wound healing in animals. Dr. Prudden then injected an
extract of bovine cartilage into a breast cancer patient
whose tumor had ulcerated her skin. The patient’s tumor
ultimately disappeared, and she lived for 12 years before
dying of other causes. In 1985, Prudden published the
first of several scientific papers on the subject.
Dr. Prudden believes that the anticancer ingredients
in bovine cartilage are mucopolysaccharides, which are
complex sugar molecules that help fight cancer by stimu-
lating the patient’s immune system. Prudden also states
367
Cartilage supplements
Cartilage supplements
that these large sugar molecules act on tumor cell mem-
branes by blocking mitosis (cell division). Other pro-
posed explanations of the effectiveness of bovine carti-
lage include the inhibition of protease, which is an en-
zyme that helps to break down proteins; and by blocking
the formation of enzymes that break down collagen pro-
teins. Numerous bovine cartilage supplements have been
made available for immunostimulation or to fight off
cancer cells. Most reports on tumor response and the sur-
vival of cancer patients after cartilage treatment, howev-
er, are anecdotal.
Shark cartilage supplements
The use of shark cartilage to treat cancer is based on
the claim that it blocks angiogenesis, or the development
of new blood vessels that tumors need to survive. A re-
searcher at Harvard Medical School in the 1970s, Judah
Folkman, M.D., developed the theory of angiogenesis.
Dr. Folkman ’s proposal that tumors, much like a normal
organ or mass of cells, require a supply of blood to deliv-
er nutrients for growth, has since become closely linked
to the treatment of cancer with shark cartilage.
In 1983, William Lane, Ph.D., motivated by Folk-
man’s research, began investigating the possible link be-
tween shark cartilage and its ability to starve tumors with
an antiangiogenetic mechanism. In 1993, Lane published
his book Sharks Don’t Get Cancer, making shark cartilage
one of the leading alternative cancer therapies, with 99% of
the cartilage market in 1997 comprised of shark cartilage.
The use of shark cartilage as an alternative treatment
has been opposed by wildlife experts who say that use of
the substance threatens the shark population. According
to figures for 1997, more than one hundred thousand
sharks are killed each year to produce cartilage products.
Further research has also shattered the myth that sharks
do not get cancer. A study discussed at a cancer research
meeting in 2000 documented about a dozen cases of ap-
parent cancer in sharks, including cancer of the cartilage.
Both shark and bovine cartilage have been used to
treat a wide variety of cancers, including tumors of the
breast, ovary, cervix, prostate, rectum, colon, stomach,
kidney, and brain. The U.S. Food and Drug Administra-
tion (FDA) maintains that both types of cartilage can be
tested as potential cancer therapy in clinical trials, but
must be sold strictly as dietary supplements. Dietary sup-
plement manufacturers are also prohibited from making
specific claims that the supplements can cure disease.
While some studies have shown positive results
from both bovine and shark supplements as a treatment
for cancer, continued research is being conducted to de-
termine their effectiveness. Some studies indicate that
the proposed antiangiogenetic effects of shark cartilage
368
are ultimately destroyed by digestion, and the substance
therefore is unlikely to be effective when taken orally.
The results from the phase II Cancer Treatment Centers
of America (CTCA) shark cartilage study were pub-
lished in November 1998. The report concluded that oral
shark cartilage given as a single agent was ineffective in
47 patients with advanced cancer.
Chondroitin sulfate
Chondroitin is best known to the general public as a
remedy for osteoarthritis, which is a form of arthritis
caused by wearing away or degeneration of the cartilage
that cushions the ends of bones. It is thought that the
drying out of cartilage tissue in osteoarthritis is a major
cause of tissue destruction. Chondroitin sulfate is given
together with glucosamine, a compound that is a build-
ing block of cartilage. The chondroitin helps to attract
and hold fluid within cartilage tissue. Tissue fluid keeps
cartilage healthy in two ways: it acts as a shock absorber
within the joints of the body, thus protecting cartilage
from being worn away by the bones; and it carries nutri-
ents to the cartilage.
Several randomized double-blind studies of chon-
droitin in osteoarthritis patients were conducted in
France and Italy in 1998. The European studies demon-
strated that oral, as well as injected, chondroitin helps to
increase joint mobility and reduce pain. A landmark
2001 study showed that combining glucosamine and
chondroitin worked better than either alone in preventing
cartilage damage and that both supplements worked well
when taken orally.
Preparations
Shark and bovine cartilage supplements are avail-
able in capsule form, while shark is also sold as a pow-
der and liquid. Shark supplements are made from
ground-up shark skeletons (mainly the fins and head),
while bovine supplements are prepared from the carti-
lage taken from cow bones. Chondroitin sulfate can be
taken orally as a pill, powder, or liquid. It can also be ad-
ministered by injection. Oral preparations of chon-
droitin, by itself or in combination with glucosamine, are
available in the United States as over-the-counter (OTC)
dietary supplements. They can be purchased over the In-
ternet, at pharmacies, health food stores, or even some
grocery stores.
The recommended dosage of shark and bovine carti-
lage varies per person and individual need. General
guidelines indicate that the effective dose of shark carti-
lage is 1 g daily per kilogram of body weight — the equiv-
alent to almost 70 g per day for a 150-pound individual.
With observed shrinkage of the tumor, the dosage may be
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
lowered. The recommended bovine cartilage dosage per
day is 9 g. With both supplements, patients must keep
taking the same dose, and include the supplements in
their diets for life. The cost of shark cartilage for six
months of therapy was estimated at $3,000-6,000 in
1997. The same amount of bovine cartilage was estimat-
ed to cost about $1,000 at this time.
Precautions
While cartilage supplements do not appear to be
harmful, persons who are considering them as a cancer
treatment should not use them as their sole form of ther-
apy and should consult their doctor before taking them.
Persons who are considering chondroitin as a treatment
for joint pain should be careful not to diagnose them-
selves. They should check with their physician to be sure
that the pain is caused by osteoarthritis. Some condi-
tions, including Lyme disease, gout, bursitis, and
rheumatoid arthritis, can also cause pain in the joints.
Although chondroitin appears to be helpful in treating
osteoarthritis, it is not useful for these other conditions.
Chondroitin has not been studied in children or in preg-
nant or nursing women.
Side effects
Both shark and bovine cartilage supplements show
little or no side effects when taken at the appropriate
dosage levels. Some patients have reported an allergic
reaction to traces of bovine protein or other side effects
that include a bad taste in the mouth, fatigue, and nau-
sea. Shark cartilage can cause hypercalcemia (excessive
amounts of calcium in the body) when taken at the rec-
ommended daily dose of 70 g per day. This dosage re-
sults in 14 times the amount of calcium recommended by
the United States Recommended Daily Allowance
(USRDA). Some patients taking chondroitin have been
known to experience nausea and gas or bloating.
Interactions
Chondroitin sulfate is not known to cause any sig-
nificant interactions with other medications. One re-
searcher, however, has suggested that chondroitin might
increase the effect of anticoagulant drugs and should
probably not be used in combination with them.
Resources
BOOKS
Theodosakis, Jason, MD, MS, MPH, Brenda Adderley, MHA,
and Barry Fox, PhD. The Arthritis Cure. New York: St.
Martin’s Press, 1997.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Angiogenesis — The development of new blood
vessels, specifically those that supply tumors with
blood and nutrients for growth.
Chondroitin — A complex carbohydrate found in
human and animal cartilage that is used to treat sev-
eral physical disorders, most importantly arthritis.
Glucosamine — A complex carbohydrate com-
posed of glucose and an amino acid called gluta-
mine. It is an important building block of cartilage
and is often taken together with chondroitin as a
treatment for osteoarthritis.
Mucopolysaccharide — An older term for a class of
large sugar molecules that are found in cartilage
and other forms of connective tissue. Mucopolysac-
charides are now called glycosaminoglycans.
PERIODICALS
Theodosakis, Jason. “Relief for your Painful Joints (Wellness).”
Better Nutrition (May 2002):32.
ORGANIZATIONS
National Cancer Institute Cancer Information Service (CIS).
(800) 4-CANCER or TTY: (800) 332-8615. http://www.
cancemet.nci.nih.gov.
NIH National Center for Complementary and Alternative Med-
icine (NCCAM). NCCAM Clearinghouse. Post Office
Box 8218. Silver Spring, MD 20907-8218. TTY/TDY:
(888) 644-6226.
OTHER
Center for Alternative Medicine Research in Cancer Home Page.
http://www.sph.uth.tmc.edu/utcam/therapies/crtlg.htm
(January 17, 2001).
Beth Rapes
Teresa G. Odle
Castor oil
Description
Castor oil is a natural plant oil obtained from the
seed of the castor plant. The castor seed, or bean, is the
source of numerous economically important products as
one of the world's most important industrial oils, and
was one of the earliest commercial products. Castor
beans have been found in ancient Egyptian tombs dating
369
Castor oil
Castor oil
back to 4000 B.c. According to the Ebers Papyrus, an
Egyptian medical text from 1500 B.c., Egyptian doctors
used castor oil to protect the eyes from irritation. The oil
from the bean was used thousands of years ago in facial
oils and in wick lamps for lighting. Castor oil has been
used medicinally in the United States since the days of
the pioneers. Traveling medicine men in the late 1800s
peddled castor oil, often mixed with as much as 40% al-
cohol, as a heroic cure for everything from constipation
to heartburn. It was also used to induce labor. At the
present time, castor oil is used internally as a laxative
and externally as a castor oil pack or poultice.
The castor plant, whose botanical name is Ricinus
communis, is native to the Ethiopian region of east
Africa. It now grows in tropical and warm temperate re-
gions throughout the world and is becoming an abundant
weed in the southwestern United States. Castor plants
grow along stream banks, river beds, bottom lands, and
in almost any warm area where the soil is well drained
and with sufficient nutrients and moisture to sustain
growth. They are annuals that can grow 6-15 ft (1.8-5
m) tall in one season with full sunlight, heat, and mois-
ture. The tropical leaves, with five to nine pointed, fin-
ger-like lobes, may be 4-30 in (10-76 cm) across. Flow-
ers occur on the plant (which is monoecious, meaning
that there are separate male and female flowers on the
same individual), during most of the year in dense termi-
nal clusters, with female flowers just above the male
flowers. Each female flower consists of a spiny ovary,
which develops into the fruit or seed capsule, and a
bright red structure with feathery branches (stigma
lobes) to receive pollen from the male flowers. Each
male flower consists of a cluster of many stamens that
shed pollen that is distributed by wind. The spiny seed
pod or capsule is composed of three sections, or carpels,
that split apart at maturity. Each carpel contains a single
seed. As the carpel dries and splits open, the seed is
ejected, often with considerable force. The seeds are
slightly larger than pinto beans and are covered with in-
tricate mottled designs, none of which have exactly the
same pattern due to genetic variations. At one end of the
seed is a small spongy structure called the caruncle,
which aids in the absorption of water when the seeds
are planted.
The name “castor” was given to the plant by English
traders who confused its oil with the oil of another shrub,
Vitex agnus — Castus, which the Spanish and Portuguese
in Jamaica called agno-casto. The scientific name of the
plant was given by the eighteenth-century Swedish natu-
ralist Carolus Linnaeus. Ricinus is the Latin word for
tick; apparently Linnaeus thought the castor bean looked
like a tick, especially a tick in engorged with blood, with
the caruncle of the bean resembling the tick’s head.
370
Communis means “common” in Latin. Castor plants
were already commonly naturalized in many parts of the
world by the eighteenth century.
There are several cultivated varieties of the castor
plant, all of which have striking foliage colorations. The
castor plant grows rapidly with little care and produces
lush tropical foliage. Its use as a cultivated plant should
be discouraged because its seeds or beans are extremely
poisonous. Children should be taught to recognize and
avoid the plant and its seeds, especially in the southwest-
ern United States where it grows wild near residential
areas. Flower heads can be snipped off of castor plants as
a protective measure.
The active poison in the castor bean is ricin, a dead-
ly water-soluble protein called a lectin. The ricin is left
in the meal or cake after the oil is extracted from the
bean, so castor oil does not contain any of the poison.
The seed is only toxic if the outer shell is broken or
chewed. Humans and horses are most susceptible to
ricin, although all pets and livestock should be kept away
from the castor seed. It has been estimated that gram for
gram, ricin is 6,000 times more deadly than cyanide and
12,000 times more deadly than rattlesnake venom. A
dose of only 70 pgrams, or one two-millionth of an
ounce (roughly equivalent to the weight of a single grain
of table salt) is enough to kill a 160-pound person. Even
small particles in open sores or in the eyes may be fatal.
As few as four ingested seeds can kill an adult human.
Lesser amounts may result in vomiting, severe abdomi-
nal pain, diarrhea, increased heart rate, profuse sweat-
ing, and convulsions. Signs of toxicity occur about
18-24 hours after ingestion. Ricin seems to cause
clumping (agglutination) and breakdown (hemolysis) of
red blood cells, hemorrhaging in the digestive tract, and
damage to the liver and kidneys.
Ricin has attracted considerable attention as of early
2003 because of its association with terrorist groups. Al-
though ricin cannot easily be used against large groups
of people, it has been used to assassinate individuals by
injection. The Centers for Disease Control and Preven-
tion (CDC) considers ricin a B-list bioterrorism agent,
meaning that it is relatively easy to make and is consid-
ered a moderate threat to life.
On the positive side, ricin is being investigated as a
tool for cancer treatment. A promising use is the produc-
tion of an immunotoxin in which the protein ricin is
joined to monoclonal antibodies. The ricin-antibody con-
jugate, which is produced in a test tube, should theoreti-
cally travel directly to the site of a tumor, where the ricin
can destroy the tumor cells without damaging other cells
in the patient.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
General use
Internal uses
Castor oil is a strong and effective cathartic or purga-
tive (laxative), with components in the oil that affect both
the small and large intestines. It has been used to clear the
bowels after food poisoning and to relieve constipation.
It is sometimes used in hospitals to prepare the patient’s
abdomen for x rays of the colon or kidneys. Castor oil is
classified as a stimulant laxative, also known as a contact
laxative. This type of laxative encourages bowel move-
ments by acting on the intestinal wall, increasing the
muscle contractions that move along the stool mass.
Stimulants are a popular type of laxative for self-treat-
ment, but unfortunately are more likely to cause side ef-
fects. There are milder types of laxatives that may be
more useful for inducing regularity and treating constipa-
tion. Generally laxatives should be used to provide short-
term relief only, unless otherwise directed by a doctor.
Castor oil is frequently used in animal experiments
to test the effects of new medications on the gastroin-
testinal tract.
If castor oil has been prescribed by a doctor, his or
her instructions for the timing and quantity of doses
should be followed. For self-treatment, users should fol-
low the manufacturer’s instructions. At least 6-8 glasses
(8 oz each) of liquids should be taken each day to soften
the stools. Castor oil is usually taken on an empty stom-
ach for rapid effect. Because results usually occur within
two to six hours, castor oil is not usually taken late in the
day. The unpleasant taste of castor oil may be improved
by chilling it in the refrigerator for at least an hour. It
may then be stirred into a glass of cold orange juice. Fla-
vored preparations of castor oil are also available.
External uses
Castor oil is also used topically to treat corns. The
oil is applied once or twice daily directly to the corns,
which are surrounded with adhesive-backed corn aper-
ture pads made of felt to hold the oil. The corns are then
covered with hypoallergenic silk tape. After soaking with
the castor oil, the corns will be softened for removal with
a pumice stone. Castor oil can be used in a similar man-
ner to remove warts. Castor oil is also used to treat ring-
worm, abscesses, bruises, dry skin, dermatitis, sun-
burn, open sores, and other skin conditions. Additional
less well-known uses of castor oil include hair tonics,
cosmetics, and contraceptive creams and jellies.
For menstrual cramping, especially when fibroids
may be present or when flows are heavy, castor oil packs
may be placed on the abdomen for up to an hour. The
packs are made by soaking square or rectangular pieces
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
of cotton, cotton flannel, or undyed wool 2-4 in (5-10
cm) thick with 4-6 oz 118-177 ml) of castor oil. The
pack is folded over once or twice, placed directly on the
abdomen, and covered with plastic wrap. Over the pack,
a water bottle or a heating pad on a low setting may be
used to keep the pack warm. After use, the skin may be
cleansed with a warm solution of baking soda and water
(2 tsp of baking soda to 1 qt water). Some herbal thera-
pists maintain that castor oil packs may aid in shrinking
small fibroids. Castor oil packs have also been used in
the treatment of many other diseases and disorders, in-
cluding breast pain, digestive tract problems, abscesses,
hemorrhoids, wounds, and gallstones.
Nonmedical uses
Castor oil and its derivatives also are used in many
industrial products, including paint and varnish, fabric
coatings and protective coverings, insulation, food con-
tainers, soap, ink, plastics, brake fluids, insecticidal oils,
and guns. It is a primary raw material for the production
of nylon and other synthetic resins and fibers, and a
basic ingredient in racing motor oil for high-perfor-
mance automobile and motorcycle engines. Castor oil is
also used as a fuel additive for two-cycle engines, im-
parting a distinctive aroma to their exhaust. Even though
it is malodorous and distasteful, it is the source of several
synthetic flower scents and fruit flavors.
Preparations
Castor oil for medicinal purposes is pressed from
the seeds of the castor plant and is slightly yellow or col-
orless. It has a lingering nauseating aftertaste, even
though peppermint or fruit juices are sometimes added
as flavor enhancers in an attempt to disguise its disagree-
able taste. Castor oil is available in both oil and emulsi-
fied liquid preparations.
Precautions
Castor oil should not be used by a pregnant woman,
as it can cause contractions. Castor oil should not be used
if a patient is hypersensitive to the castor bean; or has an
intestinal obstruction, abdominal pain, cramping, bloat-
ing, soreness, nausea, vomiting, fecal impaction, or any
signs of appendicitis or an inflamed bowel. It should not
be used by anyone for more than a week unless a doctor
has ordered otherwise. Overuse of a laxative may lead to
dependence on it. Any sudden changes in bowel habits or
function that last longer than two weeks should be
checked by a doctor before using a laxative.
Children up to the age of six should not take a laxa-
tive unless prescribed by a doctor. In older adults, the use
371
Castor oil
Cataracts
of castor oil may worsen weakness, lack of coordination,
or dizziness and light-headedness.
External overexposure to castor oil may result in a
slight local skin irritation. The irritated area should be
washed with soap and water.
Side effects
Side effects of castor oil that require medical atten-
tion include:
• confusion
• irregular heartbeat
• muscle cramps
• skin rash
• unusual tiredness or weakness
There are other less serious side effects that are less
common and may go away as the patient’s body adjusts
to the castor oil. These side effects include belching,
cramping, diarrhea, and nausea. If they do continue or
are bothersome, the person should check with a doctor.
In addition, because castor oil causes a complete empty-
ing of the contents of the intestine, patients should be ad-
vised that they may not have another bowel movement
for two to three days after a dose of castor oil.
Interactions
Patients should not take castor oil within two hours
of taking other types of medicine, because the desired ef-
fect of the other medicine may be reduced. Patients who
are taking digitalis, digoxin, or a diuretic should consult
their physician before taking castor oil, as the castor oil
may intensify the effects of these drugs by causing the
body to lose potassium.
Resources
BOOKS
McGarey, William G. The Oil That Heals: A Physician’ s Suc-
cesses with Castor Oil Treatments. A.R. E. Press, 1993.
Wilson, Billie Ann, et al. Nurses Drug Guide 1995. Norwalk,
CT: Appleton & Lange, 1995.
PERIODICALS
Layne, Marty. “Castor Oil: A Great Home Remedy for Bumps,
Bruises and Cuts.” Natural Life (July-August 2002): 14-15.
Lyall, Sarah. “Arrest of Terror Suspects in London Turns Up a
Deadly Toxin.” New York Times, January 8, 2003.
Rahman, M. T., M. Alimuzzaman, S. Ahmad, et al. “Antinoci-
ceptive and Antidiarrhoeal Activity of Zanthoxylum
rhetsa.” Fitoterapia 73 (July 2002): 340-342.
Sandvig, K., and B. van Deurs. "Transport of Protein Toxins
Into Cells: Pathways Used by Ricin, Cholera Toxin and
Shiga Toxin." FEBS Letter 529 (October 2, 2002): 49-53.
372
KEY TERMS
Bioterrorism — The use of biological agents, in-
cluding plant-derived toxic materials like ricin, to
frighten and intimidate large populations.
Digitalis — A type of medication, originally de-
rived from the foxglove plant, used as a heart
stimulant.
Ricin — An extremely poisonous protein derived
from castor beans.
ORGANIZATIONS
Centers for Disease Control and Prevention (CDC). 1600
Clifton Road, Atlanta, GA 30333. (404) 639-3311.
<www.cdc.gov>.
National Digestive Diseases Information Clearinghouse. Na-
tional Institute of Diabetes and Digestive and Kidney Dis-
ease. National Institutes of Health. 2 Information Way.
Bethesda, MD 20892-3570. (310) 654-3810.
Judith Sims
Rebecca J. Frey, PhD
Cataracts
Definition
A cataract is a cloudiness or opacity in the normally
transparent crystalline lens of the eye. This cloudiness can
cause loss of vision and may lead to eventual blindness.
Description
The human eye has several parts. The outer layer of
the eyeball consists of a transparent dome-shaped cornea
and an opaque white sclera, which is a fibrous mem-
brane. The cornea and sclera help protect the eye. The
next layer includes the iris, pupil, and ciliary body. The
iris is the colored part of the eye; the pupil is the small
dark round hole in the middle of the iris. The pupil and
iris allow light into the eye. The ciliary body contains
muscles that help the eye to focus. The lens lies behind
the pupil and iris. It is covered by a cellophane-like cap-
sule. The lens is normally transparent, elliptical in shape,
and somewhat elastic. This elasticity allows the lens to
focus on both near and far objects. The lens is attached
to the ciliary body by fibers (zonules of Zinn). Muscles
in the ciliary body act on the zonules, which then change
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
the shape of the lens. This changing of shape is called
accommodation. As people age, the lens hardens and ac-
commodates less easily, which makes it harder for the
person to see close objects. This hardening of the lens
generally occurs around the age of 40 and continues until
about age 65. The condition is called presbyopia. It is a
normal condition of aging, generally resulting in the
need for reading glasses.
The lens is made up of approximately 35% protein
and 65% water. As people age, the proteins in the lens
begin to degenerate. Changes in the proteins, water con-
tent, enzymes, and other chemicals are some of the caus-
es of cataract formation.
The major parts of the lens are the nucleus, the cor-
tex, and the capsule. The nucleus is in the center of the
lens, the cortex surrounds the nucleus, and the capsule is
the outer layer. Opaque areas can develop in any part of
the lens. Cataracts, then, can be classified according to
location (nuclear, cortical, or posterior subcapular
cataracts). The density and location of the cataract deter-
mines the extent of vision affected. If the cataract forms
in the area of the lens directly behind the pupil, the per-
son’s vision may be significantly impaired. A cataract
that occurs on the outer edges or side of the lens will
cause less severe impairment.
Cataracts in the elderly are so common that they are
considered a normal part of the aging process. People
between the ages of 52-64 have a 50% chance of devel-
oping a cataract, while at least 70% of those 70 and older
are affected. Cataracts associated with aging (senile or
age-related cataracts) most often occur in both eyes, with
each cataract progressing at a different rate. At first,
these cataracts may not affect vision. If the cataract re-
mains small or at the periphery of the lens, the visual
changes may be minor.
Cataracts that occur in people other than the elderly
are much less common. Congenital cataracts occur very
rarely in newborns. Genetic defects or an infection or
disease in the mother during pregnancy are among the
causes of congenital cataracts. There is a condition
called blue cataracts, which is inheritance-linked and af-
fects primarily Tibetans and some other Asians. Trau-
matic cataracts may develop after an injury or foreign
body damages the lens or eye. Systemic illnesses like di-
abetes may result in cataracts. Cataracts can also occur
secondary to other eye diseases — for example, an in-
flammation of the inner layer of the eye (uveitis) or
glaucoma. Such cataracts are called complicated
cataracts. Toxic cataracts result from chemical toxicity,
such as steroid use. Cataracts can also result from expo-
sure to the sun’s ultraviolet (UV) rays.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
A dense cataract on the lens of eye. The lens, which should
be clear, is so clouded that that the lines are obscured.
(Photograph by Margaret Cubberly, Phototake NYC. Repro-
duced by permission.)
Causes & symptoms
Recent studies have been conducted to determine
whether diet or the use of vitamins might have an effect
on the formation of cataracts in older people. Although
debate continues, several studies reported in late 2001
that a diet rich in certain caretenoids may protect against
development of cataracts. Likewise, there has been con-
siderable interest in the use of antioxidant supplements
as a protection against cataracts. Such antioxidant vita-
mins as vitamins A, C, E, and beta-carotene protect body
tissues against free radicals, which are byproducts of ox-
idation. Vitamin C in particular, has shown the strongest
impact on lower rates of cataracts. Some vitamins are
marketed specifically for the eyes. Patients should speak
to their doctors about the use of such vitamins.
Studies also have recently linked changes in lens
proteins to cataract formation. Soluble proteins in the
lens begin to condense and form clumps, leading to
cataracts. Researchers have identified mutations in genes
that likely lead to protein changes resulting in juvenile
cataracts. The next step is to study a possible genetic re-
lationship to formation of age-related cataracts as well.
Smoking and alcohol intake have been implicated
in cataract formation. Some studies have determined that
a diet high in fat will increase the likelihood of cataract
formation, while eating more foods rich in antioxidants
will lower the risk. More research is needed to determine
if diet, smoking, alcohol consumption, or vitamins have
any connection to the formation of cataracts.
Cataracts may have the following symptoms:
• gradual, painless onset of blurry, filmy, or fuzzy vision
• poor central vision
• frequent changes in eyeglass prescription
373
Cataracts
Cataracts
• changes in color vision
• increased glare from lights, especially oncoming head-
lights when driving at night
• “second sight” improvement in near vision (no longer
needing reading glasses), but a decrease in distance vi-
sion
• poor vision in sunlight
• the presence of a milky whiteness in the pupil as the
cataract progresses
Diagnosis
Both ophthalmologists and optometrists may detect
and monitor cataract growth and prescribe prescription
lenses for visual deficits. Only an ophthalmologist, how-
ever, can perform cataract extraction.
Cataracts are easily diagnosed from the reporting of
symptoms, a visual acuity examination using an eye
chart, and by a physician or optometrist’s examination of
the eye. Shining a penlight into the pupil may reveal
opacities or a color change of the lens even before the
patient develops visual symptoms. A slit lamp, which is
basically a large microscope, allows the doctor to exam-
ine the front of the eye and the lens, and to determine the
location of the cataract.
Some other diagnostic tests may be used to determine
if cataracts are present or how much improvement the pa-
tient may have after surgery. These tests include a glare
test, potential vision test, and contrast sensitivity test.
Treatment
Because free radicals have been implicated as a
cause of cataracts, alternative therapies emphasize the
importance of a healthful diet, nutritional supplements
and/or herbal remedies to prevent and slow down the
progression of cataracts.
Nutritional therapy
A naturopathic doctor or a nutritionist may recom-
mend the following dietary changes:
• Reduce consumption of salty or fatty foods. Diabetics
should also limit their intake of milk and other dairy
products.
• Increase intake of foods that are high in beta-carotene:
peaches, apricots, berries, carrots, and leafy green veg-
etables. Beta-carotene and other antioxidants can pro-
tect against or slow down the development of cataracts.
• Stop cigarette smoking and avoid exposure to second-
hand smoke.
374
• Eat a diet rich in fruits and vegetables with high con-
centrations of vitamin C. Take supplemental vitamin C
(1 g three times daily) and vitamin A (25,000 1U per
day).
• Take supplemental beta-carotene (25,000-100,000 IU
per day) and selenium (400 meg per day). Low seleni-
um levels may increase the risk of cataracts.
• Increase intake of L-cysteine (400 mg per day), L-glut-
amine (200 mg per day), and L-glycine (200 mg per
day). These three amino acids may be beneficial to
some cataract patients.
•Add other supplements: zinc, lutein, riboflavin, and
cod liver oil.
Herbal therapy
There are two herbal remedies that may help protect
the eyes against cataracts:
• Bilberries (40-80 mg daily). Early research indicates
that eating bilberries may halt cataract progression.
• Hachimijiogan. Hachimijiogan is an ancient Chinese
herbal formula. Animal studies suggest that it may pro-
tect the eyes against cataracts by increasing the glu-
tathione content of the lens.
Allopathic treatment
Cataracts that cause no symptoms or only minor vi-
sual changes may not require any treatment. An ophthal-
mologist or optometrist should continue to monitor and
assess the cataract at scheduled office visits. Stronger
prescription eyeglasses or contact lenses may be helpful.
Cataract surgery is the only option for patients
whose cataracts interfere with vision to the extent of af-
fecting their daily lives. It is the most frequently per-
formed surgery in the United States. It generally im-
proves vision in over 90% of patients. Some people have
heard that a cataract should be “ripe” before being re-
moved. A “ripe” or mature cataract means that the lens is
completely opaque. Most cataracts are removed before
they reach that stage. Sometimes cataracts need to be re-
moved so that the doctor can examine the back of the eye
more carefully. Patients with diseases that may affect the
eye may require cataract surgery for this reason. If
cataracts are present in both eyes, only one eye at a time
should be operated on. Healing occurs in the first eye be-
fore the second cataract is removed, sometimes as early
as the following week. A final eyeglass prescription is
usually given about four to six weeks after surgery. Pa-
tients will still need reading glasses. The overall health
of the patient needs to be considered in making the deci-
sion to operate. Age alone, however, need not preclude
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
effective surgical treatment of cataracts; people in their
90s can benefit from cataract surgery.
Patients are given antibiotic drops to prevent infec-
tion and steroids to reduce inflammation after surgery.
An eye shield or glasses during the day will protect the
eye from injury while it heals. At night, the patient
should wear an eye shield. The patient returns to the doc-
tor the day after surgery for assessment, with several fol-
low-up visits over the next two months to monitor the
healing process.
Expected results
The success rate of cataract extraction is very high,
with a good prognosis. Visual acuity of 20/40 or better
may be achieved. If an extracapsular cataract extraction
was performed, a secondary cataract may develop in the
remaining back portion of the capsule one to two years
after surgery. YAG capsulotomy is most often used to
treat this type of cataract. YAG stands for yttrium alu-
minum garnet, the name of the laser used for this proce-
dure. The laser beam makes a small opening in the re-
maining back part of the capsule, allowing light through.
Complications occur in a very small percentage
(3-5%) of surgical cataract extractions. Infections,
swelling of the cornea (edema), bleeding, retinal de-
tachment, and the onset of glaucoma have been report-
ed. Any haziness, redness, decrease in vision, nausea,
or pain should be reported to the surgeon immediately.
Prevention
Preventive measures emphasize protecting the eyes
from UV radiation by wearing glasses with a special
coating to protect against UV rays. Dark lenses alone are
not sufficient. The lenses must protect against UV light
(specifically, UV-A and UV-B). Antioxidants and herbal
remedies may also provide some protection by reducing
free radicals that can damage lens proteins. A healthful
diet rich in sources of antioxidants, including citrus
fruits, sweet potatoes, carrots, green leafy vegetables,
and/or vitamin supplements may be helpful. When tak-
ing certain medications, such as steroids, more frequent
eye exams may be necessary. Patients should speak to
their doctors to see if medications may affect their eyes.
Resources
BOOKS
“Cataract.” Medical-Surgical Nursing: Concepts and Clinical
Practice, fifth edition. Edited by Wilma J. Phipps et al. St.
Louis, MO: Mosby-Year Book, Inc., 1995.
Liberman, Shari, and Nancy Bruning. The Real Vitamin & Min-
eral Book: Using Supplements for Optimal Health,, 2nd
ed. Garden City Park, NY: Avery Publishing Group, 1997.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Glaucoma — An eye disease characterized by in-
creased pressure of the fluid inside the eye. Un-
treated, glaucoma can lead to blindness.
Hachimijiogan — A Chinese herbal formula that is
thought to protect the eyes against cataracts by in-
creasing the glutathione content of the lens.
Slit lamp — A special viewing device used by eye
specialists to examine the eye for cataracts.
Ultraviolet radiation (UV) — Electromagnetic radi-
ation that is shorter than visible light rays but
longer than x rays. UV is thought to be responsi-
ble for sunburns, skin cancers, and cataract for-
mation.
Uveitis — Inflammation of the uvea, which is a
continuous layer of tissue consisting of the iris, the
ciliary body, and the choroid. The uvea lies be-
tween the retina and sclera.
YAG — Yttrium aluminum garnet, a type of laser
used to perform surgery on secondary cataracts.
Murray, Michael, and Joseph Pizzorno. Encyclopedia of Natur-
al Medicine. Revised second ed. Rocklin, CA: Prima
Health, 1997.
PERIODICALS
Friedrich, MJ. “Insight Into Opacity: Clues to Cataract Forma-
tion." JAMA, The Journal of the American Medical Asso-
ciation 286 no. 14 (October 10, 2001): 1705.
"Nutrients May Prevent Age-Related Eye Diseases.” Health
and Medicine Week (November 26,2001): 2.
ORGANIZATIONS
American Academy of Ophthalmology (National Eyecare Pro-
ject). P.O. Box 429098. San Francisco, CA 94142-9098.
(800) 222-EYES, http://www.eyenet.org.
American Optometric Association. 243 North Lindbergh Blvd.
St. Louis, MO 63141. (314) 991-4100. http://www.aoanet.
org.
The Lighthouse. 1 1 1 East 59th Street. New York, NY 10022.
(800) 334-5497. http://www.lighthouse.org.
Prevent Blindness America. 500 East Remington Road.
Schaumburg, IL 60173. (800) 331-2020. http://www.
prevent-blindness.org.
Teresa G. Odle
Catmint see Catnip
375
Cataracts
Catnip
Catnip
Description
Catnip, or Nepeta cataria, is a flowering herb valued
for its healing properties in a wide range of maladies.
Catnip is indigenous to Europe and is now naturalized
throughout the United States. It can be identified by the
dozens of small white flowers with small purple spots
covering its flowering, spiky top. The aromatic herb is a
member of the Lamaciae or mint family; in England it is
sometimes called catmint. Catnip is harvested in the sum-
mer and fall, and dried for medicinal use.
General use
Both the flowering tops and the leaves of the catnip
plant are used for medicinal purposes. Catnip is used to
treat a variety of symptoms and illnesses, including:
• Gastrointestinal distress. Catnip has carminative prop-
erties, which means that it is helpful in preventing gas
and related nausea, colic, and diarrhea.
• Muscle cramps. The herb’s antispasmodic properties pro-
mote relaxation of the gastrointestinal muscles, the uterus
(for menstrual cramps), and other tight or sore muscles.
• Nervous disorders. Catnip can be used as a sedative to
relieve stress, ease anxiety, relieve the symptoms of
migraines and tension headaches, and promote general
relaxation.
• Cold or flu with fever. Catnip is a diaphoretic, which
means that it promotes sweating. This property makes
it a valuable remedy in treating patients with feverish
conditions, including influenza, colds, and bronchitis.
• Cuts and scrapes. Catnip is an astringent, and can be
applied externally to cuts and scrapes to stop bleeding
and promote healing.
Preparations
Catnip is most commonly taken as an infusion, or
tea. The herb can be purchased in tea bags or in loose,
dried form. Tea bag infusions can be prepared according
to package directions. When using the dried form of the
herb, place 10 tsp of catnip in a piece of muslin or
cheesecloth, in an infuser, or loose, and submerge it in
one liter of boiling water. After steeping the mixture in a
covered container for ten minutes, strain the infusion be-
fore drinking. The infusion should be steeped in a cov-
ered pot to prevent the volatile oils in the catnip from es-
caping through evaporation.
A second method of infusion is to mix the loose
catnip with cold water, bring the mixture to a boil in a
376
covered pan or teapot, and then strain the infusion be-
fore drinking. Two to three cups of the catnip infusion
can be taken daily. The remaining infusion should be
stored in a well-sealed bottle and refrigerated to pre-
vent bacteria and other micro-organisms from contam-
inating it.
Catnip can be mixed with such other herbs as bone-
set ( Eupatorium perfoliatum), elder ( Sambucus nigra),
yarrow (Achillea millefolium ), and cayenne (Capsicum
annuum ) in an infusion for treating colds.
Catnip is also available in tincture form to take by
mouth or apply topically. A tincture is a herbal prepara-
tion made by diluting the herb in alcohol. A catnip tinc-
ture or crushed catnip can be applied to a compress to
treat cuts and scrapes.
Loose catnip and catnip in tea bags should be stored
in an airtight container in a cool location out of direct
sunlight to retain potency. Careful storage also prevents
the catnip from absorbing odors and moisture.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Astringent — A substance that constricts or binds
skin cells.
Carminative — A preparation that helps to expel
gas from the stomach and bowel.
Diaphoretic — A substance or medication given to
induce or promote sweating.
Diuretic — A medication or substance that increas-
es urine output.
Infusion — A herbal preparation made by adding
herbs to boiling water and then steeping the mix-
ture to allow the medicinal herb to infuse into the
water.
Tincture — A liquid extract of an herb prepared by
steeping the herb in an alcohol and water mixture.
Volatile oil — A component of aromatic botanicals
that gives herbs their characteristic odor and may
possess therapeutic properties. Volatile oils vapor-
ize or evaporate quickly when heated and ex-
posed to air.
Precautions
Catnip should always be obtained from a reputable
source that observes stringent quality control procedures
and industry-accepted good manufacturing practices.
Botanical supplements are regulated by the FDA; however,
they currently do not have to undergo any approval process
before reaching the consumer market. Herbs are presently
classified as nutritional supplements rather than drugs.
Legislation known as the Dietary Supplement Health and
Education Act (DSHEA) was passed in 1994 in an effort to
standardize the manufacture, labeling, composition, and
safety of botanicals and supplements. In January 2000, the
FDA’s Center for Food Safety and Applied Nutrition
(CFSAN) announced a ten-year plan for establishing and
implementing these regulations by the year 2010.
Although there are no known side effects or health
hazards associated with recommended dosages of catnip
preparations, pregnant women, women who breastfeed,
and individuals with chronic medical conditions should
consult with their healthcare professional before taking
catnip or any other herb.
Side effects
Catnip has diuretic properties, and may increase the
frequency and amount of urination. It can also cause an
upset stomach in some individuals.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Because of the sedative qualities of catnip, individu-
als taking the herb should use caution when driving or
operating machinery.
Interactions
There are no reported negative interactions between
catnip and other medications and herbs, although certain
drugs with the same therapeutic properties as catnip may
enhance its effects.
Resources
BOOKS
Hoffman, David. The Complete Illustrated Herbal. New York:
Barnes & Noble Books, 1999.
Medical Economics Corporation. The PDRfor Herbal Medi-
cines. Montvale, NJ: Medical Economics Corporation,
1998.
ORGANIZATIONS
Office of Dietary Supplements. National Institutes of Health.
Building 31, Room 1B25. 31 Center Drive, MSC 2086.
Bethesda, MD 20892-2086. (301) 435-2920. Fax: (301)
480-1845. http://odp.od.nih.gov/ods/ (Includes on-line ac-
cess to International Bibliographic Information on Dietary
Supplements (IBIDS), a database of published interna-
tional scientific literature on dietary supplements and
botanicals).
Paula Ford-Martin
Cat's claw
Description
Cat’s claw is a large woody vine indigenous to the
Amazon rain forest of South America. The herb earns its
name from the curved thorns on the vine that resemble
the claws of a cat. Also known by its Spanish equivalent
uha de gato, cat’s claw has a long history of use as a folk
medicine by native peoples to treat intestinal complaints,
asthma, wounds, cancer, tumors, arthritis, inflamma-
tions, diabetes, irregularities of the menstrual cycle,
fevers, ulcers, dysentery, and rheumatism. They have
also utilized the herb as a kidney cleanser, blood
cleanser, and contraceptive.
Two species of cat’s claw are found in the rain for-
est: Uncaria tomentosa and Uncaria guianensis. Al-
though these species are similar in appearance and have
been used in many of the same ways, research on Uncar-
ia tomentosa has revealed it to be more valuable as a
therapeutic agent.
377
Cat's claw
Cat's claw
Cat’s claw plant in the Amazon rain forest. (Photo Researchers, Inc. Reproduced by permission.)
General use
Cat’s claw has been called one of the most impor-
tant botanical herbs found in the rain forest and is used
as a cleansing and supportive herb of the immune sys-
tem, cardiovascular system, and intestinal system. Al-
though research on cat’s claw began in the 1970s, it did-
n’t gain worldwide attention until the 1990s, when stud-
ies showed it to be a possible treatment for Acquired Im-
mune Deficiency Syndrome (AIDS) and Human
Immunodeficiency Virus (HIV) infection; cancer; and
other ailments. Cat’s claw is reported to enhance immu-
nity and heal digestive and intestinal disorders. It has
been used to treat many other ailments including acne,
allergies, arthritis, asthma, candidiasis, chronic fatigue,
chronic inflammation, depression, diabetes mellitus,
environmental toxicity and poisoning, Epste in-Barr virus
(EBV), fibromyalgia, hemorrhoids, herpes, hypo-
glycemia, systemic lupus erythematosus (SLE), men-
strual disorders and hormone imbalances, parasites, pre-
menstrual syndrome (PMS), tumors, upper respiratory
infections, viral infections, and wounds.
One unfortunate side effect of recent interest in cat’s
claw has been its virtual extinction in parts of the rain
forest. According to the Herb Research Foundation, the
378
government of Peru has had to outlaw the export of all
wild cat’s claw plants. Almost all cat’s claw root and
bark used for commercial preparations as of 2003 comes
from cultivated plants.
Although the stem bark of cat’s claw has some med-
icinal activity, the root is three to four times more active
than the stem bark. The strength of the active compo-
nents in cat’s claw is quite variable; it depends on the
time of year that the plant is harvested.
The active compounds in cat’s claw include alka-
loids, triterpenes, phytosterols, and proanthocyanidins.
Researchers have isolated unique alkaloids in the bark
and roots that activate the immune system by increasing
white blood cell activity. Rynchophylline, one of the al-
kaloids isolated from cat’s claw, has antihypertensive
properties that may be beneficial in lowering the risk of
strokes and heart attacks by reducing heart rate, lowering
blood pressure, increasing circulation, and lowering
blood cholesterol levels.
Researchers have also discovered substances in cat’s
claw that have antitumor, antileukemic, antioxidant, an-
timicrobial, antibacterial, anti-inflammatory, antiviral, and
diuretic properties. Dr. Brent W. Davis has studied cat’s
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
claw for a number of years and has described it as “the
opener of the way” in reference to its ability to treat many
bowel, stomach, and intestinal complaints including di-
verticulitis, leaky and irritable bowel syndromes, gastri-
tis, ulcers, hemorrhoids, Crohn’s disease, and colitis.
Cat’s claw’s anti-inflammatory actions have been ef-
fective in relieving the stiffness and swelling prevalent in
arthritis, rheumatism, and joint pain. An Austrian study
published in 2002 found that cat’s claw significantly re-
duced joint tenderness and swelling in a sample of 40 pa-
tients with rheumatoid arthritis, with only minor side
effects and no interactions with the patients ’ other arthri-
tis medications. A recent study done in Peru indicates that
the anti-inflammatory effects of cat’s claw are stronger in
extracts made with alcohol than in water-based solutions.
Studies of the therapeutic benefits of cat’s claw on
cancer have produced several interesting findings. Cat’s
claw’s immunostimulating properties have been shown
to enhance the function of white blood cells to attack and
digest carcinogenic substances and harmful microorgan-
isms that may inhibit the growth of cancer cells and tu-
mors. Used as an adjunct treatment to chemotherapy and
radiation, cat’s claw has shown promise in diminishing
side effects of hair loss, nausea, skin problems, infec-
tions, and weight loss.
Clinical studies have tested Krallendon, an immune-
boosting extract of cat’s claw, in the treatment of AIDS
patients and persons who are HIV-positive, either as a
single treatment or in conjunction with the AIDS drug
azidothymidine (AZT). Results showed that Krallendon
was able to deter the reproduction of the AIDS virus,
stop growth of cancerous cells, and activate the immune
system. In addition, painful side effects resulting from
the AZT treatment were diminished. Cat’s claw’s antiox-
idant properties help protect cells from environmental
substances such as smoke, pesticides, pollution, alcohol,
x rays, gamma radiation, ultraviolet light, rancid food,
and certain fats. The herb also helps prevent the spread
of free radicals, protecting cells from mutating and de-
veloping into tumors.
Preparations
Cat’s claw is available in health food stores and herb
shops in several forms: dry extract, crushed bark, cap-
sule, tablet, tea, and tincture.
To prepare the tea, boil 1 g (0.4 oz) of the bark in 1
cup of water for 10-15 minutes. Strain the mixture be-
fore drinking. A suggested dose is one cup of tea three
times daily.
Tincture dosage: 1-2 ml up to two times daily. Chil-
dren over two years of age and adults over 65 should
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
begin use with mild doses and increase strength gradual-
ly if needed.
Precautions
Cat’s claw is not recommended for pregnant or nurs-
ing women or for women who are trying to conceive.
Children under the age of two should not take cat’s claw.
Persons with a health condition should consult a quali-
fied herbalist before taking cat’s claw.
Side effects
European studies have reported low toxicity in the
use of cat’s claw, even when taken in large doses. The
only noted side effect was diarrhea. In 2001, however,
one case study was reported from South America of a pa-
tient with lupus developing kidney failure after taking
cat’s claw extracts.
Interactions
Cat’s claw should not be combined with hormonal
drugs, insulin, or vaccines. It may also cause the immune
system to reject foreign cells. Persons who have received
organ or tissue transplants should not use this herb. The
dosage may need to be reduced when taken with other
herbs.
Cat’s claw has also been reported to potentiate, or
intensify, the effects of antihypertensives (medications
given to control high blood pressure). Persons taking
such drugs should use cat’s claw only on the advice of a
physician.
Resources
BOOKS
Elkins. Rita. Cat’s Claw (Una de Goto): Miracle Herb from the
Rain Forest of Pern. Woodland Publishing, 1996.
Jones, Kenneth. Cat’s Claw: Healing Vine of Peru. Sylvan
Press, 1995.
Steinberg, Phillip N. Cat's Claw: The Wondrous Herb from the
Peruvian Rainforest. Healing Wisdom Publications, 1996.
PERIODICALS
Aguilar, J. L., P. Rojas, A. Marcelo et al. “Anti-Inflammatory
Activity of Two Different Extracts of Uncaria tomentosa
(Rubiaceae)” Journal of Ethnopharmacology 8 1 (July
2002): 271-276.
Blumenthal, Mark. “Una de Gato (Cat’s Claw) Rainforest Herb
Gets Scientific and Industry Attention.” Whole Foods (Oc-
tober 1995): 62, 62, 66, 68, 78.
Craig, Winston J. “A Closer Look at Cat’s Claw.” (Herb Watch).
Vibrant Life 18 (September-October 2002): 38-39.
Mur, E.. F. Hartig, G. Eibl, and M. Schirmer. "Randomized
Double-Blind Trial of an Extract from the Pentacyclic Al-
kaloid-Chemotype of Uncaria tomentosa for the Treat-
379
Cat's claw
Cayce systems
KEY TERMS
Alkaloids — A group of organic compounds found
in plants that possess a wide range of therapeutic
properties.
Antihypertensive — A medication given to lower
blood pressure.
Diuretic — A substance that increases the flow of
urine. Diuretics are given to lessen the volume of
liquid in the body.
Free radicals — Toxic molecules that cause cellular
damage to healthy tissue. Free radicals are sus-
pected to be a cause of conditions such as cancer,
diabetes, cardiovascular disease, and strokes.
Potentiation — A type of drug interaction in which
one drug or herbal preparation intensifies or in-
creases the effects of another.
Tincture — The concentrated solution of an herbal
extract, usually made with alcohol.
ment of Rheumatoid Arthritis.” Journal of Rheumatology
29 (April 2002): 678-681.
ORGANIZATIONS
Herb Research Foundation. 1007 Pearl St., Suite 200. Boulder,
CO 80302. (303) 449-2265. <www.herbs.org>.
Southwest School of Botanical Medicine. P. O. Box 4565, Bis-
bee, AZ 85603. (520) 432-5855. <www.swsbm.com>.
Jennifer Wurges
Rebecca J. Frey, PhD
Caveman diet see Paleolithic diet
Cayce systems
Definition
The Cayce Health System, or Cayce systems, com-
bine an extensive and varied assortment of treatments
for hundreds of physical conditions, diseases, and dis-
abilities into a holistic approach to health and healing.
The fundamental concepts are based on information
provided in psychic readings by Edgar Cayce
(1877-1945) for thousands of individuals with a wide
array of symptoms and ailments.
380
Origins
Often regarded as the father of modem holistic medi-
cine, Edgar Cayce was born near Hopkinsville, Kentucky
on March 18, 1877. He allegedly began exhibiting para-
normal abilities as a child, for example memorizing his
school lessons by sleeping with his head on his textbooks.
At age 24, after undergoing hypnosis during which he pre-
scribed successful treatment for his own months-long bout
of laryngitis that had baffled his doctors, Cayce began to
dispense his readings. He gave these readings while he
was in a trance-like state, leading to his designation as
“The Sleeping Prophet.” Over the course of his lifetime,
Cayce gave readings on diverse subjects, including health,
religion, dream interpretation, world affairs, and business.
Although some early readings were lost, at his death in
1945 more than 14,000 separate Edgar Cayce readings on
over 10,000 topics had been stenographically transcribed.
Almost 9,000 readings address medical ailments.
Benefits
Cayce’s holistic approach addresses the body, mind,
and spirit connection. The information offered in his read-
ings is aimed at treating the whole person and helping
people develop a self-awareness and responsibility for im-
proving their own physical health and spiritual well-being.
Cayce's readings focus on addressing the root cause
of an ailment rather than simply alleviating the symp-
toms. Almost all of his physical readings address diet
and nutrition. He felt that providing the body key build-
ing materials it needs to do its work is crucial, as is
detoxification. Poor eliminations are the most cited
cause of disease in Cayce’s readings. He also addresses
various systemic imbalances in the nervous, circulatory,
and glandular systems, and acid/alkaline imbalances. In-
fection, stress, attitudes, and emotions are also central to
his disease explanations.
Recommendations comprise an extensive variety of
therapies too numerous to list here. They include con-
ventional medicines and surgeries as well as alternative
therapies such as electrotherapy, osteopathy, and mas-
sage. Readings often recommend herbs, chemical con-
coctions, color and light therapies, colonics, castor oil,
and taking on responsible, healthful attitudes and behav-
iors such as dietary changes and prayer. Cayce even de-
veloped some original appliances to deliver his pre-
scribed treatments.
Proponents of Cayce’s therapies claim healings rang-
ing from routine to miraculous. Critics argue that many
recommended therapies lack rigorous scientific research
and evaluation, and attribute “cures” to factors other than
Cayce’s alleged psychic perception of medical needs.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Description
Cayce systems combines Cayce’s insights with
Cayce-oriented health practitioners, lay persons, organi-
zations, training programs, researchers, and health prod-
ucts. Treatment protocols are individualized for each pa-
tient. Clinicians may follow several different treatment
modalities, emphasizing the uniqueness of each individ-
ual patient and inclination of the clinician. This integra-
tion of treatment modalities is a principal concept of the
Cayce approach. Establishing healthy habits and attitudes
are also central. Self-responsibility such as self-care and
home care modalities (e.g., dietary changes, massage,
etc.) is often incorporated. Clinicians may search the
Cayce readings for the case most closely matching their
patient’s condition or medical diagnosis. However, most
readings were given for a specific individual’s complaint.
Interpreting the readings is not always a straightforward
task, since many subjects apparently had more disorders
than the one addressed in the reading. Treatment may re-
quire experimentation and the Association for Research
and Enlightenment (A.R.E.) Health and Rejuvenation Re-
search Center (HRRC) recommends that it should be un-
dertaken and evaluated under the care of a physician
trained in the Cayce approach.
As in Cayce’s original recommendations, a wide
range of therapeutic tools and treatments may be used.
These may generally be arranged under the following
categories:
• Manual therapy is therapeutic use of hands to diagnose
and treat illness. The Cayce system relies heavily on tra-
ditional osteopathic applications together with modern
chiropractic, physical medicine and massage therapy.
• Electrotherapy includes several appliances and tech-
niques such as the wet cell battery, radial appliance, vi-
olet ray appliance, ultraviolet ray lamp, sinusoidal, x-
ray, and magnetic therapy.
• Diet/Nutritional therapy focuses on acid/alkaline bal-
ance and food combining with special diets for
strengthening the blood, body, and nerves.
• Hydrotherapy (therapeutic use of water) includes
colon therapy (irrigations), fume and steam baths, sitz
baths, Epson salt baths, and various packs.
• Pharmacology relies heavily on natural remedies such
as herbal medicine and dietary supplements.
• Mental therapy covers a broad range of psychological
and psychosocial techniques such as cognitive-behav-
ioral therapy, visualization, hypnosis, and environmen-
tal therapy.
• Spiritual healing includes interventions such as prayer,
meditation, and laying on of hands.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Meditation room used by clients of Edgar Cayce systems.
Meditation is used to balance the mind, body, and spirit.
(Photo Researchers, Inc. Reproduced by permission.)
Research & general acceptance
The Cayce transcripts are housed in the A.R.E. and
are available for general research. The library also has a
collection of circulating files on various health conditions.
Numerous books organize information from the Cayce
readings. As of 2000, the HRRC is conducting research
projects including energy medicine, manual therapies,
acid/alkaline balance, and the nervous system. The HRRC
also offers individual research protocols enabling individ-
uals to apply Cayce principles at home. They solicit anec-
dotal evidence on successful applications of Cayce modal-
ities, invite clinicians using Cayce modalities to document
outcomes, and conduct historical research on osteopathic
textbooks. They also team with the Meridian Institute (a
non-profit organization dedicated to researching Cayce
health information) to look at specific illnesses.
Training & certification
Four levels of certification are offered for Cayce sys-
tems. As described on the A.R.E. website, Cayce home
health therapists help patients apply Cayce information in
their home settings. Cayce physiotherapists have passed
certifications in general manual therapy, hydrotherapy,
energy medicine, and the basic Cayce diet. Cayce health
case managers are certified in providing information and
support services (e.g., assessment, service planning, re-
ferrals, and advocacy). Cayce physicians, in additional to
being licensed by their state boards, are certified in apply-
ing Cayce system principles and techniques.
Resources
BOOKS
Bolton, Brett. An Edgar Cayce Encyclopedia of Foods for
Health and Healing. Virginia Beach, A.R.E. Press. 1996.
381
Cayce systems
Cayenne
EDGAR CAYCE 1877-1945
(Betmann/CORBIS. Reproduced by permission.)
Edgar Cayce was born on March 18, 1877, in Hop-
kinsville, Kentucky, the son of a businessman. He grew
up in rural Kentucky and received only a limited formal
education. He was a member of the Christian Church
(Disciples of Christ). As an adult he began a career as a
photographer.
Cayce's life took a radically different direction in
1898, after he developed a case of laryngitis. He was
hypnotized by a friend and while in the trance state pre-
scribed a cure that worked. Neighbors heard of the event
and asked Cayce to do similar "readings" for them. In
1909 he did a reading in which he diagnosed and cured
a homeopathic physician, Dr. Wesley Ketchum. During
the next years Cayce gave occasional sittings, but primar-
ily worked in photography.
In 1923, theosophist Arthur Lammers invited Cayce
to Dayton, Ohio, to do a set of private readings. These
readings were noteworthy because they involved
Cayce's initial exploration of individual past lives. These
readings encouraged Cayce to leave photography and
become a professional. Among his early supporters was
businessman Morton Blumenthal, who gave financial
backing for Cayce Hospital (1928) and a school, At-
lantic University (1930). Unfortunately, Blumenthal was
financially destroyed by the Great Depression and both
enterprises failed.
In 1932 Cayce organized the Association for Re-
search and Enlightenment (ARE). With the resources gen-
erated by the association, complete records of all the
readings for the next 12 years were made. These formed a
huge body of material, and Cayce's readings were later
indexed, cross-referenced, and used as the basis of nu-
merous books.
Cayce died in 1945, and his son Hugh Lynn Cayce
continued the work of the association and promoted the
abilities of his father. Cayce's work became known by a
large audience outside the psychic community in 1 967
through a biographical book by Jess Stern, Edgar Cayce,
The Sleeping Prophet.
Karp, Reba A. Edgar Cayce Encyclopedia of Healing. New
York, Warner Books. 1986.
McGarey, William A. Physician' s Reference Notebook. Vir-
ginia Beach, A.R.E. Press. 1998.
Read, Anne, Carol Ilstrup, and Margaret Gammon. Edgar
Cayce on Diet and Health. New York, Hawthorne. 1969.
Reilly, Harold J. and Ruth Hagy Brod. The Edgar Cayce Hand-
book for Health Through Drugless Therapy. New York,
Macmillan. 1975.
Stearn, Jess. Edgar Cayce: The Sleeping Prophet. Virginia
Beach, A.R.E. Press, 1997.
Sugrue, Thomas. There is a River. Virginia Beach, A.R.E. Press.
1988.
ORGANIZATIONS
The Association for Research and Enlightenment, Inc. 215 67th
St„ Virginia Beach, VA 23451. (757) 428-3588 or (800)
333-4499. are@edgarcayce.org. http://www.are-cayce.
com/index.htm.
382
Health and Rejuvenation Research Center A division of the As-
sociation for Research and Enlightenment, Inc. 215 67th
Street Virginia Beach, VA 23451-2061. (757) 428-3588
ext. 7340. hrrc@are-cayce.com.
Meridian Institute 1853 Old Donation Parkway, Suite 1 Vir-
ginia Beach, VA 23454. (757) 496-6009. http://www.
meridianinstitute.com meridian@meridianinstitute.com.
Kathy Stolley
Cayenne
Description
Cayenne (Capsicum frutescens, C. annum ) is a stim-
ulating herb that is well known for its pungent taste and
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Cayenne pepper plants. (© PlantaPhile, Germany. Reproduced by permission.)
smell. Cayenne is a popular spice used in many different
regional styles of cooking, but it has also been used med-
icinally for thousands of years.
The name cayenne is derived from a Tupi word,
“kyinha.” The cayenne plant produces long red peppers
and grows to a height of 2-6 ft (0.5-2 m). The plant is
native to tropical areas of America and is cultivated
throughout the world in tropic and subtropic climate
zones. Most of the United States’ cayenne supply is im-
ported from India and Africa.
Cayenne is a member of the genus Capsicum. Other
species of this genus include Tabasco peppers, African
peppers, Mexican chili peppers, bell peppers, pimentoes,
paprikas, and bird peppers. Cayenne is often referred to
as chili, which is the Aztec name for cayenne pepper.
The main medicinal properties of cayenne are de-
rived from a chemical called capsaicin. Capsaicin is the
ingredient that gives peppers their heat. A pepper’s cap-
saicin content ranges from 0-1.5%. Peppers are mea-
sured according to heat units. The degree of heat deter-
mines the peppers’ value and usage. Generally, the hotter
the pepper, the more capsaicin it contains. In addition to
adding heat to the pepper, capsaicin acts to relieve pain
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
and reduce platelet stickiness. Other constituents of
cayenne are vitamins C and E and carotenoids.
Cayenne has anti-inflammatory, antioxidant, anti-
septic, diuretic, analgesic, expectorant, and diaphoretic
properties. The dried ripe fruit and seeds of the plant are
used for medicinal purposes. Cayenne is available in
many forms, including capsules, ointments, liniments,
tinctures, creams, oils, and dried powders.
Origin
Cayenne was originally grown in Central and South
America in pre-Columbian times. It was cultivated in
Mexico 7,000 years ago and in Peru 4,000 years ago. Na-
tive Americans have used cayenne as a food and as a med-
icine for stomach aches, cramping pains, gas, and disor-
ders of the circulatory system for 9,000 years. Cayenne
was brought to Europe in the fifteenth century by Christo-
pher Columbus. From Europe, cayenne was transported to
tropical regions around the world, where it is now grown.
General use
Today cayenne is used worldwide to treat a variety
of health conditions, including weak digestion, chronic
383
Cayenne
Cayenne
pain, shingles, heart disease, sore throats, headaches,
high cholesterol levels, poor circulation, and toothache.
Indian Ayurvedic, Chinese, Japanese, and Korean
medicines use cayenne to treat many different condi-
tions. One Ayurvedic remedy for pain combines cayenne
and mustard seeds into a paste to be applied to the affect-
ed area. Ayurvedic medicine also utilizes cayenne to
treat gas and poor digestion. Chinese medicine employs
cayenne for digestive ailments. An ointment or tincture
made from cayenne is used in China and Japan to heal
frostbite and myalgia (muscle pains). The German Com-
mission E has approved cayenne in the treatment of
painful muscle spasms, arthritis, rheumatism, neuralgia,
lumbago, and chilblains.
Digestive aid
Cayenne is used as a digestive aid throughout India,
the East Indies, Africa, Mexico, and the Caribbean.
When taken internally, cayenne soothes the digestive
tract and stimulates the flow of saliva and stomach secre-
tions. These secretions contain substances that help di-
gest food.
Cayenne is also used to relieve constipation as it
stimulates gastric secretions, thereby activating a slug-
gish gastrointestinal tract.
Circulatory helper
Many people take cayenne internally to treat and
prevent heart disease. The intake of cayenne has been
found to have a positive effect on the circulatory system.
Cayenne may reduce the risk of heart attacks. It has been
shown to lower cholesterol levels and the risk of blood
clots. Studies have shown cayenne to lower blood pres-
sure. A study in India showed that cayenne prevented a
rise in liver and serum cholesterol levels when taken
with dietary cholesterol.
Pain relief
Cayenne is a proven remedy for the temporary relief
of pain, both external and internal. Its analgesic effect
acts to distract sensory nerves from the irritation or pain,
which results in a temporary abatement of pain. The cap-
saicin in cayenne depletes substance P, a chemical that
sends pain signals to the brain from the local nervous
system. When there is a lack of substance P, the sensa-
tion of pain diminishes because it cannot reach the brain.
Capsaicin has been approved by the United States
Food and Drug Administration (FDA) for pain caused by
shingles, an adult disease that is caused by the virus that
causes chicken pox in children. Such over-the-counter
(OTC) creams as Zostrix or Heet contain capsaicin and
384
are applied externally to treat rheumatic and arthritic
pains, cluster headaches, diabetic foot pain, fibromyal-
gia, and post-herpetic nerve pain. These creams usually
contain 0.025-0.075% capsaicin.
Research in 2002 helped to quantify capsaicin’s pain
relieving effects. Creams containing the compound low-
ered pain in arthritis sufferers’ hands by 40 percent when
used four times a day and 77 percent of people with pain
from long-term shingles had reduced pain after using the
cream for four months. The study also said that cap-
saicin-containing cream is less expensive and safer than
other painkillers used for the same conditions.
Other conditions
Cayenne can be an effective remedy for relieving
congestion and coughs. It acts to thin mucus, thus im-
proving the flow of body fluids. It is also used to boost
energy and relieve stress-related fatigue and depression.
Late in the 1990s, British journals reported that people
taking cayenne daily increased their fat metabolism and
had decreased appetites. In addition, cayenne can be
used as a treatment to prevent thumb sucking and nail
biting in children.
Preparations
Internal dosage: Cayenne should be taken internally
as directed by an experienced practitioner.
Creams: Use as directed. Generally creams must be
applied three or four times per day for two to three
weeks before their effects are felt.
Oil: Cayenne oil may be rubbed on sprains, swelling,
and sore muscles and joints to relieve pain. It should not,
however, be applied to open cuts or broken skin.
Tea: To ease gas and stomach cramps or to help pro-
mote digestion, a tea may be made by adding 0.25 tsp of
cayenne to 1 cup of hot water. When taken as a hot tea,
cayenne will induce sweating. Taken as a cold tea,
cayenne works as a diuretic, increasing urination.
Cayenne teas, however, should not be given to children.
Toothache: Chewing on a hot pepper may provide
temporary relief from toothache.
Cold feet: Ground cayenne added to talcum powder
or cornstarch can be placed inside a pair of socks. The
cayenne causes the blood vessels under the skin of the
feet to dilate, thus stimulating extra blood flow and pro-
viding warmth to the feet.
Sore throat: To treat a sore throat, combine cayenne
with myrrh and gargle as needed. This mixture can also
be used as an antiseptic mouthwash. Again, this treat-
ment should not be given to children.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Analgesic — A pain-relieving substance.
Capsaicin — A colorless, bitter compound that is
present in cayenne and gives it its heat.
Chilblains — Redness and swelling of the skin
caused by exposure to the cold.
Diaphoretic — A substance that promotes sweat-
ing.
Diuretic — A substance that increases urination.
Expectorant — A substance that increases the
coughing up of mucus.
Lumbago — Lower back pain caused by rheuma-
toid arthritis, muscle strain, osteoarthritis, or a
ruptured spinal disk.
Precautions
To avoid irritating sensitive tissues, do not apply
heating pads or hot compresses to areas of the skin
where cayenne has been applied.
Do not apply cayenne to an area for longer than two
days since the heat may cause nerve damage. Allow four
days to pass before applying cayenne in the same loca-
tion.
Avoid contact with mucous membranes, eyes, open
wounds, and sensitive areas.
Wash hands after using cayenne or wear gloves
when applying it externally.
Persons with an active gastrointestinal ulcer should
not use cayenne internally without consulting a physi-
cian.
Side effects
Cayenne may irritate the mouth, throat, eyes, and
open wounds. Drinking a glass of milk may relieve burn-
ing in the mouth and throat caused by consumption of
cayenne. The protein in the milk helps to counteract the
capsaicin.
Large internal doses of cayenne may produce vom-
iting and/or stomach pain.
Interactions
Asthma patients who are taking theophylline should
consult a physician before taking cayenne. Cayenne may
increase the amount of theophylline absorbed by the pa-
tient’s system, thus possibly leading to toxicity.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Resources
BOOKS
Lininger, D.C., Skye. The Natural Pharmacy. Rocklin, CA:
Prima Health, 1998.
PERIODICALS
Ackerson, Amber. “Scaling Down: Lose that Pear Shape with
These Safe Supplements.” Better Nutrition (August 2002):
40-42.
"Non-Drug Pain Relief.” Women’s Health Letter (September
2002): 4.
Tyler, Varro E. "Six Hot Remedies from 1 Red-Hot Pepper.”
Prevention (February 1999): 76.
Jennifer Wurges
Teresa G. Odle
Ce bai ye see Thuja
Cedar, red see Red cedar
Celiac disease
Definition
Celiac disease occurs when the body reacts abnor-
mally to gluten, a protein found in wheat, rye, barley,
and oats. Gluten causes an inflammatory response in the
small intestine, which damages the tissues and results in
impaired ability to absorb nutrients from foods.
Description
Celiac disease — also called sprue, nontropical sprue,
gluten sensitive enteropathy, celiac sprue, and adult celiac
disease — may be discovered at any age. Researchers be-
lieve that a combination of genetic and environmental
factors trigger the disease. Environmental events that may
provoke celiac disease in those with a genetic predisposi-
tion to the disorder include surgery or a viral infection.
The disorder is more commonly found among white
Europeans or those of European descent. The exact inci-
dence of the disease is uncertain. Estimates vary from one
in 5,000 to as many as one in every 300 individuals with
this background. In 2002, new research in Italy followed
patients with type 1 diabetes. Celiac disease is 20 times
more common among these patients than in the general
population, yet often goes undetected in these children. The
study authors recommended celiac disease screening pro-
grams for children recently diagnosed with type 1 diabetes.
Causes & symptoms
Celiac disease is caused by an inflammatory re-
sponse of the small intestine. The exact mechanism of
385
Celiac disease
Celiac disease
the disorder is not clearly understood, but it is known
that both heredity and the immune system play a part.
When food containing gluten reaches the small intestine,
the immune system begins to attack a substance called
gliadin, which is found in the gluten. The resulting in-
flammation causes damage to the delicate finger-like
structures in the intestine, called villi, where food ab-
sorption actually takes place.
The most commonly recognized symptoms of celiac
disease relate to the improper absorption of food in the
gastrointestinal system. The patient will have diarrhea
and fatty, greasy, unusually foul-smelling stools. The pa-
tient may complain of excessive gas (flatulence), dis-
tended abdomen, weight loss, and generalized weakness.
Not all patients have these problems. Unrecognized
celiac disease may cause or contribute to a variety of
other conditions. The decreased ability to digest, absorb,
and utilize food properly (malabsorption) may cause
anemia from iron deficiency or easy bruising from a
lack of vitamin K. Poor mineral absorption may result
in osteoporosis, which may lead to bone fractures. Vit-
amin D levels may be insufficient and bring about a
“softening” of bones (osteomalacia), which produces
pain and bony deformities. Defects in the tooth enamel,
characteristic of celiac disease, may also occur. Celiac
disease may be discovered during medical tests per-
formed to investigate failure to thrive in infants, or lack
of proper growth in children and adolescents. People
with celiac disease may also experience lactose intoler-
ance because they do not produce enough of the enzyme
lactase, which breaks down the sugar in milk into a form
the body can absorb.
A distinctive skin rash, called dermatitis herpeti-
formis, may be the first sign of celiac disease. Approxi-
mately 10% of patients with celiac disease have this
rash, but it is estimated that 85% or more of patients with
the rash have the disease.
Because of the variety of ways celiac disease can
manifest itself, it is often not discovered promptly. The
condition may persist without diagnosis for so long that
the patient accepts a general feeling of illness as normal.
This leads to further delay in identifying and treating the
disorder.
Diagnosis
If celiac disease is suspected, a blood test that looks
for the antibodies that the immune system produces in
celiac disease is ordered. Some experts advocate not just
evaluating patients with symptoms, but using these blood
studies as a screening test for high-risk individuals, such
as those with relatives known to have the disorder. An
abnormal result points towards celiac disease, but further
386
tests are needed to confirm the diagnosis. Other tests
may be ordered to look for nutritional deficiencies. For
example, doctors may order a test of iron levels in the
blood because low levels of iron (anemia) may accompa-
ny celiac disease. Doctors may also order a test for fat in
the stool, since celiac disease prevents the body from ab-
sorbing fat from food.
The next step is a biopsy of the small intestine. This
is usually done by a gastroenterologist, a physician who
specializes in diagnosing and treating bowel disorders. It
is generally performed in the office, or in an outpatient
department in a hospital. The patient remains awake, but
is sedated. A narrow tube is passed through the mouth,
down through the stomach, and into the small intestine. A
small sample of tissue is taken and sent to the laboratory
for analysis. If it shows a pattern of tissue damage charac-
teristic of celiac disease, the diagnosis is established.
Treatment
The treatment for celiac disease is a gluten-free diet
(GFD). This may be easy for the doctor to prescribe, but
difficult for the patient to follow. Gluten is present in any
product that contains wheat, rye, barley, or oats. It helps
make bread rise, and gives many foods a smooth, pleas-
ing texture.
In addition to the many obvious places gluten can be
found in a normal diet, such as breads, cereals, and
pasta, there are many hidden sources of gluten. These in-
clude ingredients added to foods to improve texture or
enhance flavor and products used in food packaging.
Gluten may even be present on surfaces used for food
preparation or cooking.
Fresh foods that have not been artificially processed,
such as fruits, vegetables, and meats, are permitted as
part of a GFD. Gluten-free foods can be found in health
food stores, mail-order companies, and in some super-
markets. Help in dietary planning is available from sup-
port groups for individuals with celiac disease. There are
many cookbooks on the market specifically for those on
a GFD.
Treating celiac disease with a GFD is almost always
completely effective in alleviating symptoms. Secondary
complications, such as anemia and osteoporosis, resolve
in almost all patients. People who have experienced lac-
tose intolerance related to their celiac disease usually see
those symptoms subside as well.
Allopathic treatment
Both complementary and allopathic healthcare prac-
titioners generally agree that a gluten-free diet is the best
treatment for celiac disease.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
There are a small number of patients who develop a
refractory type of celiac disease, where the GFD no
longer seems effective. Once the diet has been thorough-
ly assessed to ensure no hidden sources of gluten are
causing the problem, medications may be prescribed.
Steroids or immunosuppressant drugs are often used to
try to control the disease.
Expected results
The physician will periodically recheck the level of
antibody in the patient’s blood after a diagnosis of celiac
disease has been made. After several months on a GFD,
the small intestine of the patient is biopsied again. If the
diagnosis of celiac disease was correct, healing of the in-
testine will be apparent. Most experts agree that it is nec-
essary to follow these steps in order to be sure of an ac-
curate diagnosis.
Patients with celiac disease must keep a strict GFD
as long as they live. Although the disease may have
symptom-free periods, silent damage will continue to
occur if the diet is not followed. Patients who do not fol-
low their diets run higher risks of serious complications
like gastrointestinal cancers, iron-deficiency anemia,
and decreased bone mineral density. Celiac disease can-
not be “outgrown” or cured, according to medical au-
thorities.
Once the diet has been followed for several years,
individuals with celiac disease have similar mortality
rates to the general population. However, about 10% of
people with celiac disease develop a cancer involving
the lymphatic system (lymphoma).
Prevention
There is no way to completely prevent celiac dis-
ease. However, the key to decreasing its impact on over-
all health is early diagnosis and strict adherence to the
prescribed diet. Interestingly, a 2002 study of Swedish
children found that the gradual introduction of gluten-
containing foods into infant’s diets while they are still
being breast-fed can reduce the risk of celiac disease, at
least in early childhood.
Resources
BOOKS
Lowell, Jax Peters. Against the Grain: The Slightly Eccentric
Guide to Living Well without Wheat or Gluten. New York:
Henry Holt, 1996.
PERIODICALS
“Celiac Disease Develops Early in Type 1 Diabetes Course.”
Diabetes Week. (June 17, 2002): 3.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Antibodies — Proteins that provoke the immune
system to attack particular substances. In celiac
disease, the immune system makes antibodies to a
component of gluten.
Gluten — A protein found in wheat, rye, barley,
and oats.
Villi — Tiny, finger-like projections that enable the
small intestine to absorb nutrients from food.
Ivarsson, Aneeli, et al. “Breast-feeding Protects Against Celiac
Disease.” American Journal of Clinical Nutrition. (May
2002): 914-918.
Jancin, Bruce. “Lifelong, Gluten%ndash;free Diet Boosts Celi-
ac Disease Outcomes. (Avoids Anemia, Increased GI Can-
cers).” Interned Medicine News. (May 15,2002): 14.
Pruessner, H. “Detecting Celiac Disease in Your Patients.”
American Family Physician. 51 (March 1998): 1023-1034.
ORGANIZATIONS
Celiac Disease Foundation. 13251 Ventura Blvd., Suite 1, Stu-
dio City, CA 91604-1838. (818) 990-2354. http://www.
cdf@celiac.org.
Celiac Sprue Association/United States of America (CSA/
USA). PO Box 31700, Omaha, NE 68131-0700. (402)
558-0600.
Gluten Intolerance Group. PO Box 23053, Seattle, WA 98102-
0353. (206) 325-6980.
Paula Ford-Martin
Teresa G. Odle
Cell salt therapy
Definition
Cell salt therapies use a set of specific minerals, also
known as the 12 tissue salts, to correct symptoms arising
from metabolic deficiencies. They are very similar to
homeopathy, and may be prescribed by a homeopathic
doctor.
The 12 cell salts are as follows:
• Calcarea fluor (calcium fluoride)
• Calcarea phos (calcium phosphate)
• Calcarea sulph (calcium sulfate)
• Ferrum phos (iron phosphate)
• Kali mur (potassium chloride)
387
Cell salt therapy
Cell salt therapy
• Kali phos (potassium phosphate)
• Kali sulph (potassium sulfate)
• Magnesia phos (magnesium phosphate)
• Natrum mur (sodium chloride)
• Natrum phos (sodium phosphate)
• Natrum sulph (sodium sulfate)
• Silicea (silica)
Origins
Cell salt therapy was developed by a German physi-
cian, W. H. Schussler, in the 1870s. Schussler studied
cremated human bodies, and found that these 12 sub-
stances made up the bulk of the remains. From this find-
ing he theorized that these 12 so-called tissue salts are
responsible for the harmonious functioning of the human
organism. Disease follows when a person becomes defi-
cient in any of the 12 salts. Schussler recommended that
patients take the salts in pill form to cure a variety of dis-
orders. He believed that the salts provided adequate nu-
trition to the cells. If cell nutrition was adequate, then
cell metabolism would be normal, and the body would
be healthy. However, Schussler’s pills were not direct
nutritional supplements as we would understand them
today. He followed the principles of homeopathy, which
works somewhat to the reverse of modern medicine, in
that the smaller the dose, the more effective it is believed
to be. Cell salts are prepared like homeopathic medi-
cines, by a process of continued dilution and shaking or
pounding (succussion).
Benefits
Practitioners of cell salt therapy believe the minerals
to be effective against a variety of ailments. For example,
Calcarea fluor is thought to be essential to vascular
health; it is given to patients with circulatory diseases or
such conditions as varicose veins, hemorrhoids, and
hardening of the arteries. Ferrum phos is used to treat
colds, flu, and inflammation. Kali phos is used to treat
body odor, as well as mental problems. Other salts treat
other disorders, from cramps to gout to skin problems.
Some are prescribed for general healing; that is, to re-
store general health to a person without any overriding
specific disease.
Preparations
Cell salts may be derived from inorganic sources,
though they can also be derived from plants. The salts are
made into pills which are extremely dilute, following the
principles of homeopathy. The salts are crushed into fine
388
particles, and the particles go through a series of dilu-
tions, then are molded into tablets. The patient does not
swallow the tablet, but allows it to dissolve on the tongue.
Precautions
Though the cell salt pills are extremely dilute, prac-
titioners believe them to be quite potent. Practitioners
advise people to take cell salts only under the advice of a
homeopathic physician. The cell salts are not intended to
be a complete treatment, but only one part of a treatment
plan devised by a knowledgeable practitioner.
Side effects
Because of the extremely dilute nature of cell salt
pills, side effects are unlikely. Traditionally trained med-
ical doctors would consider them placebos.
Research & general acceptance
Cell salt therapy, like homeopathy, is not based on
scientific research but on provings. Provings are basical-
ly anecdotal evidence gathered from volunteers. This
method of testing the efficacy of remedies was devised
by Samuel Hahnemann, the German physician who orig-
inated homeopathy. Within the field of homeopathy, cell
salt therapy is considered a sister therapy or perhaps a
subset of homeopathy. Homeopaths prescribe cell salts,
sometimes in conjunction with other remedies.
Training & certification
Cell salts are available as over-the-counter remedies,
and patients are able to treat themselves if they wish. An
understanding of cell salts can be gained from reading
Schussler’s work, or from comprehensive guides to home-
opathy. Cell salt therapy may be administered by a homeo-
pathic doctor. Rules governing the practice of homeopathy
vary from state to state. Homeopaths in the United States
can become certified through the Council for Homeopathic
Certification. This requires at least 500 hours of training in
homeopathy through a school or seminars, plus a written
examination. Certification is also offered to practitioners
who have apprenticed for at least 2,000 hours with a certi-
fied homeopath. Other qualifications may also be neces-
sary, such as having taken a course in CPR (cardiopul-
monary resuscitation) and human anatomy.
Resources
BOOKS
Cummings, Stephen, and Ullmann, Dana. Everybody’ s Guide
to Homeopathic Medicines. New York: Jeremy P. Tarcher/
Putnam, 1996.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Placebo — A pharmacologically inactive substance
given to placate a patient who supposes it to be a
medicine.
Succussion — A part of the process of making
homeopathic remedies, in which the medicinal
substance is diluted in distilled water and then
shaken vigorously.
PERIODICALS
Stehlin, Isadora. “Homeopathy: Real Medicine or Empty
Promise?” FDA Consumer (December 1996): 15.
ORGANIZATIONS
National Center for Homeopathy. 801 North Fairfax Street,
Suite 306. Alexandria, VA 22314. (703) 548-7790.
Angela Woodward
Cell therapy
Definition
Cell therapy is the transplantation of human or ani-
mal cells to replace or repair damaged tissue and/or
cells.
Origins
The theory behind cell therapy has been in existence
for several hundred years. The first recorded discussion
of the concept of cell therapy can be traced to Phillippus
Aureolus Paracelsus (1493-1541), a German-Swiss
physician and alchemist who wrote in his Der grossen
Wundartzney (“Great Surgery Book”) in 1536 that “the
heart heals the heart, lung heals the lung, spleen heals
the spleen; like cures like.” Paracelsus and many of his
contemporaries agreed that the best way to treat an ill-
ness was to use living tissue to restore the ailing. In
1667, at a laboratory in the palace of Louis XIV, Jean-
Baptiste Denis (1640-1704) attempted to transfuse
blood from a calf into a mentally ill patient — and since
blood transfusion is, in effect, a form of cell therapy, this
could be the first documented case of this procedure.
However, the first recorded attempt at non-blood cellular
therapy occurred in 1912 when German physicians at-
tempted to treat children with hypothyroidism, or an
underactive thyroid, with thyroid cells.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
In 1931, Dr. Paul Niehans (1882-1971), a Swiss
physician, became known as “the father of cell therapy”
quite by chance. After a surgical accident by a colleague,
Niehans attempted to transplant a patient’s severely dam-
aged parathyroid glands with those of a steer. When the
patient began to rapidly deteriorate before the transplant
could take place, Niehans decided to dice the steer’s
parathyroid gland into fine pieces, mix the pieces in a
saline solution, and inject them into the dying patient.
Immediately, the patient began to improve and, in fact,
lived for another 30 years.
Benefits
Cell therapy has been used successfully to rebuild
damaged cartilage in joints, repair spinal cord injuries,
strengthen a weakened immune system, treat autoim-
mune diseases such as AIDS, and to help patients with
neurological disorders such as Alzheimer’s disease,
Parkinson’s disease, and epilepsy. Further uses have
shown positive results in the treatment of a wide range of
chronic conditions such as arteriosclerosis, congenital
defects, and sexual dysfunction. The therapy has also
been used to treat cancer patients at a number of clinics
in Tijuana, Mexico, although this application has not
been well supported with controlled clinical studies.
In September 2002, clinical trials were announced
involving a French biotechnology company to develop
cell therapy to treat heart disease. The cell therapy pro-
gram would test the theory that cell therapy could re-
verse the damage done to heart muscle during a heart
attack, stopping progression to congestive heart failure.
Another new study was working on ways to use stem
cells for patients with diabetes. New trials in 2002
showed promise for tissure regeneration of b-cells,
restoring the ability of the pancreas to secrete insulin.
Description
Cell therapy is, in effect, a type of organ transplant
which has also been referred to as live cell therapy, xeno-
transplant therapy, cellular suspensions, glandular thera-
py, or fresh cell therapy. The procedure involves the in-
jection of either whole fetal xenogenic (animal) cells
(e.g., from sheep, cows, pigs, and sharks) or cell extracts
from human tissue. The latter is known as autologous
cell therapy if the cells are extracted from and transplant-
ed back into the same patient. Several different types of
cells can be administered simultaneously.
Just as Paracelsus’ theory of “like cures like,” the
types of cells that are administered correspond in some
way with the organ or tissue in the patient that is failing.
No one knows exactly how cell therapy works, but pro-
389
Cell therapy
Cell therapy
PAUL NIEHANS 1882-1971
(APAA/ide World Photos. Reproduced by permission.)
Paul Niehans was born and raised in Switzerland.
His father, a doctor, was dismayed when he entered the
seminary, but Niehans quickly grew dissatisfied with
religious life and took up medicine after all. He first
studied at Bern, then completed an internship in
Zurich.
Niehans enlisted in the Swiss Army in 1912. When
war erupted in the Balkans, Niehans set up a hospital in
Belgrade, Yugoslavia. The war provided him the opportu-
nity to treat numerous patients, gaining a firsthand
knowledge of the body and its workings.
Since 1913, Niehans had been intrigued with Alexis
Carrel's experiments concerning the adaptive abilities of
cells, though Niehans himself specialized in glandular
transplants and by 1925 was one of the leading glandular
surgeons in Europe.
Niehans referred to 1931 as the birth year of cellular
therapy. That year, he treated a patient suffering from
tetany whose parathyroid had been erroneously removed
by another physician. Too weak for a glandular trans-
plant, the patient was given injections of the parathyroid
glands of an ox, and she soon recovered. Niehans made
more injections, even experimenting on himself, and re-
ported he could cure illnesses through injections of live
cells extracted from healthy animal organs. He believed
adding new tissue stimulated rejuvenation and recovery.
Niehans treated Pope Pious XII with his injections
and was nominated to the Vatican Academy of Science
following the pope's recovery.
Niehans remained a controversial figure throughout
his life. As of 2000, the Clinique Paul Niehans in Switzer-
land, founded by his daughter, continued his work.
Lisa Frick
ponents claim that the injected cells travel to the similar
organ from which they were taken to revitalize and stim-
ulate that organ’s function and regenerate its cellular
structure. In other words, the cells are not species specif-
ic, but only organ specific. Supporters of cellular treat-
ment believe that embryonic and fetal animal tissue con-
tains active therapeutic agents distinct from vitamins,
minerals, hormones, or enzymes.
Swedish researchers have successfully transplanted
human fetal stem cells into human recipients, and the
procedure is being investigated further as a possible
treatment for repairing brain cells in Parkinson’s pa-
tients. However, because the cells used in these applica-
tions must be harvested from aborted human fetuses,
there is an ethical debate over their use.
Currently, applications of cell therapy in the United
States are still in the research, experimental, and clinical
trial stages. The U.S. Food and Drug Administration has
approved the use of one cellular therapy technique for use
390
in repairing damaged knee joints. The procedure involves
removing healthy chondrocyte cells, the type of cell that
forms cartilage, from the patient, culturing them in a lab-
oratory for three to four weeks, and then transplanting
them back into the damaged knee joint of the patient.
Preparations
There are several processes to prepare cells for use.
One form involves extracting cells from the patient and
then culturing them in a laboratory setting until they
multiply to the level needed for transplant back into the
same patient. Another procedure uses freshly removed
fetal animal tissue, which has been processed and sus-
pended in a saline solution. The preparation of fresh
cells then may be either injected immediately into the
patient, or preserved by being freeze-dried or deep-
frozen in liquid nitrogen before being injected. Cells
may be tested for pathogens, such as bacteria, viruses, or
parasites, before use.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Precautions
Patients undergoing cell therapy treatments which
use cells transplanted from animals or other humans run
the risk of cell rejection, in which the body recognizes
the cells as a foreign substance and uses the immune sys-
tem’s T-cells to attack and destroy them. Some forms of
cell therapy use special coatings on the cells designed to
trick the immune system into recognizing the new cells
as native to the body.
There is also the chance of the cell solution trans-
mitting bacterial or viral infection or other disease and
parasites to the patient. Careful screening and testing of
cells for pathogens can reduce this risk.
Many forms of cell therapy in the United States are
still largely experimental procedures. Patients should ap-
proach these treatments with extreme caution, should in-
quire about their proven efficacy and legal use in the
United States, and should only accept treatment from a
licensed physician who should educate the patient com-
pletely on the risks and possible side effects involved
with cell therapy. These same cautions apply for patients
interested in participating in clinical trials of cell therapy
treatments.
Side effects
Because cell therapy encompasses such a wide
range of treatments and applications, and many of these
treatments are still experimental, the full range of possi-
ble side effects of the treatments are not yet known. Ana-
phylactic shock (severe allergic reaction), immune sys-
tem reactions, and encephalitis (inflammation of the
brain) are just a few of the known reported side effects in
some patients to date.
Side effects of the FDA approved chondrocyte cell
therapy used in knee joint repair may include tissue hy-
pertrophy, a condition where too much cartilage grows in
the cell-transplanted joint and the knee joint begins to
stiffen.
Research & general acceptance
There is a growing debate in the medical community
over the efficacy and ethical implications of cell therapy.
Much of the ethical debate revolves around the use of
human fetal stem cells in treatment, and the fact that
these cells must be harvested from aborted fetuses.
In 2002, a new study attempted to increase the
amount of stem cells that could be used for a Parkinson’s
disease treatment while decreasing the amount of fetal
tissue required. With careful timing of the cells’ harvest-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Anaphylactic shock — A severe allergic reaction
that causes blood pressure drop, racing heart,
swelling of the airway, rash, and possibly convul-
sions.
Culturing — To grow cells in a special substance,
or media, in the laboratory.
Encephalitis — Inflammation of the brain.
ing and development, scientists successfully harvested
more cells that proved useful by using less tissue.
While some cell therapy procedures have shown
proven success in clinical studies, others are still largely
unproven, including cell therapy for cancer treatment.
Until more large, controlled clinical studies are per-
formed on these procedures to either prove or disprove
their efficacy, they will remain fringe treatments.
Training & certification
Cell therapy should only be performed by a licensed
physician with experience in prescribing and administer-
ing the treatment. Surgical cell therapy procedures, such
as the arthroscopic surgery involved in chondrocyte cell
therapy, should only be performed by a surgical specialist.
Resources
BOOKS
Sheridan, William, and George Morstyn. Cell Therapy: Stem
Cell Transplantation, Gene Therapy, and Cellular Im-
munotherapy. Cambridge, UK: Cambridge University
Press, 1996.
PERIODICALS
“Cardiac Cell Therapy Collaboration Forged.” Heart Disease
Weekly (September 29, 2002): 15.
"In vitro-expanded Neural Stem Cell Therapy Improves Rats.”
Stem Cell Week (September 30, 2002):2.
Lawrence, David.“Stem-cell Researchers Offer Possible Thera-
py for Diabetes.” The Lancet (July 20, 2002):233.
Sinha, Gunjan. “On the Road to Recovery: Fetal Pig Cell Ther-
apy has put Parkinson’s Patient Jim Finn back in the Dri-
ver's Seat.” Popular Science 255, no. 4 (October 1999):
77-82.
ORGANIZATIONS
Center for Cell and Gene Therapy. Baylor College of Medicine.
1102 Bates St, Suite 1100, Houston, Texas 77030-2399.
(713) 770-4663. http://www.bcm.tmc.edu/genetherapy.
Paula Ford-Martin
Teresa G. Odle
391
Cell therapy
Cellulite
Cellulite
Definition
Cellulite is a popular term to describe fat deposits
under the skin, it is characterized by a dimpled or or-
ange-peel appearance due to structural changes under-
neath the skin’s top layer. Cellulite is a perfectly normal
and harmless condition, however, it is a cosmetic con-
cern of many people.
Description
Cellulite is a normal occurrence resulting from un-
even fatty deposits, mostly below the waistline. In
women, fat is arranged in large chambers underneath a
fairly thin layer of skin. These chambers are separated by
columns of collagen fibers. In obese (overweight) per-
sons, too much fat is being stuffed into these chambers,
causing the pitting and bulging of the skin. In addition,
as women age, the fibers shrink and thicken, pulling the
skin downward. This results in a quilt-like appearance on
the skin surface, especially in areas such as the buttocks,
thighs, or hips. Most women develop cellulite as they
age, regardless of their race. According to some studies,
as many as 95% of women over age 30 develop some
form of cellulite in their body.
Female hormones (estrogen, and to a lesser extent,
progesterone) play important roles in the formation of
cellulite. Estrogen stimulates the storage of fat, which is
needed for menstruation, pregnancy, and lactation. In
addition, during the later phases of pregnancy, estrogen
also causes the breakdown of collagen fibers to relax the
cervix, making it possible for a woman to deliver her
baby. This collagen breakdown sets the stage for the for-
mation of cellulite. Progesterone may also contribute to
the cellulite problem by weakening veins and causing
water retention and weight gain.
Cellulite is mostly a female problem. Due to differ-
ent body physiques, men tend to have lower percentages
of body fat, while women have higher percentages. In
addition, men tend to accumulate fat in the abdominal
area while women have fat deposits mostly in the but-
tocks and thighs. Men have thicker skin and the cham-
bers are smaller and more tightly-held together. There-
fore, cellulite is not often found in men.
Causes & symptoms
Many scientists believe cellulite, as well as obesity,
is mostly predetermined by the genes that the persons
carry. However, environmental as well as behavioral fac-
392
tors are also believed to have some effects on the devel-
opment of cellulite.
The following factors are thought to contribute to
the development of cellulite:
• Being overweight. Though cellulite also appears on
thin people, excess weight makes cellulite worse.
• Pregnancy. Cellulite problems get worse with each suc-
cessive pregnancy. During pregnancy, estrogen and
progesterone levels are high. As a result, pregnant
women have increased fatty deposits, weight gain,
water retention, and weakened fiber structure. The most
effective ways for women to get rid of body fat and cel-
lulite and get back to pre-pregnancy shape are breast-
feeding and exercise.
• Aging. As women age, skin sags and wrinkles. In addi-
tion, the body's energy requirement lowers, thus, there
is more fat accumulation.
• Poor blood circulation. When there is impaired blood
flow to the fat-storage area, collagen fibers are dam-
aged due to lack of oxygen and accumulation of toxic
wastes. The fibers shrink and thicken, resulting in the
quilted appearance of the fat chambers. In addition, be-
cause oxygen is needed to burn fat for energy, fat in
these poorly oxygenated areas is the last to be used.
This is also why cellulite is so difficult to eliminate.
Poor blood circulation is often caused by sedentary
lifestyles, smoking, and high caffeine consumption.
• Poor lymph drainage. The lymphatic system acts like a
sewage system, filtering out and carrying away cellular
wastes and toxins. If it is impaired, toxic products ac-
cumulate and inflate these fat cells, causing cellulite.
• Lack of exercise. Cellulite may be caused by impaired
blood circulation and poor muscle tone underneath the
skin, which are caused by sedentary lifestyles.
• High fat and sugar consumption. This often leads to ex-
cess caloric and fat intake, which causes increases in
body fat and thus, cellulite.
• Food allergy. Food allergy causes a variety of symp-
toms including food craving, weight gain, bloating and
water retention, all of which worsen cellulite.
• Highly processed foods that contain preservatives, arti-
ficial sweeteners and other additives. Heavy consump-
tion of prepackaged foods causes build up of these tox-
ins in the body.
• Yo-yo dieting. Yo-yo dieting causes a woman to lose fat
in the upper body while increasing fat deposits in the
buttocks, thighs, and hips. Therefore, this practice tends
to make cellulite problems worse than before dieting.
• Sun exposure. Prolonged exposure to the sun acceler-
ates the skin-aging process.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
A close-up of cellulite deposits found beneath the top layer of skin.
Diagnosis
There are high-tech methods developed to determine
the presence and extent of cellulite such as ultrasound
and electrical impedance, which are expensive and un-
necessary. However, a woman can determine for herself
if she has cellulite using the skin-pinch and roll tech-
nique. First, a woman sets up a reference point for later
comparisons. Using her fingers, a woman should gently
pinch a large fold of skin in an area not known for hav-
ing cellulite. Then she should do the same with skin in
the buttock, thigh or hip areas. Comparing the first pinch
with later experiences, she should see if there are signs
of cellulite such as skin thickening, dimpling, broken
veins, cold skin, and lumpiness.
Treatment
Exercise
The best solutions to cellulite problems involve re-
ducing subcutaneous fat through diet and exercise.
Working out for at least 30 minutes five times a week
firms up the skin by increasing muscle tone and keeping
connective tissue fibers healthy. Exercise also increases
blood circulation to these problem areas.
Diet
Dieting has to be combined with regular exercise to
be effective in controlling or reducing cellulite. The fol-
lowing dietary changes are recommended:
• Drinking lots of water. Water cleanses the digestive
system and flushes toxins out of the body.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
(Illustration by GGS Information Services, Inc. The Gale Group.)
• Eating a low-fat, low-sugar, high-fiber diet with em-
phasis on fruits, vegetables, and whole grains.
• Refraining from smoking. Smoking causes poor blood
circulation and contributes to premature aging of the
skin.
• Avoiding highly processed foods, caffeine, and alcohol.
• Avoiding salty foods. Salty foods increase water reten-
tion and make cellulite appear worse.
• Maintaining a normal, healthy body weight. Obesity in-
creases fatty deposits and makes cellulite much worse.
Body massage
Massage with or without anti-cellulite cream may
have some limited benefits by improving blood circula-
tion and lymphatic drainage. Regular massage also
helps maintain smoother skin.
Herbal supplements
There are many herbal products on the market for
the treatment of cellulite. Products such as Cellasene do
not offer any therapeutic benefits. Cellasene is a popular
herbal mixture of fucus vesiculous, grape seed extract,
sweet clover, ginkgo biloba, borage, lecithin, and fish
oil. Its manufacturer claims that the herbal combination
works by increasing the rate the body burns fat cells for
energy. Many medical experts remain doubtful of its
claim of effectiveness. A recent study shows that it may
be just another fad product that has no therapeutic value.
There are several products, though, such as Centella
asiatica (gotu kola) and Aesculus hippocastanum (horse
393
Cellulite
Cellulite
An example of cellulite on the buttocks. (© Daniel Arsenault/Getty Images. Reproduced by permission.)
chestnut) that may help improve the appearance of cel-
lulite. These herbs improve the underlying integrity of
the skin by making the connective tissue fibers stronger
and more elastic.
Allopathic treatment
Liposuction is the most widely used treatment for cel-
lulite. Fat cells are removed by suctioning through a cut or
excision in the buttocks or thigh. Then some of these fat
cells are redeposited into areas of dimpling to smooth out
the contour. While liposuction significantly reduces total
amount of fat in the body immediately, it may not signifi-
cantly improve skin appearance. In other words, liposuc-
tion may or may not remove the dimpling or unevenness
under the skin. Nor does it make leathery, wrinkling skin
look taut and young. Even when it is effective, liposuction
is only a temporary quick-fix solution. As long as there is
excessive caloric and fat intake, the excess energy will be
stored as fat and cellulite will certainly reappear, albeit
probably in other parts of the body.
Liposuction is a surgical procedure. Therefore, it
does carry some potentially severe consequences and
complications. Pain and edema (fluid accumulation)
occur in most patients. It may take up to six months for
394
the edema to completely go away. Skin dimpling may
look even worse immediately after surgery, however, the
unevenness will smooth out over time. Surgical compli-
cations such as infections, uncontrollable bleeding, fatal
blood clots, and inadequate or excessive fat removal
(leaving behind flabby skin folds) may also occur.
Expected results
Liposuction is not a generally recommended treat-
ment for cellulite because it is an invasive, potentially
life-threatening procedure. It can sometimes produce sat-
isfying results but it is not a cure for cellulite. Repeat li-
posuction is often required because as long as there is
excess caloric or fat intake, there will be fatty deposits in
the body. Unless there are significant changes in lifestyle
and diet, cellulite will reappear.
A 2002 study showed that a combination of ultra-
sound-assisted liposuction followed by mechanical mas-
sage (endermologie) proved more effective than either tech-
nique used alone in reducing cellulite. Women with the best
results also added exercise into their post-operative routine.
Fat-dissolving lotions and creams are not proven ef-
fective in treating cellulite. Herbal cellulite-dissolving
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Electrical impedance — This technique uses a
small electrical current passing through the body.
Fat impedes or slows down electrical current. The
faster the current runs through the body, the less
fat there is.
Liposuction — The surgical removal of fatty tissue
underneath the skin through a small incision in
the skin.
Ultrasound — This medical device uses sound
waves bouncing off body organs or tissues, which
are reflected back as images on the screen. Ultra-
sound can show shape, size, and certain charac-
teristics of the tissues.
products do not result in loss of body fat, as they often
claim. At most, products such as Cellasene may be able
to make the dimpling from cellulite become less notice-
able. Further, when several ingredients are combined in
these creams, it is difficult for investigators to determine
which ingredient might be responsible for any reduction
in the appearance of cellulite.
The most effective treatment for cellulite remains
diet and exercise. Adhering to a low-fat, high-fiber diet
and regular exercise will make the body as fit and trim as
it can be. These are long-term solutions that also provide
many additional health benefits including prevention of
heart disease and cancer and slowing the aging process.
Prevention
Cellulite is a normal occurrence in the human body
and predetermined by genetics. Some women will natu-
rally have more cellulite than others. However, diet and
exercise can keep the body fit and trim.
Resources
BOOKS
The Burton Goldberg Group. “Cellulite.” Alternative Medicine:
The Definitive Guide. Tiburon, CA: Future Medicine Pub-
lishing, Inc., 1999.
Dancey, Elizabeth. The Cellulite Solution. USA: St. Martin's
Press, 1996.
Murray, Michael T., and Joseph E. Pizzomo. “Cellulite." Ency-
clopedia of Natural Medicine, revised 2nd ed. Rocklin,
CA: Prirna Publishing, 1998.
PERIODICALS
Bernstein, Gerald. “Liposuction: Liposuction of the Thigh.”
Dermatologic Clinics 17 no.4 (October 1999): 849-863.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Bolivar de Souza, Pinto E., P.J.I. Erazo. F.S.A. Prado Filho, et
al. “Superficial Liposuction.” Aesthetic Plastic Surgery 20
(1996): 1 1 1-122. In Year Book of Dermatologic Surgery,
1997.
"Dermatologists Shed Light on Treatments for Cellulite.” Obe-
sity, Fitness & Wellness Week (September 21, 2002): 8.
Lis-Balchin M. “Parallel Placebo-Controlled Clinical Study of
a Mixture of Herbs Sold as a Remedy for Cellulite." Phy-
tother Res 13 no.7 (Nov 1999): 627-629.
Scheck, Anne. “Dual Lipoplasty, Endermologie Approach Of-
fers Successful Cellulite Reduction.” Cosmetic Surgery
Times (July 2002): 22.
ORGANIZATIONS
The American Society of Plastic and Reconstructive Surgeons
(ASPRS). 444 East Algonquin Road, Arlington Heights,
IL 60005. (800) 228-9900. http://www.plasticsurgery.org
OTHER
Srinivasan, Kalpana. “FTC Eyes Cellulite Supplement: Can
Manufacturer Substantiate Claims?” Dr. Koop.com http://
abcnews.go.com/sections/living/DailyNews/cellulitepill
990527.html.
Mai Tran
Teresa G. Odle
Cerebral palsy
Definition
Cerebral palsy (CP), or static encephalopathy, is the
name for a collection of movement disorders caused by
brain damage that occurs before, during, or shortly after
birth. A person with CP is often also affected by other
conditions caused by brain damage.
Description
The affected muscles of a person with CP may be-
come rigid or excessively loose. The person may lose
control of muscles, or have problems with balance and
coordination. A combination of these is also possible.
Those with CP may be primarily affected in the legs
(paraplegia or diplegia), or in the arm and leg of one side
of the body (hemiplegia), or all four limbs may be in-
volved (quadriplegia).
A person with CP may also be affected by a number
of other problems, including a seizure disorder, visual
deficits, hearing problems, mental retardation, learning
disabilities, and attention-deficit hyperactivity disor-
der. None of these is necessarily part of CP, however,
they may accompany the disorder.
395
Cerebral palsy
Cerebral palsy
CP affects approximately 500,000 children and
adults in the United States, and is diagnosed in more than
6,000 newborns and young children each year, it is not an
inherited disorder, and as of yet there is no way to predict
with certainty which children will develop CP. It is not a
disease, and is not communicable. CP is a nonprogressive
disorder, which means that symptoms neither worsen nor
improve over time. However manifestation of the symp-
toms may become more severe over time. For example,
rigidity of muscles can lead to contractures and deformi-
ties that require a variety of interventions.
Causes & symptoms
Causes
Cerebral palsy is caused by damage to the motor
control centers of the brain. When the nerve cells (neu-
rons) in these regions die, the appropriate signals can no
longer be sent to the muscles under their control. The re-
sulting poor control of these muscles causes the symp-
toms of CP.
The brain damage leading to CP may be caused by
lack of oxygen (asphyxia), infection, trauma, malnutrition,
drugs or other chemicals, or hemorrhage. In most cases it
is impossible to determine the actual cause, although pre-
mature birth is recognized as a significant risk factor. It
was once thought that difficult or prolonged delivery was
responsible for many cases of CP, but most researchers
now believe that the great majority of cases result from
brain damage occurring before birth. The same injury that
damages the motor areas can harm other areas as well,
leading to problems commonly associated with CP.
If brain cells do not get enough oxygen because of
poor circulation, they may die. Defects in circulation in the
developing brain may cause CP in some cases. Asphyxia
during birth is also possible, and about half of newborns
known to have suffered asphyxia during birth (perinatal as-
phyxia) develop CP. However, asphyxia during birth is
usually considered a symptom of an underlying neurologi-
cal problem in a newborn, rather than its cause, and the re-
sulting CP may be another sign of that problem. Asphyxia
after birth can be caused by choking, poisoning (such as
from carbon monoxide or barbiturates), or near-drowning.
The fetal brain may be damaged by an infection
contracted by the mother. Infections correlated with CP
include rubella (German measles), toxoplasmosis (often
contracted from cat feces), cytomegalovirus (a herpes
virus), and HIV (the virus that causes AIDS). Encephali-
tis and meningitis, infections of the brain and its cover-
ings, can also cause CP when contracted by infants.
Physical trauma to the pregnant mother or infant
may cause brain damage. Blows to the infant’s head, as
396
from a motor vehicle accident, violent shaking, or other
physical abuse can damage the infant’s brain. Maternal
malnutrition may cause brain damage, as can the use of
drugs, including cocaine or alcohol. Although these fac-
tors may cause CP, they may be more likely to cause
mental retardation or other impairments.
Incompatibility between the Rh blood types of
mother and child was once a major cause of athetoid CP,
one type of movement impairment seen in cerebral palsy.
In some cases, this incompatibility can cause the moth-
er’s defense (immune) system to attack and destroy the
child’s blood cells during pregnancy, a condition called
erythroblastosis fetalis. High levels of a blood cell break-
down product called bilirubin in a child’s circulation,
leading to yellowish pigmentation of the skin caused by
bile (jaundice) can result in brain damage. This condi-
tion is now rare because of testing procedures that identi-
fy potential Rh incompatibility, and treatment that pre-
vents the mother’s immune system from attacking the
child’s blood cells. Jaundice that does occur can be treat-
ed with special lights that help the breakdown of biliru-
bin. Blood transfusions for the child are also possible in
extreme cases. Despite the virtual elimination of this
cause of CP in the last few decades, CP rates have not
declined, largely because of the increase of survival of
premature babies.
Prematurity is one of the most significant risk fac-
tors for CP. About 7% of babies weighing less than three
pounds at birth develop CP, and the risk increases dra-
matically as weight falls. Prematurity may increase the
risk of CP because of the increased likelihood of hemor-
rhaging in the brain associated with low birth weight.
Brain hemorrhage is most common in babies weighing
less than four pounds at birth, and the risk increases as
weight decreases. The hemorrhage may destroy brain tis-
sue, either through asphyxia or release of toxic break-
down products.
Researchers in Sweden reported in 2002 that babies
conceived through in vitro fertilization (IVF) were 3.7
times more likely to have CP than babies conceived nat-
urally. Some of the reason can be attributed to a higher
rate of twins, low birthweight, and premature births as-
sociated with IVF babies, but some single births also
have higher rates of CP.
Symptoms
The symptoms of CP are usually not noticeable at
birth. As children develop in the first 1 8 months of life,
however, they progress through a predictable set of de-
velopmental milestones. Children with CP will develop
these skills more slowly because of their motor impair-
ments, and delay in reaching milestones is usually the
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
first symptom of CP. The more severe the CP, the earlier
the diagnosis is usually made.
Selected developmental milestones, and the ages at
which a child will normally acquire them, are given
below. There is some cause for concern if the child does
not acquire the skill by the age shown in parentheses:
• sits well unsupported, 6 months (8-10 months)
• babbles, 6 months (8 months)
• crawls, 9 months (12 months)
• finger feeds, holds bottle, 9 months (12 months)
• walks alone, 12 months (15-18 months)
• uses one or two words other than dada/mama, 12
months ( 1 5 months)
• walks up and down steps, 24 months (24-36 months)
• turns pages in books, removes shoes and socks, 24
months (30 months)
Children do not consistently favor one hand over the
other before 18 months, and doing so may be a sign that
the child has difficulty using the other hand. This same
preference for one side of the body may show up as an
asymmetric crawling effort, or continuing to use only
one leg for the work of stair climbing after age three.
It must be remembered that children normally
progress at somewhat different rates, and slow initial ac-
complishment is often followed by normal development.
There are also other causes for delay in reaching some
milestones, including problems with vision or hearing.
Because CP is a non-progressive disease, loss of previ-
ously acquired milestones indicates that CP is not the
cause of the problem.
The impairments of CP become recognizable in
early childhood. The type of motor impairment and its
location are used as the basis for classification. There are
five generally recognized types of impairment:
• Spastic. Muscles are rigid, posture may be abnormal,
and fine motor control is impaired.
• Athetoid. It is marked by slow, writhing, involuntary
movements.
• Hypotonic. Muscles are floppy, without tone.
• Ataxic. Balance and coordination are impaired.
• Dystonic. Impairment is mixed.
The location of the impairment usually falls into one
of three broad categories:
• Hemiplegia. One arm and one leg on the same side of
the body are involved
• Diplegia. Both legs; arms may be partially involved.
• Quadriplegia. All four extremities are involved.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
A person with CP may be said to have spastic diple-
gia, or ataxic hemiplegia, for instance. CP is also termed
mild, moderate, or severe, although these are subjective
categories with no firm boundaries.
Loss of muscle control, especially of the spastic
type, can cause serious orthopedic problems, including
scoliosis (spine curvature), hip dislocation, or contrac-
tures. Contracture is shortening of a muscle, caused by
an imbalance of opposing force from a neighboring mus-
cle. Contractures begin as prolonged contractions, but
can become fixed or irreversible without regular range of
motion exercises. A fixed contracture occurs when the
contracted muscle adapts by reducing its overall length.
Fixed contractures may cause postural abnormalities in
the affected limbs, including clenched fists, tightly
pressed or crossed thighs, or equinus. In equinus, the
most common postural deformity, the foot is extended by
the strong pull of the rear calf muscles, causing the toes
to point. The foot is commonly pulled inward as well, a
condition called equinovarus. Contractures of all kinds
may be painful, and may interfere with normal activities
of daily living, including hygiene and mobility.
As noted, the brain damage that causes CP may also
cause a large number of other disorders. These may in-
clude:
• mental retardation
• learning disabilities
• attention-deficit hyperactivity disorder
• seizure disorder
• visual impairment, especially strabismus (“cross-eye”)
• hearing loss
• speech impairment
These problems may have an even greater impact on
the child’s life than the physical impairment of CP, al-
though not all children with CP are affected by other
problems. About one-third of children with CP have
moderate to severe mental retardation, one-third have
mild mental retardation, and one-third have normal to
above average intelligence.
Diagnosis
The tracking of developmental progress is the most
important test the physician has in determining whether
a child has cerebral palsy. Most children with CP can be
confidently diagnosed by 18 months. However, diagnos-
ing CP is not always easy, since variations in child devel-
opment may account for delays in achieving milestones,
and since even children who are obviously delayed may
continue to progress through the various developmental
stages, attaining a normal range of skills later on. Serious
397
Cerebral palsy
Cerebral palsy
or prolonged childhood illness may cause delays that are
eventually caught up.
Evidence of other risk factors may aid the diagnosis.
The Apgar score, evaluated immediately after birth, mea-
sures a newborn’s heart rate, cry, color, muscle tone, and
motor reactions. Apgar scores of less than three out of a
possible 10 are associated with a highly increased indi-
cation of CP. Presence of abnormal muscle tone or
movements may signal CP, as may the persistence of in-
fantile reflexes. A child with seizures or congenital organ
malformation has an increased likelihood of CP. Ultra-
sound examination, a diagnostic technique that creates a
two-dimensional image of internal body structures, may
help to identify brain abnormalities, such as enlarged
ventricles (chambers containing fluid) or periventricular
leukomalacia (an abnormality of the area surrounding
the ventricles), which may be associated with CP.
X rays, magnetic resonance imaging (MRI) studies,
and computed tomography (CT) scans are often used to
look for scarring, cysts, expansion of the cerebral ventri-
cles (hydrocephalus), or other brain abnormalities that
may indicate the cause of symptoms. Blood tests and ge-
netic tests may be used to rule out other possible causes,
including muscular dystrophy (a disease characterized by
the progressive wasting of muscles), mitochondrial (cel-
lular) disease, and other inherited disorders or infections.
Treatment
A number of people with cerebral palsy, both chil-
dren and adults, have found systematic relief and en-
hanced quality of life from a combination of alternative
and complementary treatments, including nutritional
therapy, craniosacral therapy, bodywork, herbal thera-
py, homeopathy, and acupuncture.
General recommendations
Pregnant women should avoid cleaning cat litter, which
may contain toxoplasma parasite. This organism causes se-
vere brain damage or death in the unborn fetus. Unprotected
sex increases risk of contracting sexually transmitted dis-
eases such as genital herpes, which can infect the unborn
child. Women should also vaccinate before getting pregnant
to prevent measles and rubella, which can cause severe brain
damage to the fetus. They should avoid taking certain dmgs,
smoking, or drinking alcohol. Cocaine, heroine, nicotine
and alcohol are toxic to the developing brain of the fetus.
Nutritional therapy
The following dietary adjustments have been recom-
mended to alleviate some symptoms in patients with
cerebral palsy:
398
• Those with CP should avoid potential allergenic foods.
Allergic foods are believed to worsen symptoms in
many CP patients.
• CP patients should also avoid preservatives and food ad-
ditives such as MSG (which are potentially toxic to the
brain) by eating fresh and unprocessed foods such as
whole grains, vegetables, beans, fruits, nuts, and seeds.
• To improve muscle tone, CP patients should supplement
their diets with magnesium, thiamine, pyridoxine, vi-
tamin C, and bioflavonoids. Alternatively, they can
take daily multivitamin/mineral supplements that can
provide all these helpful nutrients and make sure they
are getting adequate protein in diet or supplements.
Osteopathy
Craniosacral therapy, a special form of osteopathic
treatment, may be successful in preventing cerebral
palsy if performed right after a difficult labor or delivery
by forceps. This manipulation of bones of the newborn’s
skull may prevent stress and distortion of the child’s
head occurring during traumatic delivery. Craniosacral
therapy is less successful, however, in established cere-
bral palsy in an older child.
Bodywork
Bodywork such as massage, reflexology, Felden-
krais, or rolfing can help improve blood circulation and
muscle tone and reduce muscle spasms in patients with
cerebral palsy.
Other therapies
Other potentially helpful treatments include
acupuncture, homeopathy and herbal therapy, and dance
and music therapy. Although still not proven in clinical
trials, hyperbaric oxygen therapy (HBOT) has been used
to alleviate many symptoms of CP. It provides pure oxy-
gen at higher-lha-normal pressure in an enclosed cham-
ber and is more commonly known for treating divers with
compression sickness. A Cornell University study in
1999-2000 studied the effects of 40 one-hour sessions on
23 children with moderate to severe CP. They noted im-
provements in motor skills, attention, language, and play.
Allopathic treatment
Cerebral palsy cannot be cured, but many of the dis-
abilities it causes can be managed through planning and
timely care. Treatment for a child with CP depends on
the severity, nature, and location of the impairment, as
well a child’s associated problems. Optimal care of a
child with mild CP may involve regular interaction with
only physical and occupational therapists, whereas care
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
for a more severely affected child may include a speech-
language therapist, special education teacher, adaptive
sports therapist, nutritionist, orthopedic surgeon, and
neurosurgeon.
Parents of a child newly diagnosed with CP are not
likely to have the necessary expertise to coordinate the
full range of care their child will need. Support groups
for parents of physically or mentally impaired children
can be significant sources of both practical advice and
emotional support. Many cities have support groups that
can be located through the United Cerebral Palsy Associ-
ation or a local hospital or social service agency. Chil-
dren with CP are also eligible for special education ser-
vices. The diagnosing doctor should refer parents to the
local school district for these services. Even children
aged birth to three years are eligible through early inter-
vention programs.
Influence of CP on development
Cerebral palsy may restrict a child’s ability to reach
for and grasp objects, to move about, to explore the
properties of toys, and to communicate with others,
which are all central activities in the child’s growth and
development. Therefore, the disease inhibits acquisition
of motor skills, knowledge of the world, and social com-
petence. The family can do much to overcome these re-
strictions by adapting the child’s environment to meet his
or her needs and providing challenges within the child’s
abilities to accomplish. The advice and direction of an
occupational therapist can be critical to promoting nor-
mal development of the child with CP.
Posture and mobility
Spasticity, muscle coordination, ataxia, and scoliosis
are all significant impairments that affect the posture and
mobility of a person with cerebral palsy. Physical thera-
pists work with the family to maximize the child’s ability
to move affected limbs, to develop normal motor pat-
terns, and to maintain posture. Adaptive equipment may
be needed, including wheelchairs, walkers, shoe inserts,
crutches, or braces. The need for adaptive equipment
may change as the person develops, or as new treatments
are introduced.
SPASTICITY. Spasticity causes muscles to shorten,
joints to tighten, and postures to change. Spasticity can
affect the ability to walk, use a wheelchair, and sit unaid-
ed; and it can prevent independent feeding, dressing, hy-
giene, or other activities of daily living. Contracture and
dislocations are common consequences of spasticity.
Mild spasticity may be treated by regular stretching
of the affected muscles through their full range of mo-
tion. This usually is done at least daily. Moderate spas-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
ticity may require bracing to keep a limb out of the ab-
normal position, or serial casting to return it to its normal
position. Ankle-foot braces (orthoses) made of light-
weight plastic are often used to increase a child’s stabili-
ty and to promote proper joint alignment.
Spasticity may also be treated with muscle relaxing
drugs, including diazepam (Valium), dantrolene
(Dantrium), and baclofen (Lioresal). A variety of ex-
perimental surgeries have been tried for people with
cerebral palsy to control spasticity. Most of these have
not proven effective.
ATAXIA AND COORDINATION Ataxia, or lack of
balance control, is another factor affecting mobility.
Physical therapy is an important tool to help the child
with CP maximize balance. Coordination can be wors-
ened if one member of a muscle pair is overly strong;
bracing or surgical transfer of the muscle to a less over-
powering position may help.
SCOLIOSIS. Scoliosis, or spine curvature, can devel-
op when the muscles that hold the spine in place become
either weak or spastic. This can cause pain, as well as in-
terfere with normal posture and internal organ function.
Scoliosis may be treated with a trunk brace. If this proves
unsuccessful, spinal fusion surgery may be needed to join
the vertebrae together, which keeps the spine straight.
Seizures
Seizures occur in 30-50% of children with CP.
Seizures may be treated with drugs, most commonly car-
bamazepine (Tegretol) or ethosuximide (Zarontin). A
combination of a ketogenic diet and fasting may also be
used to control seizures. Although the need for anti-
seizure medication is temporary in some children, it may
be required throughout life for others.
Strabismus
Strabismus, or squinting and lack of parallelism in
the eyes, occurs in nearly half of all people with spastic
CP. Strabismus may be treated with patching and correc-
tive lenses. When these do not work, it may be treated
with either surgery on the eye muscles causing the prob-
lem or by injection of botulinum toxin.
Nutrition
Due to poor muscle coordination, CP children may
not take in adequate nutrition for full growth and devel-
opment, worsening the results of the disorder. Careful at-
tention to nutritional needs and nutritional supplements
is required. Poor swallowing coordination may lead to
aspiration, or inhaling of food or saliva. A speech-lan-
guage therapist may be able to teach the person more ef-
399
Cerebral palsy
Cerebral palsy
fective movement patterns to avoid aspiration. In severe
cases, a gastrostomy tube may be required to provide ad-
equate nutrition directly into the digestive system while
preventing aspiration.
Other common medical problems
Drooling, dental caries (cavities), and gum disease
are more common in people with CP than in the general
population, partly because of lowered coordination and
increased muscle tightness in the mouth and jaw. Each of
these can be prevented to some degree, either through
behavioral changes alone or in combination with drug
therapy. Constipation is more common as well, and may
be treated through dietary changes, or with enemas or
suppositories when necessary.
Communication
Poor coordination of the tongue and mouth muscles
can also affect speech. Children may benefit from pic-
ture boards or other communication devices that allow
them to point to make their desires known. For school-
age children or older persons with CP, there are a large
number of augmentative communication devices, includ-
ing shorthand typing programs and computer-assisted
speech devices. A speech-language therapist can offer
valuable advice on the types of equipment available.
Education
The best choice of school for the child with CP de-
pends on the presence and degree of mental impairment
and physical impairment, as well as the facilities avail-
able in the area. “Inclusion,” or mainstreaming the child
in a regular public school classroom, may work well for
the child with mild physical impairment. Separate class-
rooms or special schools may be needed for more se-
verely involved children. Schooling for disabled students
is governed by the Individuals with Disabilities Educa-
tion Act (IDEA) at the federal level and state special ed-
ucation rules at the local level. An educational specialist
within the school system or from a community social
services agency may be able to help the family navigate
the various bureaucratic pathways that will ensure the
best schooling available.
The process of developing an educational plan for a
child with CP begins with an assessment of the child’s
needs. The assessment is carried out under state guide-
lines by a team of medical professionals. After the as-
sessment, the school district works with the parents and
others involved in the child’s education and treatment to
develop an Individualized Educational Plan (IEP). The
IEP states the child’s specific needs for special instruc-
tion and indicates what services will be provided. The
400
special services may be as simple as allowing extra time
to travel between classes or as extensive as individual-
ized instruction, adapted classroom equipment, and spe-
cial testing procedures. More information about assess-
ments and lEPs is available through the National Infor-
mation Center for Children and Youth with Disabilities.
The United Cerebral Palsy Assocation is another re-
source for advocacy, information, and legal rights.
Behavioral and mental health services
The child with CP may have behavioral problems or
emotional issues that affect psychological development
and social interactions. These may require special inter-
vention or treatment, including behavior modification
programs or individual and family counseling. Attention-
deficit hyperactivity disorder is common in children with
CP, and may require behavioral, educational, and med-
ical intervention.
Expected results
Cerebral palsy can affect every stage of maturation,
from childhood through adolescence to adulthood. At
each stage, the person with CP and his or her caregivers
must strive to achieve and maintain the fullest range of
experiences and education consistent with the person’s
abilities. The advice and intervention of professionals re-
mains crucial for many people with CP.
Although CP is not a terminal disorder, it can affect
a person’s lifespan by increasing the risk of infection, es-
pecially lung infections. Poor nutrition can contribute to
the likelihood of infection. People with mild cerebral
palsy may have near-normal lifespans. The lifespan of
those with more severe forms, especially spastic quadri-
plegia, is often considerably shortened. However, over
90% of infants with CP survive into adulthood.
In 2002, a radical new method for repairing the
damage caused by lack of oxygen at delivery of babies
with CP was being funded for study. The possible treat-
ment involved transplanting mature stem cells into ba-
bies’ circulations, which will then migrate to the site of
injury caused by oxygen deprivation, hopefully promot-
ing natural repair of the brain damage. However, this
treatment was in very early stages of testing in animals
only as of late 2002.
Prevention
The cause of most cases of CP is unknown, but it
has become clear in recent years that birth difficulties are
not to blame in most cases. Developmental problems be-
fore birth, usually unknown and generally undiagnos-
able, are responsible for most cases. Although the inci-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Ataxic — Ataxic refers to a condition called ataxia,
in which balance and coordination are impaired.
Athetoid — The type of CP that is marked by slow,
writhing, involuntary muscle movements.
Attention-deficit/hyperactivity disorder — A be-
havioral disorder marked by inattentiveness, hyper-
activity, and impulsivity.
Augmentative communication devices — Comput-
ers, picture boards, and other devices that increase
the ability to communicate, either with or without
speech.
Contracture — Shortening of a muscle caused by
an imbalance of force between opposing muscles.
Diplegia — Paralysis of corresponding parts on both
sides of the body.
Dorsal rhizotomy — Surgical procedure that cuts
nerve roots to reduce spasticity in affected muscles.
Dystonic — Dystonic refers to a condition called
dystonia, in which fine motor control is confused.
Equinovarus — A condition in which the foot is
commonly pulled inward.
Equinus — The most common postural deformity,
the foot is extended by the strong pull of the rear
calf muscles, causing the toes to point.
Hemiplegia — Paralysis of one side of the body.
Hypotonic — Hypotonic refers to a condition called
hypotonia, in which fine motor control is floppy,
without tone.
IEP — Ind ividualized Educational Plan; a plan that
guides the delivery of services to a child with spe-
cial education needs.
Ketogenic diet — A specialized diet designed to in-
crease the blood levels of breakdown products
known as ketone bodies. For unknown reasons,
this aids in seizure control.
Perinatal asphyxia — Asphyxia, or lack of oxygen,
that occurs during birth.
Quadriplegia — Paralysis of all four limbs.
Serial casting — A series of casts designed to gradu-
ally move a limb into a more functional position,
as opposed to doing it all at once with one cast, as
would be done in setting a broken bone.
Spastic — Spastic refers to a condition in which the
muscles are rigid, posture may be abnormal, and
fine motor control is impaired.
Tenotomy — Surgical procedure that cuts the ten-
don of a contractured muscle to allow lengthening.
dence of CP caused by Rh factor incompatibility has de-
clined markedly, the incidence of CP as a consequence
of prematurity has increased, because of the increasing
success of medical intervention in keeping premature ba-
bies alive.
The risk of CP can be decreased through good mater-
nal nutrition, avoidance of drugs or alcohol during preg-
nancy, and prevention or prompt treatment of infections.
Recent preliminary research suggests that magnesium
sulfate may reduce the risk of CP in mothers taking it for
the medical treatment of preeclampsia and preterm labor
Resources
BOOKS
The Burton Goldberg Group. “Cerebral Palsy.” Alternative
Medicine: The Definitive Guide. Tiburon, CA: Future
Medicine Publishing, Inc., 1999.
“Cerebral Palsy." Reader's Digest Guide to Medical Cures and
Treatments. Canada: The Reader’s Digest Association,
Inc., 1996.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Kramer, Laura. Uncommon Voyage: Parenting a Special Needs
Child in the World of Alternative Medicine. Faber &
Faber, 1996.
Miller, Freema, and Steven J. Bachrach. Cerebral Palsy: A
Complete Guide for Caregiving. Johns Hopkins Universi-
ty Press, 1995.
Vickers, Andrew. Health Options: Complementary Therapies
for Cerebral Palsy and Related Conditions. Element Pub-
lications, 1994.
PERIODICALS
Exceptional Parent Magazine. 555 Kinderkamack Road,
Oradell, NJ 07649-1517; 800-EPARENT, or 201-634-
6550.
"Hyperbaric Oxygen Therapy." The Exceptional Parent (July
2002): 52.
“IVF Babies at Increased Risk of Cerebral Palsy.” Contempo-
rary OB/GYN (July 2002): 41.
Kuban, KCK, and A. Leviton. “Cerebral Palsy.” New England
Journal of Medicine (1994): 188-95.
"Mature Stem Cell Transplants Linked to Treatment.” Pain &
Central Nervous System Week (July 22, 2002): 1 1 .
401
Cerebral palsy
Cerebral vascular insufficiency
ORGANIZATION
Cranial Academy. 3500 Depaw Boulevard. Indianapolis, IN
46268.(317) 879-0713.
National Information Center for Children and Youth with Dis-
abilities. PO Box 1492, Washington DC 20013-1492.
(800) 695-0285.
United Cerebral Palsy Association. 1660 L Street, NW Wash-
ington, DC 20036-5602. (800) USA-5-UCP,(202) 776-
0406, (202) 973-7197 (TTY). Fax: (202) 776-0414. ucp-
natl@ucpa.org. http://www.ucpa.org.
OTHER
Electronic forum for cerebral palsy, http://neuro-www.mgh.
harvard.edu/forum/CerebralPalsyMenu.html.
Mai Tran
Teresa G. Odle
Cerebral vascular
insufficiency
Definition
Cerebral vascular insufficiency is defined as insuffi-
cient blood flow to the brain. The most common cause of
decreased blood flow is atherosclerosis of the arteries
that supply blood to the brain.
Description
Cerebral vascular insufficiency is a common condi-
tion in the older population of developed countries due
to the high prevalence of atherosclerosis. The artery af-
fected in most cases of this disease is the carotid artery,
which carries most of the brain’s blood supply.
Causes & symptoms
A stroke, caused by reduced blood and oxygen sup-
ply, may be an indication of severe blockage in the
carotid artery. Less severe blockage may still cause
“mini-strokes” or transient ischemic attacks (TIAs),
which can cause symptoms of dizziness, ringing in the
ears, blurred vision, and confusion. Any of these prob-
lems could indicate cerebral vascular insufficiency.
Diagnosis
Diagnosis of cerebral vascular insufficiency is based
upon the presence of one or more of the following symp-
toms:
• blurred vision
402
• depression
• vertigo (dizziness)
• headache
• lack of vigilance
• senility
• short-term memory loss
• ringing in the ears (tinnitus)
The diagnosis is confirmed by using an ultrasound
exam to analyze blood flow to the brain.
Treatment
EDTA chelation therapy
EDTA (ethylene-diamine-tetra-acetic acid) chela-
tion therapy involves intravenous or oral administration
of EDTA, a compound which pulls out plaque compo-
nents and helps to break it down. EDTA can improve
blood flow and relieve symptoms associated with athero-
sclerotic vascular disease. It may be necessary to take vi-
tamin and mineral supplements during EDTA therapy to
avoid certain deficiencies, so a health practitioner should
be consulted before beginning therapy, and a qualified
EDTA chelation specialist should be consulted for intra-
venous therapy.
Aortic glycosaminoglycans ( GAGs)
A natural medicine which can be helpful is an ex-
tract of aortic glycosaminoglycans (GAGs), a mixture
which is naturally present in the human aorta. Significant
improvements in both symptoms of cerebral vascular in-
sufficiency and blood flow have been noted when aortic
GAGs are added to the diet. An effective dosage of aortic
GAGs is 100 mg daily and should be used for at least six
months after a stroke or TIA, after consultation with a
health practitioner.
Ginkgo biloba
In well-designed studies, ginkgo biloba (Ginkgo
biloba ) extract (GBE) has displayed an ability to reduce
major symptoms of cerebral vascular insufficiency, in-
cluding short-term memory loss, vertigo, headache, ring-
ing in ears, lack of vigilance, and depression. A consulta-
tion with a practitioner or doctor is recommended before
beginning a ginkgo biloba regimen.
Properties of GBE helpful for cerebral vascular in-
sufficiency:
• neutralizes free radicals
• makes blood more available in ischemic areas through
dilation
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• inhibits platelet-activating factor (PAF) as an alterna-
tive for those allergic to aspirin
• increases the rate at which information is transmitted at
the nerve cell level, improving vigilance and mental
performance
Coleus forskohlii
Many of the properties of coleus (Coleus forskohlii)
prove helpful for this condition. Coleus is a vasodilator,
an agent that widens or dilates blood vessels to allow
more blood flow. The use of coleus as a treatment for
high blood pressure indicates its usefulness in cerebral
vascular insufficiency and resulting stroke. Its ability to
retard platelet activation and accumulation indicate that
it may be helpful in preventing atherosclerotic events.
Spinal manipulative therapy
In one study, some patients receiving soft tissue
therapy, trigger point therapy, postisometric relax-
ation of spasmed muscles (a technique used for relax-
ation of muscle tension), and spinal manipulation to par-
tially dislocated vertebrae experienced improvement of
cerebral vascular insufficiency symptoms such as verti-
go, fatigue, and sleep disturbances, and improved cere-
bral circulation. However, patients who were initially di-
agnosed with an early form of cerebral vascular insuffi-
ciency with vascular disturbances in the neck area or ver-
tebral artery syndrome had their symptoms worsen
during manipulative treatment. A person with these diag-
noses should not undergo spinal manipulation.
Allopathic treatment
Vasodilators help to treat the symptoms of cerebral
vascular insufficiency and arteriosclerosis by increasing
the blood flow in veins and arteries. Isoxsuprine is a va-
sodilator which relaxes blood vessels, making them
wider and allowing blood to flow through them more
easily. Other treatments which are becoming more com-
mon are carotid angioplasty (surgical repair of the arter-
ies that pass up the neck and supply the head) and stent-
ing. (A stent is a device that is used to keep open a tubu-
lar structure, like a blood vessel.)
If a person has severe cerebral vascular insufficien-
cy, including frequent TIAs or past stroke and severe
(about 70%) blockage, carotid endarterectomy may be
necessary. This surgery involves the surgical removal of
the atherosclerotic plaque from the carotid artery.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Arteriosclerosis — Any hardening of the arteries.
Atherosclerosis — Hardening of the arteries char-
acterized by plaque buildup.
Endarterectomy — A procedure in which the dis-
eased inner portions of an artery, including any
deposits, are removed.
Free radicals — Atoms in the body which carry an
unpaired electron. Thought to promote the forma-
tion of arterial plaque in atherosclerosis.
Homocysteine — An amino acid in the blood, too
much of which is related to a higher risk of vascu-
lar disease.
Ischema — Local anemia due to mechanical ob-
struction, mainly arterial narrowing, of the blood
supply.
Vigilance — Attentiveness or alertness.
Expected results
Physicians who use EDTA chelation treatment claim
great success; however EDTA chelation therapy has not
been FDA approved for treatment of atherosclerosis.
People considering this therapy may want to do some re-
search and talk with their doctors or an EDTA chelation
specialist.
Carotid endarterectomy is a surgery which may have
serious complications, including strokes, which may
cause permanent neurological damage or death. Howev-
er, for people with severe cerebral vascular insufficiency
this may be the best option. A person with this condition
should talk with his or her doctor about the risks and
benefits of surgery.
Any treatment for vascular disease caused by ather-
osclerosis should include an evaluation of diet and other
factors to prevent re-blocking of the arteries. Improved
diet and exercise can help a person’s long term outlook
for this condition.
Prevention
Measures taken to prevent hypertension and reduce
cholesterol and atherosclerosis will also help prevent
cerebral vascular insufficiency. Proper diet and lifestyle
may not only protect against atherosclerosis, but may
also reverse blockage in the arteries. A low-fat diet in-
cluding vegetables, grains, legumes, and soybean prod-
ucts along with cold water fish and some poultry (no red
meat) along with stress reduction techniques and exer-
403
Cerebral vascular insufficiency
Cervical dysplasia
cise can reduce atherosclerosis. Other important factors
are controlling high blood pressure and diabetes and
avoiding tobacco. Homocysteine, an amino acid the
human body produces that is related to atherosclerosis,
may be reduced through dietary reform as mentioned
above and supplementation of folic acid, B 6 (pyridox-
ine), and B 12 . Gingko biloba may also be taken as a sup-
plement for its properties mentioned above.
Resources
BOOKS
Goldberg, Burton. Alternative Medicine: The Definitive Guide.
Tiburon, CA: Future Medicine Publishing, Inc., 1999.
ORGANIZATIONS
American College for Advancement in Medicine. 23121 Ver-
dugo Drive, Suite 204, Laguna Hills, CA 92653. http://
www.acam.org.
Life Extension Foundation. 995 SW 24th Street, Fort Laud-
erdale, FL 33315. (954) 766-8433, (877) 900-9073. http://
www.lef.org.
National Institute of Neurological Disorders and Stroke.
Bethesda. MD 20892. http://www.ninds.nih.gov/index.
htm.
OTHER
Oral chelation for improved heart function. http://www.kirlian.
org/life_enhancement_products/oralchelation.html. July
25, 2000.
Melissa C. McDade
Cervical dysplasia
Definition
Cervical dysplasia is the existence of abnormal cells
on the uterine cervix.
Description
The cervix is an organ in the female reproductive
system. It is narrow and located at the lower end of the
uterus. The cervix serves as a tubular passageway be-
tween the uterus and vagina. When a woman is pregnant,
the cervix closes and seals off the uterus for the develop-
ing fetus. During childbirth, the cervix expands to allow
the baby to pass through. When a woman is not preg-
nant, the lining of the uterus passes through the cervix
each month during the menstrual cycle. The cervix also
secretes mucus during ovulation, which assists in the fer-
tilization of the egg by sperm cells. Women can usually
feel the cervix by inserting a finger toward the back of
404
the vagina. The cervix resembles a small mound with a
dimple in the middle.
The cervix has two types of cells. The outer part of
the cervix near the vagina is covered with cells called
squamous epithelial cells. The cervix canal is lined with
epithelial cells that secrete mucus during ovulation. The
border between these two types of cells is called the
transformation zone, which changes shape and position
with age. Doctors may closely examine the transforma-
tion zone to watch for problems in both types of cells.
Cervical dysplasia occurs when cells on the cervix
have abnormalities. The condition is technically called
cervical intraepithelial neoplasia (CIN) or squamous in-
traepithelial lesions (SIL), depending on the affected
cells. The cervix is also susceptible to other problems,
including cervicitis (inflammation), sexually transmitted
diseases (STDs), infections, and cancer (dysplasia is a
precursor to cancer).
Causes & symptoms
The two factors that create the highest risks for cer-
vical dysplasia are smoking and sexual behavior. Cervi-
cal dysplasia is two to three times more likely to occur in
women who smoke than in those who do not. One study
showed that the risk of dysplasia increases directly with
the number of cigarettes a woman smokes per day. A
second study published in the late fall of 2002 showed
that smokers infected with HPV had infections that last-
ed longer and were more difficult to eradicate than
women who were infected but had never smoked. Nico-
tine, a toxin in cigarette smoke, can be found in the cer-
vical cells of smokers.
Sexual behavior is another major risk factor. Studies
have shown that the presence of sexually transmitted dis-
eases are strongly correlated with the occurrence of cer-
vical dysplasia. Women who have human papillomavirus
(HPV), which causes genital warts, have higher occur-
rences of cervical dysplasia. Other STDs are believed to
influence cervical dysplasia as well, including herpes,
hepatitis B and C, and HIV. Risky behaviors for con-
tracting STDs and cervical dysplasia include having
many sexual partners, having intercourse at a young age,
and having unprotected sex.
As of late 2002, there is a clear need to educate
women more effectively about the link between human
papillomavirus infections and cervical cancer. A recent
study found that even women who understand the impor-
tance of early cervical cancer detection are much less
well informed about the risk factors for cervical cancer.
Other factors that influence the development of cervi-
cal dysplasia are a high number of pregnancies; long-term
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
use of birth control pills; use of immunosuppressive drugs
(drugs which weaken the immune system); and deficien-
cies of folic acid, vitamin A, and vitamin C. Folic acid
deficiency is often observed with heavy alcohol consump-
tion, which may indirectly pose a risk as well, as may
drug abuse. Cervical dysplasia has also been observed to
have higher incidence in women in low income groups.
Cervical dysplasia is generally asymptomatic, which
means that most women are not alerted to the condition
by detectable symptoms. To detect cervical dysplasia,
women must rely on diagnostic tests.
Diagnosis
The most common method for diagnosing cervical
dysplasia is the Pap smear, which was invented by the
American researcher George Papanicolaou in the 1950s.
Due to the effectiveness of the Pap smear in detecting
cervical problems, the incidence of cervical cancer has
decreased by as much as 50% since 1960. Deaths from
cervical cancer have decreased by as much as 70% in
groups of women who get frequent Pap tests.
The Pap test is a simple procedure. A doctor inserts
a small brush and obtains a sample of cervical cells that
are then analyzed under a microscope. Cell abnormali-
ties, or cervical dysplasia, can be classified as low grade
or high grade, or ranked numerically. A Class 1 Pap re-
sult is normal. Class 5 represents cervical cancer, and the
numbers in between indicate relative severity. It should
be noted that the Pap smear is not perfectly accurate. In
20% or more of tests, the Pap smear can fail to find prob-
lems. The Pap smear may also overestimate the severity
of abnormalities. Thus, if dysplasia is found for the first
time, it is a good idea to have follow-up Pap tests to con-
firm the diagnosis. To increase the accuracy of Pap tests,
women should not douche or use a tampon for three days
before an exam, should abstain from intercourse for two
days, and should allow a week after menstrual periods or
vaginal infections before having the exam performed.
Since women exposed to the HPV virus are also
more susceptible to cervical dysplasia and cervical can-
cer, in 2002, a Food and Drug Administration (FDA)
panel backed an HPV test as an accompaniment to the
Pap smear. The test could help separate women at high
or low risk for cervical disease.
If Pap tests continue to detect cervical dysplasia,
other diagnostic tests may be ordered. A cervigram is a
photograph of the cervix that can be performed along-
side a Pap test. A colposcopy is a procedure in which a
tiny camera allows the physician to view the cervix and
the interior of the vagina. If cancer or severe problems
are suspected after a colposcopy, a biopsy may be used,
in which tissue from the cervix, vagina, and uterus is sur-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Dyplastic cells in the cervix. (Photograph by Jonathan Ash-
ton. Science Photo Library, National Audubon Society Collec-
tion/Photo Researchers, Inc. Reproduced by permission.)
gically removed in order to be analyzed. In a cone biop-
sy, a surgeon removes a cone-shaped section of the
cervix to check for cancerous cells. Cone biopsies can
cause permanent internal scarring, so women should
carefully consider this procedure, particularly in cases
where dysplasia is not severe.
Treatment
There are several alternative therapies that can be
utilized for cervical dysplasia. During and after alterna-
tive treatment, cervical dysplasia should still be moni-
tored by Pap smears from standard physicians, particu-
larly for severe cases.
Dietary and nutritional therapies seek to balance the
hormonal system and support the immune system. Diets
for cervical dysplasia should be predominately vegetari-
an and low in fat, emphasizing fresh fruits, vegetables,
grains, nuts, and legumes (beans and lentils). Alcohol,
caffeine, fried foods, and sugar should be avoided, as
should foods that may contain artificial hormones and
estrogen, such as dairy and meat products that are not or-
ganically produced. Women should eat plenty of yellow
and leafy green vegetables. Tomatoes contain a sub-
stance called lycopene that may protect against dyspla-
sia. Soy products should also be frequently added to the
diet for their estrogen balancing effects.
Nutritional support includes the supplementation of
B-complex vitamins, particularly folic acid, vitamin B 6 ,
and vitamin B 12 . Vitamins A, C, and E are recommended,
as are the minerals selenium and zinc. Grape seed ex-
tract and pine bark extract are recommended antioxi-
dants to assist healing, and nutritional yeast and spiruli-
na are natural supplements for B vitamins and minerals.
Recommended herbs include vitex berries (also
called chasteberries, or chasteberry tree) and black co-
405
Cervical dysplasia
Cervical dysplasia
hosh to balance hormones and stimulate healing in the
reproductive system. Herbs to stimulate and support the
immune system include echinacea, goldenseal, bur-
dock, milk thistle, shiitake mushrooms, yarrow, ginger,
and astragalus. Herbs that may balance hormones in-
clude red clover, kudzu root, licorice root, and Siber-
ian ginseng. Aromatherapy baths may also help, utiliz-
ing the essential oils of geranium, rose, lavender, bitter
orange, rosemary, or tea tree oil. Herbal douches and
herbal vaginal suppositories are available that utilize
herbs and essential oils to stimulate internal healing.
Exercise is recommended to stimulate the immune
system and reduce stress. Yoga has exercises specifical-
ly designed to stimulate circulation in the lower ab-
domen and reproductive organs. Plenty of fresh air dur-
ing the day is also beneficial for those trying to improve
their health and energy.
Stress and emotional problems may also play a sig-
nificant role in cervical dysplasia and in problems with
the reproductive system in general. Mind/body tech-
niques such as psychotherapy, meditation, progressive
relaxation, breath work, and visualization may help re-
duce stress, remove emotional blockages, and stimulate
healing. Detoxification therapies may also be recom-
mended, including fasting, sweating, and other tech-
niques, particularly for women who may have accumu-
lated toxins in the body from smoking, drug abuse, or
poor dietary and lifestyle habits.
Allopathic treatment
For mild cases of cervical dysplasia, physicians may
choose to monitor a patient with Pap smears every three
months, to determine if the condition can improve on its
own. For severe or chronic cases of dysplasia, allopathic
treatment seeks to remove or destroy abnormal cells on
the cervix. Cryosurgery destroys dysplastic cells by
freezing them. Abnormal cervical cells can be burned off
with a solution of trichloroacetic acid. Laser surgery may
also be employed, as well as the loop electroexcision
procedure (LOOP), a surgery in which a small wire loop
with an electrical charge is used to destroy abnormal cer-
vical cells. Conventional surgery may be used for severe
cases of dysplasia. Women with high-risk HPV infection
are typically treated by conization, which is a procedure
in which the surgeon excises, or cuts out, a cone-shaped
piece of the cervix. Conization is reported to be about
73% effective in eliminating the HPV infection. Partial
hysterectomies remove the uterus and cervix.
Expected results
Several outcomes are possible with cervical dysplasia.
In some cases, dysplasia may clear up completely without
406
medical intervention. Some statistics have shown that
moderate to severe cervical dyplasias (Class 3) improve on
their own in 50% of cases. Mild dysplasia may progress to
severe dysplasia in up to 25% of cases. A 2002 study found
that HIV-infected women were more likely than women
not infected with HIV to have a recurrence of cervical dys-
plasia even after treatment for it. Hysterectomy was the
most effective method to preventing recurrence.
As of late 2002, there is still no completely satisfac-
tory treatment for cervical dysplasia associated with
HPV infection. None of the present therapies are 100%
effective in eradicating HPV infection.
Cervical dysplasia does not directly progress to cer-
vical cancer, especially when it is detected early and
treated. In some studies, cervical dysplasia progressed to
cervical cancer in approximately 15% of cases that were
not diagnosed and treated properly. Cervical cancer is
the second most common malignancy in women between
the ages of 15 and 34; about 1% of cervical cancers
occur in pregnant or recently pregnant women. When de-
tected early by frequent Pap smears and other tests, how-
ever, cervical cancer is very treatable. One study estimat-
ed that cervical cancer is fatal for 1 in 30,000 women.
Prevention
The most important recent development related to
prevention of cervical dysplasia is the positive outcome of
clinical trials of a vaccine against HPV. According to an
article published in the New England Journal of Medicine
in November 2002, a vaccine against HPV type 16 was ef-
fective in reducing the incidence of cervical dysplasia as
well as HPV infection in the study subjects. Similar find-
ings have been reported by Australian researchers.
Until a vaccine against HPV is approved for general
use, however, women should eliminate risky sexual be-
haviors and should immediately quit smoking. Healthy
dietary and lifestyle habits should be adopted, and birth
control pills should be avoided. Pap tests and gynecolog-
ical exams should be performed once a year or more to
monitor for recurring dysplasia. In fact, regular Pap tests
are critical to early detection of cervical disease. A 2002
report by the College of American Pathologists said that
of those women who die of cervical cancer, 80 percent
had not seen their doctors for a Pap test in the five years
preceding their diagnoses.
Resources
BOOKS
“Gynecologic Neoplasms.” Section 18, Chapter 241 in The
Merck Manual of Diagnosis and Therapy, edited by Mark
H. Beers, MD, and Robert Berkow, MD. Whitehouse Sta-
tion, NJ: Merck Research Laboratories, 1999.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Cervix — The lower narrow end of the uterus,
sometimes called the neck of the womb.
Conization — Surgical removal of a cone-shaped
piece of tissue from the cervix.
Dysplasia — An abnormality or alteration in the
size, shape, or organization of mature cells.
Gynecologist — Medical doctor specializing in
women's reproductive disorders.
Human papillomavirus (HPV) — Any of about 70
types of viruses that cause plantar warts and geni-
tal warts in humans. HPV types 16, 18, 31, 33,
35, and 39 are associated with an increased risk
of cervical dysplasia in infected women.
Uterus — Female reproductive organ that contains
the developing fetus during pregnancy.
Hobbs, Christopher and Kathi Keville. Women’s Herbs,
Women' s Health. Loveland, CO: Interweave Press, 1998.
Morgan, Peggy and the Editors of Prevention Magazine. The
Female Body: An Owner's Manual. Emmaus, PA: Rodale,
1996.
PERIODICALS
Bodner, K., B. Bodner-Adler, F. Wierrani. et al. “Is Therapeutic
Conization Sufficient to Eliminate a High-Risk HPV In-
fection of the Uterine Cervix? A Clinicopathological
Analysis Anticancer Research 22 (November-December
2002) (6B): 3733-3736.
Castellsague, X., F. X. Bosch, and N. Munoz. "Environmental
Co-Factors in HPV Carcinogenesis.” Virus Research 89
(November 2002): 191-199.
“College of American Pathologists Applauds New Pap Test
Guidelines.” Women s Health Weekly (May 30, 2002): 12.
Frazer, I. “Vaccines for Papillomavirus Infection.” Virus Re-
search 89 (November 2002): 271-274.
Frieden, Joyce. "FDA Advisory Panel; Backs HPV Test as Pap
Smear Adjunct (Identifies High-Risk Strains).” Family
Practice News (June 15, 2002): 30-31.
Giulian, A. R., R. L. Sedjo, D. J. Roe, et al. “Clearance of
Oncogenic Human Papillomavirus (HPV) Infection: Ef-
fect of Smoking (United States).” Cancer Causes and
Control 13 (November 2002): 839-846.
Koutsky, L. A., K. A. Ault, C. M. Wheeler, et al. "A Controlled
Trial of a Human Papillomavirus Type 16 Vaccine.” New
England Journal of Medicine 347 (November 21, 2002):
1645-1651.
Pitts, M., and T. Clarke. “Human Papillomavirus Infections and
Risks of Cervical Cancer: What Do Women Know?”
Health Education Research 17 (December 2002):
706-714.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Tate, Darren R. and Ralph J. Anderson. “Recrudescence of
Cervical Dysplasia Among Women Who are Infected with
the Human Immunodeficiency Virus: A Case-Control
Analysis.” American Journal of Obstetrics and Gynecolo-
gy (May 2002): 880-883.
Tewari, K. S., and P. J. DiSaia. “Primary Prevention of Uterine
Cervix Cancer: Focus on Vaccine History and Current
Strategy.” Obstetrics and Gynecology Clinics of North
America 29 (December 2002): 843-868.
Zanotti, K. M„ and J. Belinson. “Update on the Diagnosis and
Treatment of Human Papillomavirus Infection.” Cleveland
Clinic Journal of Medicine 69 (December 2002):
948-956.
ORGANIZATIONS
American College of Obstetricians and Gynecologists
(ACOG). 409 12th Street, SW, P. O. Box 96920, Washing-
ton, DC 20090-6920. <www.acog.com>.
Centers for Disease Control and Prevention. 1600 Clifton Road
NE. Atlanta, GA, 30333. (404) 639-3534.
The Health Resource. 209 Katherine Drive, Conway, AR
72032. (501) 329-5272.
OTHER
Health Wisdom for Women. 7811 Montrose Road, Potomac,
MD 20854.(800) 804-0935.
Douglas Dupler
Rebecca J. Frey, PhD
CFS see Chronic fatigue syndrome
Chakra balancing
Definition
Chakra balancing is based on the ancient Indian be-
lief in a series of seven chakras, or energy centers. Chakra
is the Sanskrit word for wheel. These energy centers are
believed to be located at specific points between the base
of the spine and the top of the skull. Some esoteric sys-
tems include additional chakras, said to extend beyond the
physical body into the human auric field. Each chakra is
believed to relate to particular organs of the body, ail-
ments, colors, elements, and emotions. However, different
systems or sources that use the idea of chakras may dis-
agree about the details. The concept of chakras plays a key
role in two ancient Indian healing systems (ayurvedic
medicine and yoga) that are popular today. In recent
decades, however, many modern therapies (like polarity
therapy, therapeutic touch, process acupressure, core
energetics, and color therapy) have also incorporated the
idea of chakras into their own visions of healing. Various
approaches may be used to “balance” the chakras. Chakra
407
Chakra balancing
Chakra balancing
balancing is believed to promote health by maximizing the
flow of energy in the body, much as a tune-up enables a
car to operate at peak efficiency.
Origins
Yoga
Chakras are part of the ancient belief system associ-
ated with yoga. These traditions were handed down orally
for thousands of years before being codified by Patanjali
in his Yoga Sutras, several centuries before Christ.
Ayurveda
The ancient healing science of ayurveda is based on
a collection of scriptures known as vedas (a Sanskrit
word meaning knowledge or wisdom). Ayurveda literally
means “life knowledge.” It remained the predominant
form of health care in India until the British colonial
government tried to suppress it during the nineteenth
century. Over the last half-century, however, a modern-
ized form of ayurveda has gained considerable populari-
ty in India. More recently, traditional ayurveda has been
popularized in the West by such high-profile advocates
as Deepak Chopra.
Benefits
Balancing the chakras is believed to promote general
health and well-being by ensuring the free flow of life en-
ergy (also known as prana or qi) throughout the body. It
is believed that blockages in the flow of this vital energy
will eventually result in mental, emotional, and/or physi-
cal illness. By removing such blockages and maximizing
energy flow, practitioners are said to enable body, mind,
and spirit to function optimally. Some alternative practi-
tioners, such as medical intuitives, say they can “read” a
patient’s chakras to detect imbalances and diagnose prob-
lems. This is also sometimes done using a pendulum.
Description
Yoga
Just as the various forms of yoga attempt to mediate
between the physical and spiritual realms, so the chakras
are believed to operate as energy transformers. They are
often shown as circles, spaced at intervals along the
spine, or sometimes as funnels of energy. Specific chants
or sounds associated with the different chakras are used
in some yogic meditation practices as tools for healing
and spiritual evolution.
Each of the seven chakras is said to have specific
physiological and metaphysical functions that relate to
408
both the nature of the associated blockages and to the
physical problems they produce.
• Base/root chakra (muladhara). The first chakra, located
at the base of the spine, is linked with basic survival
and with the adrenal glands. It is associated with the
color red and the earth element.
• Second chakra (svadisthana). Thought to reside in the
genital region, this chakra is linked with sexuality and
with the reproductive system. It is associated with the
color orange and the water element.
• Third chakra (manipura). Situated near the navel, this
chakra is linked with the pancreas and the solar plexus.
It is associated with the color yellow, the fire element,
and power in the world.
• Heart chakra (cnahata). The fourth chakra, associated
with the heart and the immune system, is believed to be
the seat of love and compassion. It is associated with
the color green and the air element.
• Throat chakra (visuddha). The fifth chakra, situated in
the throat area, is associated with the thyroid gland, the
color blue, and communication.
• Brow/forehead chakra (ajna). The sixth chakra, also
known as the “Third Eye,” is said to reside in the fore-
head. It is associated with hormonal production, the
color indigo, and intuition.
• Crown chakra (saha srara). The seventh chakra, located
at the top of the skull, is associated with elevated spiritu-
al consciousness, the pineal gland, and the color violet.
Precautions
In recent decades, yoga has gained widespread ac-
ceptance in the West as a tool for relaxation, stress re-
duction, increased flexibility and energy. However, there
is no generally recognized scientific evidence for the ex-
istence of either chakras or prana.
Side effects
Although the concept of chakra balancing is harm-
less, any of the many contemporary therapies that in-
clude chakras may also use specific treatments or prac-
tices with potential side effects. Anyone exploring such
therapies should be cautious and keep his or her health-
care provider informed of these therapies.
Research & general acceptance
Although there is a growing body of research docu-
menting the positive effects of yoga and meditation,
chakras have not been measured by scientific instru-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
ments. Support for the concept is based on anecdotal
rather than scientific evidence.
Resources
BOOKS
Cassileth, Barrie R. The Alternative Medicine Handbook. New
York: W.W. Norton & Company, 1998.
Pond, David. Chakras for Beginners: A Guide to Balancing
Your Chakra Energies. Saint Paul: Llewellyn Publica-
tions, 1999.
Woodham, Anne, and David Peters. DK Encyclopedia of Heal-
ing Therapies. New York: DK Publishing, 1997.
Peter Gregutt
Chamomile
Description
Chamomile is a traditional medicinal herb native to
western Europe, India, and western Asia. It has become
abundant in the United States, where it has escaped culti-
vation to grow freely in pastures, cornfields, roadsides,
and other sunny, well-drained areas. The generic name,
chamomile, is derived from the Greek, khamai, meaning
“on the ground,” and melon , meaning “apple.” The offi-
cial medicinal chamomile is the German chamomile Ma-
tricaria recutita. Chamomile was revered as one of nine
sacred herbs by the ancient Saxons. The Egyptians val-
ued the herb as a cure for malaria and dedicated
chamommile to their sun god, Ra. Two species of this
sweet-scented plant, Roman chamomile and German
chamomile, have been called the true chamomile be-
cause of their similar appearance and medicinal uses.
Roman chamomile Chamaemelum nobiie is a mem-
ber of the Asteraceae , or daisy family. It is a hardy, low-
growing, perennial. Because of the creeping roots and
compact, mat-like growth of this species it is sometimes
called lawn chamomile. Roman chamomile releases a
pleasant, apple scent when walked upon. It was used as a
strewing herb during the middle ages to scent the floors
and passageways in the home and to deter insects. The
Spanish call the herb manzanilla, or “little apple.” This
fragrant evergreen is a garden favorite. It is also called the
physician herb because of its beneficial effect on other
herbs as a companion in the garden. Blossoms grow
singly on long stalks attached to the erect, branching,
hairy stems. The tiny, daisy-like flowers, blooming May to
September, have a small yellow solid cone surrounded by
white rays. The leaves are twice divided and have a feath-
ery appearance. They are light green, and somewhat shiny.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Chamomile flowers. (Scott Camazine/Photo Researchers, Inc.
Reproduced by permission.)
German chamomile Matricaria recutita, or Cham-
omiiia recutita is a hardy, self-seeding annual herb. It has
long been cultivated in Germany to maximize its medici-
nal properties. The hollow, bright gold cone of the blos-
som is ringed with numerous white rays. The herb has
also been called scented mayweed, and Balder’s eyelash-
es, after Balder, the Norse God of Light. German
chamomile is also a sprawling member of the Asteraceae
family, as it closely resembles the Roman chamomile.
Dyer’s chamomile Anthemis tinctora, also known as
yellow chamomile, or golden marquerite, is valued for its
use primarily as a dye plant. This native of southern and
central Europe is also found in Britain and North America,
where it grows wild in many places. It closely resembles the
other species, but does not have the medicinal properties of
Roman and German chamomile. This species may be bien-
nial or perennial. Both the disk and the rays of the blossom
are golden yellow, yielding a distinctive dye that varies
from a bright yellow to a more brownish-yellow tint. The
type of mordant used influences the color produced. Dyer’s
409
Chamomile
Chamomile
chamomile is hardy and can grow to three feet, spreading
out as wide as it is high. The branched stems are erect and
woolly, with leaves that can grow to three inches long.
General use
The aromatic flower heads and herba (leaves) of
both Roman and German chamomile are used medicinal-
ly. They are highly scented with volatile, aromatic oil,
including the heat-sensitive Azulene, which is the blue
chamomile essential oil. The phytochemical constituents
in chamomile also include flavonoids, coumarins, plant
acids, fatty acids, cyanogenic glycosides, choline, tan-
nin, and salicylate derivatives. This bittersweet herb acts
medicinally as a tonic, anodyne, antispasmodic, anti-in-
flammatory, antibacterial, anti-allergenic, and sedative.
Traditionally, a mild infusion of the herb has been safely
used to calm restless children, and to ease colic and
teething pain in babies. It is also effective in relieving
acid indigestion and abdominal pain. Its carminative
properties relieve intestinal gas, and it helps in cases of
diarrhea, constipation, and peptic ulcers. The herbal
tea can ease symptoms of colds and flu by relieving
headache and reducing fever. The infusion is also help-
ful to treat toothache, arthritis, gout, and premenstrual
tension. It may also be used in douche preparations, or
sitz baths. As an external wash in strong infusion, or de-
coction, or as part of a hot compress, the herb can soothe
burns and scalds, skin rashes, and sores. Chamomile
can be used in a douche, as a gargle for mouth ulcers, as
a soothing eye wash for conjunctivitis, and as a hair
rinse to brighten the hair. Chamomile blossoms may also
be used as an herbal aromatic treatment, providing a
tonic lift with its pleasing scent. This use of chamomile
is especially popular among Hispanics living in the
southwestern United States, who use the herb at signifi-
cantly higher levels than the rest of the population.
Preparations
Chamomile is most often prepared as an infusion of
the blossoms of German chamomile, and less commonly
of Roman chamomile. Traditionally the tiny blossoms
are picked on midsummers’ eve. The best time to harvest
is on a sunny day when the mass of blossoms is at its
fullness in the morning. Harvesting chamomile blossoms
can be painstaking work, requiring a gardner’s best pa-
tience. Pinch off the flower head, leaving the stem. Fresh
or dried blossoms may be used in herbal preparations.
Blossoms to be dried for storage should be spread
singly on a screen or mat and placed in a well-ventilated
place, out of direct sun, with a temperature close to 95°F
(35°C). The rapid drying will preserve much of the
volatile oil and other medicinal properties. A few blos-
410
soms go a long way with this pleasant and safe herbal
ally. Store dried blossoms in tightly sealed, glass con-
tainers, away from light. They will maintain potency for
about one year. Chamomile is prolific, and the plant
blossoms frequently throughout the summer. Sometimes
two or three harvests can be made in one season.
Chamomile tea may be made from an infusion of
blossoms prepared as a tisane, for a single, soothing cup,
or in a larger quantity for use throughout the day.
Chamomile combines well with mints, such as lemon
balm (Melissa officinalis') or spearmint (Mentha spica-
ta), combined in equal quantity. For a tisane, use 1 tsp of
dried blossoms, or 1.5 tsp of freshly picked flowers in a
warm cup. Heat water to the boiling point and pour over
the blossoms in glass container. Cover, and infuse for
3-5 minutes. Let strain. Be careful not to oversteep
chamomile, lest it lose its delicate flavor to a bitter edge.
Standard dose is up to three cups per day. The prepared
tea will keep for a day or two in the refrigerator.
To prepare a chamomile decoction, which is a stronger
preparation, let the plant parts steep in a covered nonmetal-
lic pot for at least ten minutes. The decoction may be used
as a skin wash, hair rinse, mouth wash, or to bathe wounds.
An extract of the essential oil can be prepared by
placing 2 oz (57 g) of fresh blossoms into a glass con-
tainer and covering the plant with 0.5-1 pt (0.24-0.47 1)
of olive oil. Place the mixture on a sunny window sill for
about one week. Strain and store in a dark container with
a tight-fitting lid. The oil remains potent for up to one
year. It is best when applied warm.
Precautions
Chamomile has been used over the centuries and is
generally considered a safe and gentle herbal rememdy
that may be used daily as a calming tea. Persons who
may be allergic to such pollen-bearing plants as
chamomile would be wise to experiment with this herbal
remedy with some caution.
Side effects
The moderate internal use of chamomile prepara-
tions has no known side effects; however, some herbal-
ists warn that the herb, when taken internally in exces-
sive doses, can induce vomiting and produce vertigo
(dizziness). With regard to the external use of
chamomile preparations, a small number of persons ex-
perience mild skin irritation.
Interactions
There are no contraindications for using this gentle,
healing herb. Chamomile does combine well with other
herbs that enhance its pleasant and medicinal qualities.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Anodyne — A medicinal herb that relieves distress
or soothes pain.
Coumarin — A chemical compound found in
plants that breaks down red blood cells.
Decoction — A plant extract obtained by boiling
the water in which plant parts have been soaked
and then straining out the plant materials.
Resources
BOOKS
Gladstar, Rosemary. Herbal Healing for Women. New York:
Simon & Schuster, 1993.
Hoffman, David. The New Holistic Herbal. Boston, MA: Ele-
ment Books, Inc., 1992.
McIntyre, Anne. The Medicinal Garden. New York: Henry Holt
and Company, 1997.
Me Vicar, lekka. Herbs for the Home. New York: Viking Pen-
guin, 1995.
PERIODICALS
Rivera, J. O., M. Ortiz, M. E. Lawson, and K. M. Verma.
“Evaluation of the Use of Complementary and Alternative
Medicine in the Largest United States-Mexico Border
City." Pharmacotherapy 22 (February 2002): 256-264.
Schempp, C. M.. E. Schopf, and J. C. Simon. “Plant-Induced
Toxic and Allergic Dermatitis (Phytodermatitis).” [Article
in German] Hautarzt 53 (February 2002): 93-97.
Clare Hanrahan
Rebecca J. Frey, PhD
Charcoal, activated
Description
Activated charcoal is a fine, black, odorless, and
tasteless powder. It is made from wood or other materials
that have been exposed to very high temperatures in an
airless environment. It is then treated, or activated, to in-
crease its ability to adsorb by reheating with oxidizing
gas or other chemicals to break into a very fine powder.
Activated charcoal is pure carbon specially processed to
make it highly adsorbent of particles and gases in the
body’s digestive system.
Activated charcoal has often been used since ancient
times to cure a variety of ailments including poisoning.
Its healing effects have been well documented since as
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
early as 1550 B.c. by the Egyptians. However, charcoal
was almost forgotten until 15 years ago when it was re-
discovered as a wonderful oral agent to treat most over-
doses and toxins.
General use
Activated charcoal’s most important use is for treat-
ment of poisoning. It helps prevent the absorption of
most poisons or drugs by the stomach and intestines. In
addition to being used for most swallowed poisons in hu-
mans, charcoal has been effectively used in dogs, rabbits,
rats and other animals, as well. It can also absorb gas in
the bowels and has been used for the treatment of gas or
diarrhea. Charcoal’s other uses such as treatment of
viruses, bacteria, bacterial toxic byproducts, snake ven-
oms and other substances by adsorption have not been
supported by clinical studies. By adding water to the
powder to make a paste, activated charcoal can be used
as an external application to alleviate pain and itching
from bites and stings.
Poisons and drug overdoses
It is estimated that one million children accidentally
overdose on drugs mistaken as candies or eat, drink, or
inhale poisonous household products each year. In the
year 2000, the American Association of Poison Control
Centers said that more than 1,142,000 calls had been re-
ceived in centers around the country about poison expo-
sures to children under six years of age. Activated char-
coal is one of the agents most commonly used for infants
and toddlers. It can absorb large amounts of poisons
quickly. In addition, it is non-toxic, may be stored for a
long time, and can be conveniently administered at
home. Charcoal works by binding to irritating or toxic
substances in the stomach and intestines. This prevents
the toxic drug or chemical from spreading throughout
the body. The activated charcoal with the toxic substance
bound to it is then excreted in the stool without harm to
the body.
When poisoning is suspected the local poison con-
trol center should be contacted for instructions. They
may recommend using activated charcoal, which should
be available at home so that it can be given to the poi-
soned child or pet immediately. For severe poisoning,
several doses of activated charcoal may be needed. A
2002 study showed that in some cases, charcoal could be
administered at home sooner than in the emergency
room, and was beneficial for children who had ingested
poisonous mushrooms. However, the study concluded
that more research was needed to be sure that home-ad-
ministered doses were accurate and the best solution for
other types of poisoning.
411
Charcoal, activated
Charcoal, activated
Intestinal disorders
In the past, activated charcoal was a popular remedy
for gas. Even before the discovery of America by Euro-
peans, Native Americans used powdered charcoal mixed
with water to treat an upset stomach. Now charcoal is
being rediscovered as an alternative treatment for this
condition. Activated charcoal works like a sponge. Its
huge surface area is ideal for soaking up different sub-
stances, including gas. In one study, people taking acti-
vated charcoal after eating a meal with high gas-produc-
ing foods did not produce more gas than those who did
not have these foods. Charcoal has also been used to
treat other intestinal disorders such as diarrhea, consti-
pation, and cramps. There are few studies to support
these uses and there are also concerns that frequent use
of charcoal may decrease absorption of essential nutri-
ents, especially in children.
Other uses
Besides being a general antidote for poisons or rem-
edy for gas, activated charcoal has been used to treat
other conditions as well. Based on its ability to adsorb or
bind to other substances, charcoal has been effectively
used to clean skin wounds and to adsorb waste materials
from the gastrointestinal tract. In addition, it has been
used to adsorb snake venoms, viruses, bacteria, and
harmful materials excreted by bacteria or fungi. Howev-
er, because of lack of scientific studies, these uses are
not recommended. Activated charcoal, when used to-
gether with other remedies such as aloe vera, aci-
dophilus, and psyllium, helps to keep symptoms of ul-
cerative colitis under control. While charcoal shows
some anti-aging activity in rats, it is doubtful if it can do
the same for humans.
Preparations
For poisoning
Activated charcoal is available without prescription.
However, in case of accidental poisoning or drug over-
dose an emergency poison control center, hospital emer-
gency room, or doctor’s office should be called for ad-
vice. In cases where both syrup of ipecac and charcoal
are recommended for treatment of the poison, ipecac
should be given first. Charcoal should not be given for at
least 30 minutes after ipecac or until vomiting from
ipecac stops. Activated charcoal is often mixed with a
liquid before being swallowed or put into the tube lead-
ing to the stomach. Activated charcoal is available as 30-
gram liquid bottles. It is also available in 15-gram con-
tainer sizes and as slurry of charcoal pre-mixed in water
or as a container in which water or soda pop is added.
412
Keeping activated charcoal at home is a good idea so that
it can be taken immediately when needed for treatment
of poisoning.
For acute poisoning, the dosage is as follows:
• infants (under 1 year of age): 1 g/kg
• children (1-12 years of age): 15-30 g or 1-2 g/kg with
at least 8 oz of water
• adults: 30-100 g or 1-2 g/kg with at least 8 oz of water
For diarrhea or gas
A person can take charcoal tablets or capsules with
water or sprinkle the content onto foods. The dosage for
treatment of gas or diarrhea in adults is 520-975 mg after
each meal and up to 5 g per day.
Precautions
Parents should keep activated charcoal on hand in
case of emergencies.
Charcoal should not be taken together with syrup of
ipecac, as the charcoal will adsorb the ipecac. Charcoal
should be taken 30 minutes after ipecac or after the vom-
iting from ipecac stops.
Some activated charcoal products contain sorbitol.
Sorbitol is a sweetener as well as a laxative, therefore, it
may cause severe diarrhea and vomiting. These products
should not be used in infants.
Charcoal may interfere with the absorption of med-
ications and nutrients such as vitamins or minerals. For
uses other than for treatment of poisoning, charcoal
should be taken two hours after other medications.
Charcoal should not be used to treat poisoning
caused by corrosive products such as lye or other strong
acids or petroleum products such as gasoline, kerosene,
or cleaning fluids. Charcoal may make the condition
worse and delay diagnosis and treatment. In addition,
charcoal is also not effective if the poison is lithium,
cyanide, iron, ethanol, or methanol.
Parents should not mix charcoal with chocolate
syrup, sherbet, or ice cream, even though it may make
charcoal taste better. These foods may prevent charcoal
from working properly.
Activated charcoal may cause swelling or pain in
the stomach. A doctor should be notified immediately. It
has been known to cause problems in people with intesti-
nal bleeding, blockage or those people who have had re-
cent surgery. These patients should talk to their doctor
before using this product.
Charcoal may be less effective in people with slow
digestion.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Antidote — A remedy to counteract a poison or in-
jury.
Adsorption — The binding of a chemical (e.g., drug
or poison) to a solid material such as activated
charcoal or clay.
Charcoal should not be given for more than three or
four days for treatment of diarrhea. Continuing for
longer periods may interfere with normal nutrition.
Charcoal should not be used in children under three
years of age to treat diarrhea or gas.
Activated charcoal should be kept out of reach of
children.
Side effects
Charcoal may cause constipation when taken for
overdose or accidental poisoning. A laxative should be
taken after the crisis is over.
Activated charcoal may cause the stool to turn
black. This is to be expected.
Pain or swelling of the stomach may occur. A doctor
should be consulted.
Interactions
Activated charcoal should not be mixed together
with chocolate syrup, ice cream or sherbet. These foods
prevent charcoal from working properly.
Resources
BOOKS
Blumenthal, Mark. Linden Charcoal. The Complete German
Commission E Monographs, Therapeutic Guide to Herbal
Medicines, American Botanical Council, Boston: Integra-
tive Medicine Communications, 1998. Accessed online.
http://home.mdconsult.com.
Cooney, David. Activated Charcoal: Antidote, Remedy, and
Health Aid. Brushton, NY: TEACH Services, Inc., 1999.
Lacy Charles F., Lora L. Amstrong, Naomi B. Ingrim, and
Leonard L. Lance. Charcoal. The Drug Information
Handbook Pocket Version: 1998-1999, Hudson, OH:
Lexi-Comp Inc., 1998.
Roberts. Activated Charcoal. Clinical Procedures in Emer-
gency Medicine, Philadelphia. PA: W. B. Saunders Com-
pany, 1998: 726-8. Accessed online. http://home.mdcon-
sult.com.
Wilson, Billie A.. Margaret T. Shannon, and Carolyn L. Stang.
Charcoal, Activated (Liquid Antidote ). Nurses Drug
Guide 2000, Stamford, CT: Appleton & Lange, 2000.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
PERIODICALS
Bond, C. Randall. “Activated Charcoal in the Home: Helpful
and Important or Simply a Distraction.” Pediatrics (Janu-
ary 2002) : 145.
Mai Tran
Teresa G. Odle
Chasteberry tree
Description
The chasteberry tree, whose botanical name is Vitex
agnus castus , belongs to the Verbenaceae family. The
fruit is also called chasteberry, vitex, or monk’s pepper.
The terms “chasteberry” and “vitex” are used inter-
changeably below.
The chasteberry tree can grow to a height of 22 ft
(6.71 m) and can be found on wet banks of rivers in
southern Europe and the Mediterranean area. It is also
grown as an ornamental plant in the United States. Al-
though the red-black berry is the most used part, accord-
ing to Joe and Terry Graedon, the leaves contain the
highest amount of flavonoids — up to 2.7%, with the
blue-violet flowers a close second at 1.5%. The berries
contain nearly 1% flavonoids, including casticin,
kaempferol, isovitexin, orientin and quercatagetin.
The Graedons also list the other components of
chasteberry. Surprisingly, in spite of chasteberry ’s use
for hormonal problems, it does not contain plant estro-
gen. Instead, the chasteberry tree contains:
• androstenedione, epitestosterone, hydroxyprogesterone,
progesterone and testosterone in the flowers and leaves
• iridoid glycosides, such as aucubin and agnuside, in the
berries
• essential oil, which includes cineol and pinene
monoterpenes, as well as castine, citronellol, eucalptol,
limonene, linalool and sesquiterpenes ( Chasteberry ’s
spicy aroma is derived from its essential oil.)
• vitricine, an alkaloid
General use
Chasteberry was used by the ancient Greeks and Ro-
mans as well as by medieval monks to lower sexual de-
sire. The Greeks and Romans also used it to keep away
evil. Hippocrates used chasteberry to treat injuries.
Dioscorides advised its application for inflamed wombs,
diseases of the spleen and lactation. European nuns used
413
Chasteberry tree
Chasteberry tree
chasteberry for women’s hormonal problems, and this
latter application is chasteberry ’s main function today. It
is considered a uterine tonic.
Chasteberry acts as a balancer, not only in female
hormonal problems, but also with regard to libido.
Therefore, chasteberry can act as both an aphrodisiac
and an anaphrodisiac. It can normalize hormonal imbal-
ances; treat amenorrhea or dysmenorrhoea; and act to in-
crease or suppress lactation.
According to Robin Landis and Karta Purkh Singh
Khalsa, chasteberry works by helping the pituitary gland
to raise progesterone levels. Chasteberry induces the pi-
tuitary gland to free a luteinizing hormone and stop a
follicle-stimulating one. Landis and Singh Khalsa call
chasteberry a support for female hormones from men-
struation to menopause.
PMS problems are usually caused by low proges-
terone levels in relation to the estrogen level. Taking the
progesterone-laden vitex can relieve many PMS symp-
toms, as was shown in a 1997 double-blind clinical
study. One hundred and seventy-five women randomly
received daily doses of a standard vitex capsule (3. 5-4. 2
mg), a placebo, or two pyridoxine capsules (100 mg
each) to measure the alleviation of such PMS symptoms
as bloating, irritability, depression, breast tenderness,
weight gain, skin problems, and digestive problems. In
the efficacy part of the study, 77.1% of subjects taking
vitex reported improvement in their symptoms, as
against only 60.6% in the pyridoxine group.
Some studies show that chasteberry can both increase
and decrease prolactin levels in the body. Too much pro-
lactin is related to amenorrhea (no menstrual periods) and
breast tenderness associated with PMS; too little prolactin
can mean reduced milk production. In one study featuring
100 nursing mothers, those who took chasteberry had
more milk than those who took a placebo. In another clini-
cal study of PMS associated with high prolactin levels,
vitex balanced not only prolactin levels but the menstrual
cycle itself. According to David L. Hoffman, taking vitex
after stopping birth control pills can regulate cycles and
therefore increase the likelihood of pregnancy. Another
writer has described her own situation of stopping birth
control pills and having no periods for two and a half
years until she started taking chasteberry. German studies
also show that vitex may also help prevent a miscarriage.
Chasteberry is also used to treat fibroid cysts, espe-
cially cysts in smooth muscle. Vitex has been said to be
effective in stopping the heavy bleeding of peri-
menopause and reduce the hot flashes in menopause it-
self. It is used extensively in England for this purpose.
Also, chasteberry ’s antiandrogenic influence can help to
reduce acne in teenagers of either sex.
414
Preparations
Chasteberry may be taken as a tincture, an extract, a
tea or in capsules. The usual dosage is 200 mg of the
berry, with a standardized amount (0.5%) of the active
ingredient agnuside. The recommended dosage varies
with the ailment being treated, and should be decided
upon in conjunction with a health care practitioner.
Tincture and extracts of chasteberry are mixed with
water or juice, 10-30 drops per drink. They should be
taken up to three times daily.
Chasteberry tea is made from 1 tsp of ripe berries to
1 cup (250 ml) of boiling water. The tea must be steeped
for 10-15 min and should be drunk three times daily.
According to one naturopathic physician, the usual
dosage of extract of chasteberry is 175-225 mg on a
daily basis. Capsules are available in doses from 40-400
mg. The capsules are usually taken one to three a day
about one hour before breakfast to increase their absorp-
tion. If taken before bedtime, chasteberry may aid in
sleeping as well as increasing the secretion of melatonin
in the early morning. Because chasteberry acts slowly in
the body, it can take from one to six months to see per-
manent results. These results should continue even after
discontinuing taking chasteberry. To increase milk pro-
duction, women are advised to take chasteberry the first
10 days after giving birth.
Chasteberry may be taken in conjunction with Vita-
min B 6 for PMS.
Precautions
Some practitioners of alternative medicine recom-
mend that pregnant women should abstain from taking
chasteberry. German research indicates that chasteberry is
safe for the first three months of pregnancy, but is unsafe
after that time as it might start the flow of milk too early.
Herbal experts may also advise patients with breast
cancer, uterine cancer, or pituitary tumors not to take
chasteberry. It is always best to check with your health
care provider first.
Because chasteberry does not contain plant estro-
gens, it should not be used as a substitute for hormonal
replacement therapy, or HRT. Women who are concerned
about the possible side effects of HRT should consider
fo-ti or other herbs shown to have measurable estrogen-
like activity, such as licorice and hops.
Side effects
Chasteberry rarely has side effects but a few have
been reported: allergic rashes; minor headaches and
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Agnuside — The active ingredient in chasteberry.
Amenorrhea — The abnormal absence of menstru-
al periods.
Anaphrodisiac — A substance or medication that
suppresses sexual desire.
Dopamine — A neurotransmitter that acts within
certain brain cells to regulate movement and emo-
tions.
Essential oil — Oil from a herb, obtained by steam
distilling or cold pressing, then mixed with a veg-
etable oil or water. It has many functions, includ-
ing use with massage or as an inhalant.
Extract — A concentrated form of the herb made
by pressing the herb with a hydraulic press, soak-
ing it in water or alcohol, then letting the excess
water or alcohol evaporate.
Flavonoids — Plant pigments that have a variety of
effects on human physiology. The casticin,
kaempferol, isovitexin, orientin and quercatagetin
contained in chasteberry are flavonoids.
Melatonin — A hormone secreted by the pineal
gland that helps to regulate biorhythms.
Perimenopause — The time span just before a
woman reaches menopause. It usually begins when
a woman is in her 40s and may produce many of
the symptoms associated with menopause.
Pyridoxine — Another name for vitamin B 6 .
Tincture — An alcohol-based extract prepared by
soaking plant parts.
nausea when first taking chasteberry; changes in the
length of the menstrual period; and increased bleeding.
The alcohol in chasteberry tinctures may cause some
gastric irritation if taken on an empty stomach. This situ-
ation can be avoided by mixing the tincture in water; or
by taking half the tincture before breakfast and half after
lunch; or by taking capsules.
Interactions
Chasteberry should not be combined with such syn-
thetic hormones as those contained in birth control pills
or hormone replacement therapy. The latter includes Pre-
marin and Provera.
Drugs that act on a neurotransmitter in the brain
called dopamine may either affect or be affected by
vitex. These include medications for Parkinson’s dis-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
ease (L-dopa, Parlodel); psychosis (Haldol); smoking
cessation (Zyban); and depression (Wellbutrin).
Resources
BOOKS
Ali, Elvis et al. The All-In-One Guide to Natural Remedies and
Supplements. AGES Publications, 2000.
Balch, James F., MD, and Phyllis A. Balch, CNC. Prescription
for Nutritional Healing. 2nd ed. New York: Avery Pub-
lishing Group, 1997.
Landis, Robin, with Karta Pukh Singh Khalsa. Herbal Defense.
New York: Warner Books, Inc., 1997.
Murray, Michael, ND. Encyclopedia of Nutritional Supple-
ments. Rocklin. CA: Prima Publishing, 1996.
Murray, Michael, ND. The Healing Power of Herbs, 2nd ed.
Rocklin, CA: Prima Publishing, 1995.
PERIODICALS
Oerter Klein, K., M. Janfaza, K. A. Wong, and R. J. Chang.
“Estrogen Bioactivity in Fo-Ti and Other Herbs Used for
Their Estrogen-Like Effects as Determined by a Recombi-
nant Cell Bioassay.” Journal of Clinical Endocrinology
and Metabolism 88 (September 2003): 4077^-079.
ORGANIZATIONS
National Center for Complementary and Alternative Medicine
(NCCAM) Clearinghouse. P.O. Box 7923, Gaithersburg,
MD 20898-7923. (888) 644-6226. <http://nccam.nih.gov>.
U. S. Food and Drug Administration (FDA). 5600 Fishers
Lane. Rockville, MD 20857. (888) 463-6332. <http://
www.fda.gov>.
OTHER
Herb World News Online, Herb Research Foundation, http://
www.herbs.org.
Whole Health Products, http://wholehealthproducts.com, 2000.
Sharon Crawford
Rebecca J. Frey, PhD
Chelated minerals
Description
Chelated minerals are specially formulated miner-
al supplements designed to improve absorption of
these essential nutrients into the body. What makes a
mineral a chelated compound is the bonding of the
mineral to nitrogen and the ligand that surrounds the
mineral and protects it from interacting with other
compounds. Although chelated minerals are believed
to be better absorbed within the body, studies have
shown no significant difference between chelated and
nonchelated forms.
415
Chelated minerals
Chelated minerals
General use
The importance of minerals
Minerals are vital to health because they are the
building blocks that make up muscles, tissues, and
bones. They also are important components of many life-
supporting systems and activities, and are important to
hormones, oxygen transport, and enzyme systems.
Minerals participate in the chemical reactions that
occur inside the body. These nutrients may work as co-
factors or helpers. As cofactors, minerals help enzymes
function properly. Minerals may also work as catalysts to
initiate and speed up these enzymatic reactions.
Minerals are the electrolytes that the body needs to
maintain normal body fluids and the acid-base balance.
As electrolytes, minerals act as stop gates to control
nerve signal movements throughout the body. Because
nerves control muscle movements, minerals also regulate
muscle contraction and relaxation.
Many minerals such as zinc, copper, selenium, and
manganese act as antioxidants. They protect the body
against the damaging effects of free radicals (reactive
molecules). They scavenge or mop up these highly reac-
tive radicals and change them into inactive, less harmful
compounds. In so doing, these minerals help prevent
cancer and many other degenerative diseases such as
premature aging, heart disease, autoimmune diseases,
arthritis, cataracts, Alzheimer’s disease, and diabetes.
There are two kinds of minerals: the major (or
macro) minerals and the trace minerals. Major minerals
are the minerals that the body needs in large amounts.
The following minerals are classified as major: calcium,
phosphorus, magnesium, sodium, potassium, sulfur,
and chloride. They are needed to build muscles, blood,
nerve cells, teeth, and bones. They are also essential
electrolytes that the body requires to regulate blood vol-
ume and the acid-base balance.
Unlike the major minerals, trace minerals are need-
ed only in tiny amounts. Even though they can be found
in the body in exceedingly small amounts, they are also
very important. These minerals participate in most
chemical reactions in the body. They are also needed to
manufacture important hormones. The following are
classified as trace minerals: iron, zinc, iodine, copper,
manganese, fluoride, chromium, selenium, molybde-
num, and boron.
Why supplements are used
Recent studies have shown that mineral supplements
are needed because most Americans don’t get adequate
amounts of minerals in their diets. More and more peo-
416
pie now take chelated minerals daily to ensure that the
body has enough of these nutrients to function properly.
Many healthy people take minerals to boost their body’s
immune system and to achieve maximal levels of energy
and mental alertness.
Treatment and prevention of diseases
People take individual minerals to prevent or treat
certain diseases and conditions. The following are the
benefits/uses of key minerals and the optimum daily in-
take (ODI) of each mineral. ODI is the amount most
people require to function at their best level.
CALCIUM (ODI = 1,000-1,500 MG). Calcium supple-
ments are commonly used for the prevention and treat-
ment of osteoporosis (a bone thinning disease). Howev-
er, calcium supplements also provide other benefits as
well. Studies have shown that calcium may also be effec-
tive in treating high blood pressure and relieving symp-
toms of leg cramps and arthritis. It may also prevent
colon cancer.
Calcium supplements may be contaminated with
lead, which is highly toxic. A study by the Department
of Environmental Toxicology, University of California,
Santa Cruz, indicates that for calcium supplements,
chelation may be a bad idea. They found that non-chelat-
ed calcium supplements had lower levels of lead contam-
ination than the chelated products.
PHOSPHORUS (ODI = 200-400 MG). Phosphorus is
an important mineral in our body. However, because
Americans often exceed their phosphorus requirements
due to high consumption of sodas and meat, phosphorus
supplements are neither necessary nor recommended.
Excessive consumption of phosphorus accelerates bone
loss leading to osteoporosis.
MAGNESIUM (ODI = 500-750 MG). Magnesium sup-
plements have been used to promote healthy teeth and
bones, treat muscle spasms, relieve premenstrual pain,
and lower high blood pressure in patients with low mag-
nesium levels. Magnesium has also been used to prevent
premature labor and low birth weight.
ZINC (ODI = 22.5-50 MG). Zinc is one of the most
frequently used supplements. A strong antioxidant, zinc
protects the body against damaging free radicals and
boosts the body’s immune system. It helps heal burns
and wounds, offers some protection against common in-
fections such as colds or flu, and helps prevent cancer. It
may be effective in the prevention and/or treatment of
age-related macular degeneration (an eye disease), in-
fertility, hair loss, anorexia nervosa (an eating disor-
der), prostate enlargement, and common skin problems
like acne.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
IRON (ODI = 15-25 MG FOR MEN; 18-30 MG FOR
WOMEN) Iron supplements are most often prescribed to
treat iron deficiency anemia. Iron is also used to in-
crease energy and mental sharpness.
COPPER (ODI = 0.5-2 MG). Copper deficiency is rel-
atively rare due to the abundance of it in natural food
sources and in drinking water. Because of the potential
risk of severe toxicity, copper is best taken as part of a
multivitamin-mineral formula.
MANGANESE (ODI = 15-30 MG). Supplements of
this trace mineral have been used to prevent cancer, to
improve blood sugar control, and to treat arthritic symp-
toms.
CHROMIUM (ODI = 200-600 MICROGRAMS OR
MCG). This trace mineral may help prevent or treat low
blood sugar levels and diabetes. It may also offer protec-
tion against heart disease by lowering blood cholesterol
levels.
SELENIUM (ODI = 50-400 MCG). A good antioxi-
dant, selenium may help protect the body against cancer,
premature aging, and degenerative diseases such as heart
disease and arthritis.
IODINE (ODI = UP TO 150 MCG). Iodine is some-
times used to prevent goiter, an iodine deficiency dis-
ease.
POTASSIUM (ODI = 99-300 MG). Potassium supple-
ments are most often prescribed to treat potassium defi-
ciency caused by chronic diuretic use. Diuretics are
products that make the body eliminate more urine.
BORON. There is no ODI for boron; however, 3-6
mg of boron may be helpful in preventing osteoporosis
and improving symptoms of osteoarthritis.
Prevention of drug-induced side effects
Mineral supplements are used to prevent drug-in-
duced mineral deficiencies. A mineral deficiency some-
times occurs after prolonged use of certain drugs. For ex-
ample, patients who receive diuretics such as hy-
drochlorothiazide or furosemide for high blood pressure
often have low potassium levels. The condition is so
common that doctors routinely prescribe potassium sup-
plements together with diuretics. Because high potassi-
um levels are toxic to the body, patients shouldn’t take
more potassium than the doctor has ordered.
Preparations
One major problem associated with mineral supple-
ments has been poor absorption. Traditional forms of
mineral supplements, the mineral salts, are very inexpen-
sive. However, they don’t absorb well into the body.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Most of the minerals contained in these tablets pass right
through the body and aren’t absorbed into the blood.
Chelation has been used as a means of improving ab-
sorption of minerals from supplements, but the value of
this method is limited at best. Generally, chelated miner-
als are not absorbed more than 5% more effectively than
unchelated supplements. This minor benefit rarely justi-
fies the higher prices charged for chelated products. The
poor absorption of minerals is taken into account when
the daily diet recommendations are developed, so that the
recommended intake should be enough of the mineral to
provide the levels that are actually desired.
Precautions
People should remember several guidelines when
using chelated mineral supplements.
• Mineral supplements are not substitutes for a healthy
diet. In addition, they are not absorbed well by a mal-
nourished body. Therefore, it is important to adhere to a
low-fat, high-fiber diet. People should eat lots of fruits
and vegetables and limit consumption of coffee, alcohol,
red meat, processed foods, and foods high in fat or sugar.
• A naturopath or a nutritionist may recommend one or sev-
eral individual supplements for short-term treatment for a
specific mineral deficiency. However, if continued for too
long, this may upset the mineral balance inside the body
and cause deficiencies of other minerals. For general good
health, it is best to use multiple vitamin and mineral sup-
plements with the minerals in the form of chelates.
• Because of potential interactions between minerals
(such as calcium, iron, or zinc) and other herbal supple-
ments or medications, people should inform their doc-
tor about all supplements they are taking.
• Unlike vitamins, minerals are easily over used and can
become toxic. People should not take minerals at
dosages far exceeding the recommended ODI.
Side effects
The following are some of the adverse effects associ-
ated with high-dose individual mineral supplementation.
• Copper. Copper toxicity is a serious condition. Abdom-
inal pain, nausea, vomiting, diarrhea, dizziness, gen-
eral fatigue, headache, depression, insomnia, and
poor brain function are some of the adverse reactions
associated with copper toxicity.
• Fluoride. High fluoride levels in the body may cause
stomach ulcers and increase the risk of bone cancer.
• Iron. Iron toxicity causes nausea, vomiting, and ab-
dominal pain. Too much iron in the diet has been asso-
ciated with increased risk of infections and cancer.
417
Chelated minerals
Chelation therapy
• Zinc. Excessive zinc supplementation may cause cop-
per deficiency, nausea, and vomiting.
• Potassium. Potassium toxicity can occur if a person
takes more than 18 g of supplement per day. Symptoms
of potassium toxicity include irregular heart beat, mus-
cle fatigue, and heart failure.
• Selenium. Symptoms of selenium toxicity include hair
loss, brittle fingernails, skin irritation, nausea, fatigue,
garlic odor on the breath, and increased risk of infections.
Interactions
Foods increase absorption of minerals. Therefore,
mineral supplements should be taken with food for better
absorption.
Minerals such as calcium, iron, manganese, magne-
sium, copper, or zinc can bind to many drugs when taken
together and can decrease their effectiveness. Therefore,
mineral supplements should be taken two hours before
or two hours after any of the following medications:
• ciprofloxacin
• ofloxacin
• tetracycline
• doxycycline
• erythromycin
• warfarin
• mineral oil
Resources
BOOKS
Bergner, Paul. The Healing Power of Minerals, Special Nutri-
ents, and Trace Minerals. Rocklin, CA: Prima Health,
1997.
Lieberman, Shari, and Nancy Bruning. The Real Vitamin &
Mineral Book. Garden City Park, NY: Avery Publishing
Group, 1997.
Lininger, Schuyler W., ed. A-Z Guide to Drug-Herb-Vitamin
Interactions: How to Improve Your Health and Avoid
Problems When Using Common Medications and Natural
Supplements Together. Rocklin, CA: Prima Health, 1999.
Redmon, George L. Minerals: What Your Body Really Needs &
Why. Garden City Park, NY: Avery Publishing Group.
PERIODICALS
“Doubt Dubious Descriptons on Supplements.” Environmental
Nutrition (February 2002): 7.
Roa, L. “Vitamins, Fact or Fiction?” Prevention (January
1999).
Scelfo, G. M., A. R. Flegal. “Lead in calcium supplements.”
Environ Health Perspect (April 2000): 309-19.
“When (And How) To Take Your Vitamin And Mineral Supple-
ments.” Tufts University Health & Nutrition Letter (March
1999).
418
ORGANIZATIONS
American Association of Naturopathic Physicians. 601 Valley
St., Suite 105. Seattle, WA 98109. (206) 298-0126. Fax:
(206) 298-0129. <http://www.naturopathic.org>.
National Center for Complementary and Alternative Medicine.
NCCAM Clearinghouse. National Institute of Health. PO
Box 8218. Silver Spring, MD 20907-8218. (888) 644-
6226. Fax: (301) 495-4957. <http://nccam.nih.gov>.
Samuel Uretsky, Pharm.D.
Chelation therapy
Definition
Chelation therapy is an intravenous treatment de-
signed to bind heavy metals in the body in order to treat
heavy metal toxicity. Proponents claim it also treats
coronary artery disease and other illnesses that may be
linked to damage from free radicals (reactive molecules).
Origins
The term chelation is from the Greek root word
“chele,” meaning “claw.” Chelating agents, most common-
ly diamine tetraacetic acid (EDTA), were originally de-
signed for industrial applications in the early 1900s. It was
not until the World War II era that the potential for medical
therapy was realized. The initial intent was to develop anti-
dotes to poison gas and radioactive contaminants. The need
for widespread therapy of this nature did not materialize,
but more practical uses were found for chelation. During
the following decade, EDTA chelation therapy became
standard treatment for people suffering from lead poison-
ing. Patients who had received this treatment claimed to
have other health improvements that could not be attrib-
uted to the lead removal only. Especially notable were
comments from those who had previously suffered from
intermittent claudication and angina. They reported suffer-
ing less pain and fatigue, with improved endurance, after
chelation therapy. These reports stimulated further interest
in the potential benefits of chelation therapy for people suf-
fering from atherosclerosis and coronary artery disease.
Benefits
The benefits of EDTA chelation for the treatment of
lead poisoning and excessively high calcium levels are
undisputed. The claims of benefits for those suffering
from atherosclerosis, coronary artery disease, and other
degenerative diseases are more difficult to prove. Report-
ed uses for chelation therapy include treatment of angi-
na, gangrene, arthritis, multiple sclerosis, Parkinson’s
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
disease, psoriasis, and Alzheimer’s disease. Improve-
ment is also claimed for people experiencing diminished
sight, hearing, smell, coordination, and sexual potency.
Description
If the preparatory examination suggests that there is a
condition that could be improved by chelation therapy,
and there is no health reason why it shouldn’t be used,
then the treatment can begin. The patient is generally
taken to a comfortable treatment area, sometimes in a
group location, and an intravenous line is started. A solu-
tion of EDTA together with vitamins and minerals tailored
for the individual patient is given. Most treatments take
three to four hours, as the infusion must be given slowly in
order to be safe. The number of recommended treatments
is usually between 20 and 40. They are given one to three
times a week. Maintenance treatments can then be given
at the rate of once or twice a month. Maximum benefits
are reportedly attained after approximately three months
after a treatment series. The cost of therapy is consider-
able, but it is a fraction of the cost of an expensive medical
procedure like cardiac bypass surgery. Intravenous vita-
min C and mercury chelation therapies are also offered.
Preparations
A candidate for chelation therapy should initially have
a thorough history and physical to define the type and ex-
tent of clinical problems. Laboratory tests will be done to
determine whether there are any conditions present that
may prevent the use of chelation. Patients who have preex-
isting hypocalcemia, poor liver or kidney function, conges-
tive heart failure, hypoglycemia, tuberculosis, clotting
problems, or potentially allergic conditions are at higher
risk for complications from chelation therapy. A Doppler
ultrasound may be performed to determine the adequacy of
blood flow in different regions of the body.
Precautions
It is important for people who receive chelation
therapy to work with medical personnel who are experi-
enced in the use of this treatment. Treatment should not
be undertaken before a good physical, lifestyle evalua-
tion, history, and any laboratory tests necessary are per-
formed. The staff must be forthcoming about test results
and should answer any questions the patient may have.
Evaluation and treatment should be individualized and
involve assessment of kidney function before each treat-
ment with chelation, since the metals bound by the
EDTA are excreted through the kidneys.
Although EDTA binds harmful, toxic metals like
mercury, lead, and cadmium, it also binds some essential
nutrients of the body, such as copper, iron, calcium,
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
zinc, and magnesium. Large amounts of zinc are lost
during chelation. Zinc deficiency can cause impaired im-
mune function and other harmful effects. Supplements of
zinc are generally given to patients undergoing chelation,
but it is not known whether this is adequate to prevent
deficiency. Also, chelation therapy does not replace
proper nutrition, exercise, and appropriate medications
or surgery for specific diseases or conditions.
Side effects
Side effects of chelation therapy are reportedly un-
usual, but are occasionally serious. Mild reactions may
include, but are not limited to, local irritation at the infu-
sion site, skin reactions, nausea, headache, dizziness,
hypoglycemia, fever, leg cramps, or loose bowel move-
ments. Some of the more serious complications reported
have included hypocalcemia, kidney damage, decreased
clotting ability, anemia, bone marrow damage, insulin
shock, thrombophlebitis with embolism, and even rare
deaths. However, some doctors feel that the latter groups
of complications occurred before the safer method cur-
rently used for chelation therapy was developed.
Research & general acceptance
EDTA chelation is a highly controversial therapy. The
treatment is approved by the United States Food and Drug
Administration (FDA) for lead poisoning and seriously high
calcium levels. However, for the treatment of atherosclerotic
heart disease, EDTA chelation therapy is not endorsed by
the American Heart Association (AHA), the FDA, the Na-
tional Institutes of Health (NIH), or the American College of
Cardiology. The AHA reports that there are no adequate,
controlled, published scientific studies using currently ap-
proved scientific methods to support this therapy for the
treatment of coronary artery disease. However, a pooled
analysis from the results of more than 70 studies showed
positive results in all but one. And in 2002, the American
College of Advancement in Medicine pledged its full sup-
port to a $30 million federal study aimed at determining the
safety and efficacy of chelation therapy in patients with heart
disease. The five-year clinical trial involves more than 2,000
people at about 100 sites around the country.
Training & certification
The American Board of Chelation Therapy (ABCT)
provides minimum standards for members administering
chelation. Diplomates have passed written and oral tests
and received supervision of treatment in order to receive
certification.
One professional group that makes recommenda-
tions for treatment methods is the American College for
Advancement in Medicine (ACAM). If contacted, the or-
419
Chelation therapy
Chemical poisoning
KEY TERMS
Angina — Chest pain caused by reduced oxygen to
the heart.
Atherosclerosis — Arterial disease characterized by
fatty deposits on inner arterial walls.
Hypocalcemia — Low blood calcium.
Hypoglycemia — Low blood sugar.
Intermittent claudication — Leg pain and weak-
ness caused by walking.
Thrombophlebitis — Inflammation of a vein to-
gether with clot formation.
ganization will mail out a directory of doctors who are
members and follow their methods. AC AM also offers
chelation therapy workshops.
Resources
BOOKS
Cassileth, Barrie. The Alternative Medicine Handbook. New
York: W. W. Norton & Company, Inc., 1998.
Cranton, Elmer. Bypassing Bypass. Virginia: Medex Publish-
ers, Inc., 1997.
PERIODICALS
Chappel, Stall. Journal of the Advancement of Medicine 6
(1993): 139-160.
“Physician Group Backs New NIH Chelation Therapy Study
for Heart Disease." Heart Disease Weekly (September 29,
2002): 13.
ORGANIZATIONS
The American College for Advancement in Medicine (ACAM).
23121 Verdugo Dr.. Suite 204, Laguna Hills, CA 92653.
(714)583-7666.
American Heart Association, http://www.americanheart.org/
Heart_and_Stroke_A_Z_Guide/chelat.html. 2000.
OTHER
Cranton, Elmer. Chelation therapy, http://www.drcranton.com/
chelation.html. 1999.
Green, Saul. Quackwatch: Chelation therapy. http://www.quack
watch.com/0 1 QuackeryRelatedTopics/chelation.html. 2000.
Judith Turner
Teresa G. Odle
Chemical poisoning
Definition
Chemical poisoning is a major public health con-
cern. Approximately 95% of all accidental or intentional
420
poisonings are due to chemicals. Nearly 90% of these
cases occur at home. The smallest children, infants and
toddlers, are at the highest risk for accidental (acute) poi-
soning. In 2000, poison control centers received well
over a million calls about poison exposures to children
younger than age 6. Chronic exposure is chemical poi-
soning that occurs slowly and insidiously over a pro-
longed period of time. Many chronic, degenerative dis-
eases have been linked to environmental pollution or
poisoning. The list may include cancer, memory loss,
allergies, multiple chemical sensitivity, chronic fa-
tigue syndrome, infertility in adults, learning and be-
havioral disorders, developmental abnormalities, and
birth defects in children.
Description
Currently there are millions of natural and synthetic
chemicals in our world. Approximately 3,000 of them
are known to cause significant health problems. Acci-
dental chemical poisoning involving common household
or garden products is easy to diagnose and treat, as long
as it is recognized early enough. On the other hand, poi-
soning due to daily exposure to chemicals is more diffi-
cult to diagnose and the extent of damage is more diffi-
cult to assess. Toxic chemicals can be found everywhere
— in homes, in the yard, at work, on the playground —
even in foods and drinking water. Some result from ille-
gal dumping. However, many chemical poisoning occur
insidiously by the supposedly harmless chemicals that
people bring into their homes or office to make their
lives more comfortable.
Household poisons
Because of the tremendous amounts of toxic chemi-
cals that can be found inside the house, scientists now
believe the home — not the office or the freeway — is the
most contaminated place of all. Any chemicals found in-
side the house can be accidentally ingested by small chil-
dren. Daily exposure to chemicals indoors may also
cause significant health risks. Major chemical poisons
inside home include volatile organic compounds, lead,
radon, carbon monoxide, and those found in household
cleaners and carpet.
VOLATILE CHEMICALS. Indoor air pollution is
caused by volatile chemicals. These are chemicals that
evaporate at room temperature. When we use products
that contain these volatile substances, these chemicals
are trapped inside our homes reaching to levels thou-
sands of times higher than the outdoor air. Chronic expo-
sure to polluted air may cause lung infections,
headaches, nausea, mental confusion, fatigue, depres-
sion, and memory loss. In addition, they may cause dam-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
age to an unborn fetus and increase the risk of develop-
ing cancer. The following are some of the most common
volatile substances found inside our homes:
• trichloroethane (spray cans, insulation, spot removers)
• tetrachloroethylene (dry-cleaning solutions)
• formaldehyde (glue, foam, preservatives, plywood, fab-
rics, insulation)
• para-dichlorobenzene (P-DCB) (mothballs, air freshen-
ers)
• toluene (solvents, cleaning fluids, wood finishing prod-
ucts)
• benzene (gasoline)
• xylene (paints, finishing products)
• acetone (nail polish removers)
• styrene (foam, carpets, adhesives)
• carbon tetrachloride (dry cleaning solutions, paint re-
movers)
• perchloroethylene (cleaning solvents)
LEAD AND OTHER HEAVY METALS. Lead is a very
toxic chemical, especially to small children. It can cause
poisoning that leads to learning disabilities and behav-
ioral problems in children. Lead poisoning in pregnant
mothers can cause fetal abnormalities, brain damage,
and impaired motor skills in babies. Lead is often found
in leaded paint (in old houses), pesticides, pottery and
china, artist’s paint, and products used for hobbies and
crafts. Also harmful are other heavy metals, such as mer-
cury and cadmium.
RADON. Radon is an odorless gas produced from
the radioactive decay of uranium. It is believed to be the
most common cause of lung cancer. In the outdoor envi-
ronment, radon gas is usually too well-dispersed to accu-
mulate to dangerous levels. It is indoors, without proper
ventilation, in places such as basements, where radon
can seep from the soil and accumulate to dangerous con-
centrations. The only way to know if a home is contami-
nated is through radon testing.
CARBON MONOXIDE. Carbon monoxide (CO) is the
most lethal gas produced by a burning heal source.
Sources of CO are gas heat, fireplaces, or idling cars in
the garage. A CO detector is needed in all homes be-
cause this gas is odorless, colorless, and very deadly.
CHEMICALS TRAPPED INSIDE CARPET. Carpet con-
tains many chemicals capable of causing nerve damage.
These neurotoxic chemicals include acetone, benzene,
toluene, phenol, xylene, decane, and hexane.
HOUSEHOLD CLEANERS. The following are neuro-
toxic chemicals commonly found in household cleaners:
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• chlorine (dishwasher detergents)
• ammonia (antibacterial cleaning agents)
• petroleum (dish soaps, laundry detergents, floor waxes)
MEDICINES. Medicines are one of the most common
causes of accidental and intentional (suicide) poisonings.
Drugs most commonly involved are aspirins, aceta-
minophen, sedatives, any psychoactive drug where a pa-
tient is more prone to impulsive, suicidal action (e.g., an-
tidepressants), antiseizure drugs, iron pills, vitamins/
mineral supplements containing iron, and cardiac drugs,
such as digoxin and quinidine.
Yard chemicals
Yard materials that can be toxic to humans and pets
include:
• Insecticides. Toxic chemicals that can be found in in-
secticide preparations include chlordane, lindane,
toxaphene, arsenic, lead, malathion, diazinon, and
nicotine.
• Rodenticides (chemicals that kill mice or rats). Roden-
ticides often contain very toxic chemicals, such as
sodium fluoroacetate, phosphorus, thallium, barium,
strychnine, methyl bromide, and cyanides.
• Herbicides (chemicals that kill weed). Herbicides con-
tain carbaryl and diazinon, which increase the risk of
childhood brain cancer.
Occupational hazards
Workers are often exposed to toxic effects of various
chemicals in their working environment:
• Polluted air. Workers in poorly ventilated plants which
manufacture paints, insecticides, fungicides, pesticides.
• Radiation. Workers in poorly constructed nuclear
chemical plants.
• Contaminated environment. Miners who labor under-
ground.
• Obnoxious fumes. Fire fighters are most at risk.
• Skin contact with toxic chemicals. Crop pickers being
accidentally sprayed with insecticides.
Toxic chemicals in foods
Highly processed or prepackaged foods use various
chemical additives to make these foods look more attrac-
tive, taste better, or store for longer periods of time.
Harmful substances that can be found in foods include:
• Monosodium glutamate (MSG), a common flavoring
agent. Excessive consumption of MSG may cause hy-
peractivity, memory loss, or other types of brain dam-
421
Chemical poisoning
Chemical poisoning
age. It is often associated with the so-called “Chinese
restaurant syndrome” characterized by headaches, nau-
sea, vomiting, palpitations, and flushing of skin, due to
the MSG content in the food.
• Artificial sweeteners, such as aspartame or saccharin.
These sweeteners can cause a variety of health prob-
lems, including headaches (migraines included), dizzi-
ness, seizures, depression, nausea, and vomiting, and
abdominal cramps. Their use may be associated with
hyperactivity in children. Whether or not they may in-
crease risk of cancer is unknown at this time. Pregnant
women should definitely avoid using these sweeteners.
• Artificial colors. Color additives can be found in a vari-
ety of foods including cereals, juices, candy, frozen
foods, ice cream, cookies, pizza, salad dressings and
soft drinks. Children and adults alike may be exposed
to cancer-causing artificial colors such as Red numbers
8, 9, 19, and 37, or Orange number 17.
• Preservatives. Many of the preservatives found in foods
are very hazardous. Nitrates, a common preservatives
in cured and luncheon meats and canned products, are
known to cause cancer. In addition, a pregnant woman
who consumes large amounts of nitrates (for example,
through eating hot dogs or salami) unknowingly in-
creases risk of brain damage in her unborn child. Syn-
thetic antioxidants are used in prepackaged foods to
prevent food spoilage. Common synthetic antioxidants,
such as butylated hydroxyanisole (BHA) and butylated
hydroxytoluene (BHT), can be found in cereals, baking
mixes, or instant potatoes. These products are known to
cause brain, liver, and kidney damage, as well as respi-
ratory problems.
• Food contaminants. Fruits and vegetables are definitely
healthy foods. However, they may contain dangerous
herbicide and pesticide residues on the surface. Fish in
contaminated lakes or rivers may contain mercury,
dioxin, PCBs, or other polluted chemicals. Babies of
mothers who ate contaminated fish during pregnancy
have lower birth weight, smaller heads, developmental
delays, and lower scores on tests of baby intelligence.
Air pollution and environmental contamination
Air pollution can cause or worsen lung or heart dis-
eases and increase risk of cancer. Chemicals most often
cause pollution in the air and water supply include as-
bestos, carbon monoxide, hydrogen sulfide, lead, nitro-
gen oxides, halogenated hydrocarbons, and pesticides. In
2002, researchers reported a link between carbon
monoxide in air pollution in Los Angeles and increased
risk of heart defects in pregnant women’s developing
children. Women exposed to high levels of air pollution,
especially that caused by vehicles, during the second
422
month of pregnancy were more likely to have children
with heart-related birth defects.
Causes & symptoms
Acute poisoning
The following are possible causes for acute poisoning:
• Accidental ingestion of household products. This af-
fects mostly children under five.
• Medication errors or mix-ups. This happens most often
to elderly people. Sometimes it is hospital staff that
makes the error; at other times, it is the patient who
gets confused about the identity or dosage of the drugs.
• Suicide.
• Excessive alcohol or drug abuse.
The following are signs and symptoms of acute
chemical poisoning:
• difficulty breathing
• changes in skin color
• headaches or blurred vision
• irritated eyes, skin or throat
• sweating
• dizziness
• breath odor: bitter almond (cyanide poisoning), garlic
odor (arsenic poisoning)
• nausea, vomiting, diarrhea
• unusual behavior
• difficulty walking or standing straight
Chronic poisoning
COMMON ROUTES OF EXPOSURE TO TOXIC CHEMI-
CALS. A person may accumulate toxic amounts of a
chemical in his or her body through daily exposure to the
chemicals. Common routes of exposure include:
• inhalation of the poisonous gas
• consumption of contaminated food, water, or medica-
tions
• contact with toxic or caustic chemicals in the eyes,
skin, or through contaminated clothing.
• pregnant mother’s exposure to toxic chemicals during
pregnancy, especially during the first trimester
EFFECTS OF TOXIC CHEMICALS ON DEVELOPING FE-
TUSES AND CHILDREN. Toxic chemicals can have devas-
tating effects on the developing fetuses and young chil-
dren. The following diseases and conditions are linked to
chronic exposure to home and environmental pollution:
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• miscarriages and spontaneous abortions
• low birth weight
• premature births
• stillbirths
• birth defects
• sudden infant death syndrome (SIDS)
• developmental delays
• poor motor coordination
• attention-deficit hyperactivity disorder (ADHD)
• aggressive behavior
• learning disabilities
• speech and language problems
• autism
• sensory deficits
• allergies and chemical sensitivity in childhood and in
later years
• asthma, hay fever, and sinusitis
• cancer in childhood, adulthood, and in subsequent gen-
erations
• poorly functioning organs and systems
• weakened immune system and increased risk of infec-
tions
The following chronic diseases and conditions may
occur in adults as a result of cumulative chemical poi-
soning:
• fatigue
• headaches
• skin rashes
• aches and pains
• generalized weakness
• asthma
• increased risk of infections
• depression and irritability
• liver diseases, such as jaundice (yellowing of the skins
and eyes), inflammation of the liver (hepatitis), and
cirrhosis (a chronic degenerative disease of the liver)
• lung diseases
• heart diseases
• cancer
• decreased life expectancy
• sick building syndrome
• Gulf War syndrome
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Diagnosis
Acute poisoning
In many cases, the identity of the poison is known to
the patient or the parents of the affected child. The role of
the physician is to determine what treatment (if any) is nec-
essary based on the amount of toxic substance ingested, the
identity of the chemical and patient’s signs and symptoms.
Chronic poisoning
Chronic environmental poisoning is more difficult
to diagnose. To find out if environmental pollution is
causing a person sick, a physician will conduct a thor-
ough physical exam of the patient. He or she also obtains
a thorough medical history with detailed information
concerning the food and water sources, as well as the na-
ture of the person’s work, or the place where he or she
lives. Lab tests may include blood and urine tests and
hair sample analysis. In addition, liver and kidney func-
tion tests are also conducted to see if these organs are af-
fected. The doctor also inquires about other diseases the
patient may have developed recently.
Treatment
Alternative treatments are not appropriate for acute
chemical poisoning. When an emergency poisoning oc-
curs, especially in children, parents are encouraged to
call a new toll-free hotline that is staffed 24 hours a day
at 1-800-222-1222. However, they may be useful in
treating chronic exposure to toxic chemicals. Specific
treatment plan depends on the type of poison by which a
person is affected. Generally speaking, most treatments
involve identifying the offending chemical and avoiding
future exposures to the offending agent. A healthy diet,
nutritional supplements and/or detoxification therapy
are also helpful. Detoxification therapy is especially ef-
fective for the liver, which is the organ that metabolizes
most toxins.
Detoxification diet
Naturopaths sometimes recommend patients sus-
pected of chronic chemical poisoning to follow a “detox-
ification diet” for at least several months. Pregnant
women, small children, or very frail people should avoid
taking this diet. A detox diet has the following character-
istics:
• Low fat intake to increase fat mobilization (moving fat
from storage to be used for energy). Limited consump-
tion of olive oil and vegetable oils is allowed.
• Limited intake of sugar and highly processed foods,
and avoidance of alcohol, caffeine, and tobacco.
423
Chemical poisoning
Chemical poisoning
• High fiber consumption to absorb the toxic chemicals
and eliminate them from the body.
• Limited consumption of red meat. The bulk of protein
intake should come from vegetable sources, such as
legumes and tofu, as well as fish from unpolluted waters.
• Strong emphasis on organic fruits and vegetables (and
their juices) with detoxification effects. They include
papayas, apples, pears, strawberries, dark green leafy
vegetables, carrots, beets, and garlic. Antioxidant
foods, such as broccoli, cauliflower, kale, yams, toma-
toes, peaches, watermelon, hot peppers, green tea, red
grapes, citrus fruits, soybeans, and whole grains are
also recommended.
• Increased water intake to at least eight glasses of water
per day to help eliminate waste from the body.
• Dietary supplementation with high potency multivita-
min/mineral products.
Exercise
Exercise to the point of perspiration helps eliminate
toxins from the body. Daily walking for 30 minutes is
helpful and appropriate for most people.
Herbal therapy
Milk thistle (Silybum mariannum ) is a powerful an-
tioxidant that protects the liver and assists in the detoxifi-
cation process by increasing glutathione supply in the
liver. Glutathione is the enzyme primarily involved in the
detoxification of many toxic chemicals in the environ-
ment, such as solvents, pesticides, and heavy metals.
Traditional Chinese medicine
Depending on a patient’s specific condition, an ex-
pert Chinese herbalist may prescribe herbal remedies
that can help remove toxins from the body and improve
liver function.
Homeopathy
For homeopathic therapy, patients should consult a
homeopathic physician who will prescribe specific reme-
dies based on knowledge of the underlying cause.
Fasting
Fasting is one of the most ancient ways of detoxifi-
cation and is also very efficient. During three-day fasting,
patients should take supplements and drink four glasses
of juice a day to assist the cleansing process and to pre-
vent exhaustion. Supplements recommended are those
that include antioxidants, such as vitamins C and E, sele-
nium, zinc, and magnesium. For patients suspected of
424
significant poisoning, a naturopath may also prescribe
milk thistle to aid the detoxification process and provide
support for the body. The patient may also consider con-
suming a food fast, where only food that is simple to di-
gest is consumed. For example, "ultraclear” hydrolyzed
rice is simple to digest and is also hypo-allergenic.
Allopathic treatment
Acute poisoning
For acute poisoning, patient or parents of an affected
child should call 91 1, a local poison control center, or 1-
800-222-1222 immediately. The toll-free number is a na-
tional hotline launched nationwide in 2002 by the Ameri-
can Association of Poison Control Centers to provide 24-
hour poison treatment and prevention services. If a child is
suspected of eating or drinking hazardous chemicals, par-
ents should look for the container and call for instructions.
Patients or parents of the poisoned child should wait for
instructions before administering syrup of ipecac, activat-
ed charcoal, or anything else by mouth. Treatment of a
particular poison depends on the identity of the poison and
how the poison was absorbed into the body.
INHALED POISONS. Treatment of inhaled poison in-
cludes bringing the patient out and away from the area
contaminated with poisonous gas. The patient should be
given oxygen and other respiratory support as necessary.
SKIN AND EYE CONTAMINATION. If a person’s skin
comes into contact with toxic chemicals, the contaminat-
ed clothing should be removed, the chemical carefully
brushed off the skin, and the body flushed with running
water to dilute the poison. The wounds, if any, should be
covered with sterile gauze or cloth and the patient be
transferred to the hospital for treatment of chemical
burn. If toxic or caustic chemicals get in the eyes, the af-
fected person should remove glasses or any contact lens-
es from the eyes immediately, rinse the eyes well with
clean water or normal saline solution, and go to the
emergency room for further treatment or observation.
INGESTED POISONS. Depending on the specific type
of ingested poisons, syrup of ipecac, activated charcoal,
and/or gastric lavage can be used.
For most cases of accidental poisoning, the drug
parents and doctors can rely on is syrup of ipecac. When
swallowed, it irritates the stomach and induces vomiting.
Syrup of ipecac is now considered the safest drug to treat
poisoning and is often the most effective. Syrup of
ipecac can be used for most ingested poisons. However,
syrup of ipecac should not be used if the suspected poi-
son is strychnine, a corrosive substance (strong acids or
lye), petroleum products (gasoline, kerosene, paint thin-
ner, or cleaning fluids), or certain prescription drugs,
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
such as antidepressants or sustained-release theo-
phylline. In addition, it should not be used in patients
who are unconscious or seizing.
Activated charcoal is also an effective treatment for
many chemical poisons. It can absorb poisons quickly and
in large amounts. In addition, it is nontoxic, may be stored
for a long time, and can be conveniently administered at
home. Charcoal works by binding to irritating or toxic sub-
stances in the stomach and intestines. This prevents the
toxic drug or chemical from spreading throughout the body.
The toxic drug or chemical and the activated charcoal will
be excreted in the stools without harming the body.
If both syrup of ipecac and charcoal are recom-
mended for treatment of the poison, ipecac should be
given first. Charcoal should not be given for at least 30
minutes after ipecac or until vomiting from ipecac stops.
Activated charcoal is often mixed with a liquid before
being swallowed or put into the tube leading to the stom-
ach. Activated charcoal is available as 30-g liquid bot-
tles. It is also available in 15-g container sizes, and as
slurry of charcoal premixed in water, or as a container in
which water or soda pop is added.
Charcoal should not be used to treat poisoning
caused by corrosive products, such as lye or other strong
acids, or petroleum products, such as gasoline, kerosene,
or cleaning fluids. Charcoal may make the condition
worse and delay the diagnosis and treatment. In addition,
charcoal is also not effective if the poison is lithium,
cyanide, iron, ethanol, or methanol.
Gastric lavage may also be used to treat chemical
poisoning. This procedure is done by medical profes-
sionals in emergency rooms only. Lavage fluids (saline
water or water) is given through a large tube down the
patient’s throat and the stomach contents are pumped
out. This procedure is repeated many times until the
physician is confident that most of the toxic substance is
removed. Then a specific antidote for the chemical or ac-
tivated charcoal can be given to absorb the rest.
Sometimes, antidotes are available to neutralize poi-
son and render it harmless. The following are some of
the common antidotes:
• naloxone: for morphine, methadone, or heroine overdose
• atropine: for organophosphate (insecticide) poisoning
• acetylcysteine: for acetaminophen (Tylenol) toxicity
• digoxin immune fab (Digibind): for digoxin toxicity
Chronic chemical poisoning
Treatment of chronic chemical poisoning involves
identifying, eliminating the source of poison from the pa-
tient’s environment, and symptomatic treatment of the
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
condition. Chelation therapy can be used to remove
heavy metals, such as lead, iron, mercury, copper, nickel,
zinc, cadmium, beryllium, and arsenic. This treatment
uses chelating agents, such as ethylenediamine tetraacetic
acid (EDTA) and dimethylsuccinate (DMSA) to bind and
precipitate metals and remove them from the body.
Expected results
Depending on the severity of the poisoning, the af-
fected person may have total or partial recovery. If the
rescue effort comes too late, a patient may die of acute
chemical or drug poisoning. For those affected by chronic
exposure to environmental poisoning, recovery depends
on the severity of the poisoning, the ability to stay away
from the offending agent, and appropriate diagnosis and
treatment. Total recovery can occur in many patients.
Prevention
• Avoiding eating contaminated fish, especially that
which comes from known contaminated areas or a lot
of big fish, such as shark, swordfish, or tuna, which
tend to contain higher amounts of mercury than smaller
fish. Pregnant women should not consume more than 7
oz of tuna per week. Mercury can cause brain damage
in the developing fetus.
•Not painting or remodeling a home while pregnant or
when the children are still small. Paint contains lead
and cadmium that can harm developing fetus and cause
learning disabilities in small children.
• Limiting use of chemicals inside the house as much as
possible and instead using natural alternatives, such as
baking soda (as cleaner, deodorizer), distilled white
vinegar (as cleaner), essential oils (as fragrances), lemon
juice (as cleaner), and liquid soaps (as detergents).
• Increasing ventilation inside the house.
• Considering installing tile or wood floors in new homes
instead of new carpet.
• Having the house tested for radon.
• Eating organic foods. Otherwise, to better remove tox-
ins, washing fruits and vegetables carefully before eat-
ing with a mild acid solution, such as diluted vinegar.
• Avoiding toxic chemical exposure as much as possible
if pregnant.
• Keeping all medications, petroleum products, cleaning
products locked and away from small children. In-
stalling child-proof locks or gates to prevent children
from finding poisons.
• Avoiding mixing up household cleaning products. Non-
toxic chemicals when mixed together can release toxic
gases or cause explosion.
425
Chemical poisoning
Chemical poisoning
• Keeping all chemicals in original containers, properly
identified and stored away from foods.
• Only using chemicals in well-ventilated areas to avoid
breathing in fumes. Using adequate skin, eye, and res-
piratory protection.
• Never putting household chemicals in food or beverage
containers.
• Avoiding smoking or lighting a candle near household
chemicals, such as cleaning solutions, hair spray,
paints, or paint thinner or pesticides.
• Disposing all hazardous chemicals properly according
to the manufacturer’s instructions.
Resources
BOOKS
The Burton Goldberg Group. “Chemical Poisoning." In Alter-
native Medicine: The Definitive Guide. Tiburon, CA: Fu-
ture Medicine Publishing, Inc., 1999.
Cooney, David. Activated Charcoal: Antidote, Remedy, and
Health Aid. Brushton, NY: TEACH Services, Inc., 1999.
Dreisbach, Robert H. and William O. Robertson. Handbook of
Poisoning: Prevention, Diagnosis and Treatment. New
York, NY: Appleton & Lange, 1988.
Ellsworth, Allan J., Daniel M. Witt, David C. Dugdale, et al.
“Ipecac.” In Mosby’s Medical Drug Reference 1999-
2000. St. Louis, MO: Mosby, Inc., 1999.
Murray, Michael T. and Joseph E. Pizzorno. Encyclopedia of
Natural Medicine. 2d ed. Rocklin, CA: Prima Publishing,
1998.
“Poisoning.” In The Merck Manual of Diagnosis and Therapy.
http://www.merck.com/pubs/mmanual/section23/chapter
307/307a.htm.
Steinman, David and R. Michael Wisner. Living Healthy in a
Toxic World: Simple Steps to Protect You and Your Family
From Everyday Chemicals, Poisons, and Pollution. New
York, NY: The Berkley Publishing Group, 1996.
PERIODICALS
Bond, C. Randall. "Activated Charcoal in the Home: Helpful
and Important or Simply a Distraction.” Pediatrics (Janu-
ary 2002) : 145.
Kaplan, Sheila and Jim Morris. “Kids at Risk.” U.S. News and
World Report. (June 19, 2000): 47-53.
“National Campaign to Promote New 24/7 Poison Hotline.”
Medical Letter on the CDC & FDA (March 10, 2002) : 12.
"Researchers Link Two Air Pollutants to Increased Risk of
Heart Defects.” Women's Health Weekly (January 17,
2002 ) : 2 .
ORGANIZATIONS
Agency for Toxic Substances and Disease. Registry Public In-
formation Office. 1600 Clifton Road, NE. Atlanta, GA
30333. (404) 639-0501.
American Association of Poison Control Centers. 3201 New
Mexico Avenue, Suite 310. Washington, DC 20016. (800)
222 - 1222 .
426
KEY TERMS
Antidote — A remedy to counteract a poison.
Cumulative — Increasing in effects or quantity by
successive additions.
Detoxification — A structured program for remov-
ing stored toxins from the body.
Diazinon — A member of the organophosphate
family of pesticides. This chemical causes nerve
and reproductive damage.
Insecticides — Any substance used to kill insects.
Pesticides — Chemicals used to kill insects and weeds.
Environmental Protection Agency. Public Information Center.
Room 311 West Towers, Mail Code 3406, 401 M. Street,
SW, Washington, DC 20460. (202) 260-7751.
The American Academy of Environmental Medicine. 4510
West 89th Street, Prairie Village, KS 66207. (913) 642-
6062.
OTHER
“CFC Alternative Causes Liver Disease.” Doctor’ s Guide:
Global Edition, http://pslgroup.com/dg/9f626.htm.
“Child Leukemia Deaths in Berkshire & Oxfordshire Higher
Near Nuclear Sites.” Doctor’s Guide: Global Edition.
http ://pslgroup . com/dg/3 3882.htm.
“Increased Birth-Defect Risk of Mothers Living Near Haz-
ardous-Waste Landfills.” Doctor’s Guide: Global Edition.
http://pslgroup.com/dg/9f626.htm.
“Low Birthweight, Early Births Found Among Infants Near
Hazardous Landfill.” Doctor’ s Guide: Global Edition.
http://www.pslgroup.com/dg/3771e.htm.
“Occupational Exposure to Organic Solvents Places Fetus at
Risk of Malformations.” Doctor's Guide: Global Edition.
http://pslgroup.com/dg/ef312.htm.
“Parental Smoking Kills 6,200 Kids Each Year.” Doctor's
Guide: Global Edition, http://pslgroup.com/dg/2efa6.htm.
“PCB Exposure May Increase Lymphoma Risk.” Doctor's
Guide: Global Edition, http://pslgroup.com/dg/32882.htm.
“Pesticides Linked with Stillbirths.” Doctor’ s Guide: Global
Edition, http://pslgroup.com/dg/2e2fa.htm.
“Relatively Low Levels of Air Pollution May Shorten Life Ex-
pectancy.” Doctor’s Guide: Global Edition. http://www.
pslgroup.com/dg/3f282.htm.
“Sick Building Study Blames Air. Not Vibes.” Doctor’s Guide:
Global Edition, http://pslgroup.com/dg/5dl2e.htm.
“Strong Links between Heart Attacks and Pollution.” Doctor’s
Guide: Global Edition, http://pslgroup.com/dg/33d8a.htm.
“Water Contaminant Linked to Miscarriage.” Doctor’s Guide:
Global Edition, http://pslgroup.com/dg/51daa.htm.
Teresa G. Odle
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Cherry, wild see Wild cherry
Cherry bark
Description
Cherries are members of the botanical genus
Primus, which is a member of the Rosaceae (or rose)
family. Cherries can be a shrub or a tree, and are be-
lieved to have originated in the Caucasus mountain re-
gion between Europe and Asia.
Cherries are divided into two broad groups: sweet
(Primus avium) and sour (Primus cerasus ). Varieties of
the cherry are widely distributed throughout temperate
regions of the world and have been cultivated for thou-
sands of years. Roman historian Pliny reported that sour
cherries were introduced to ancient Rome as part of a
victory celebration after the defeat of the Parthians at a
place called Cerasus.
From the simple division of sweet and sour cherries,
classification of the various cherry types has grown in-
creasingly complex through the years. Today, there are
literally hundreds of varieties due to their long record of
cultivation and crossbreeding.
Cherry trees have been used widely for their fruit,
eaten fresh and also used in cooking. Both the fermented
fruit and the crushed pits are used in making the Euro-
pean liqueur kirsch. The tree is also a source of wood
used in making high-quality furniture. The stalks from
some of these cherry varieties have been used medicinal-
ly as an astringent. However, it’s most widely accepted
that the cherry tree whose bark is utilized in herbal medi-
cine is the wild cherry (listed now as Primus serotina ,
but in nineteenth century herbal books is listed as Primus
virginianus).
The wild cherry is a native of North America. It is
found in central and northern parts of the United States,
as well as in cooler, nondesert parts of the Southwest.
Wild cherry trees characteristically grow to a height of
50-80 ft (15.2-24.4 m), with a trunk width of 2-4 ft (0.6-
1.2 m). The leaf of the wild cherry is oval, with a
minutely serrated edge, and is more pointed toward the
tip. Its leaves are approximately 3 in (7.6 cm) in length,
dark green and shiny on top, and paler and fuzzy on the
underside. Small, white, petaled flowers appear along
the stems before the leaves in early spring. Pea-sized,
purplish black fruits that are bitter develop and ripen by
late summer.
The outer bark of the wild cherry tree is dark gray to
black, very rough to the touch, and breaks away easily
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
from the trunk. Even though the bark from the roots,
trunk, and branches has medicinal properties, it is the
root bark that is the most beneficial. Beneath a cherry
root’s dark outer covering, the interior is a dusky reddish
color. It has an almond-like aroma that evaporates when
dried, but re-emerges when the bark is crushed or dis-
solved. Its tastes astringent and bitter. Its chemical con-
stituents include cyanogenic glycosides, starch, resin,
tannin, gallic acid, fatty matter, lignin, red coloring ma-
terial, as well as calcium, potassium, and iron salts.
General use
Wild cherry bark has a strong sedating effect on the
cough reflex and is particularly useful to treat dry, non-
productive coughs in respiratory conditions. Because of
its antispasmodic qualities, it has been used with other
herbs to treat asthma. It is given for spasmodic cough to
enhance relaxation and resting or at night to reduce
cough and enhance sleep. Its astringent properties make
it useful as a bitter, taken to stimulate sluggish digestion
and the appetite. A cold infusion of wild cherry bark has
been noted to soothe eye inflammation.
Preparations
Bark is collected in the autumn by carefully strip-
ping away small sections. The outer wild cherry bark is
then removed and the lighter colored, reddish interior
cortex is dried, but not in direct sunlight. Once thorough-
ly dried, it must be stored in airtight containers away
from light. Because it deteriorates so rapidly, it is more
beneficial if used when still fresh and must be newly col-
lected each year. The fragments of inner bark crush easi-
ly to make a powder. This powdered cherry bark can
then be dissolved in either alcohol or water. A cough
remedy is made by dissolving 4 oz (1 13 g) of the bark in
4 oz (120 ml) of water for several hours. The solution is
then strained, and honey is added to sweeten to taste.
Boiling cherry bark is not recommended since this de-
creases the medicinal properties. Cherry bark can also be
used to make a tincture and lozenges.
Precautions
Coughing is a normal and helpful reaction to airway
or lung irritation. It is designed to expel harmful sub-
stances (such as excess phlegm or irritants) from the
lungs. Suppressing a cough, then, can actually prevent or
postpone recovery. It is persistent coughing that needs
treatment. It is also important for potential users to re-
membered that a cough is merely a symptom of some
other illness, as are digestive problems. Wild cherry bark
preparations should not be taken for an extended period
of time. They should be used for temporary relief only of
427
Cherry bark
Chickenpox
KEY TERMS
Antispasmodic — An agent used to relieve muscle
spasms.
symptoms. A doctor should be consulted for persistent
cough or digestive problems.
Side effects
Wild cherry bark preparations can cause sedation,
especially if recommended dosage is exceeded.
Interactions
None known.
Resources
BOOKS
Grieve, M., and C.F. Leyel. A Modern Herbal: The Medical,
Culinary, Costmetic and Economic Properties, Cultiva-
tion and Folklore of Herbs, Grasses, Fungi, Shrubs and
Trees With All of Their Modern Scientific Uses. Barnes
and Noble Publishing, 1992.
Hoffman, David, and Linda Quayle. The Complete Illustrated
Herbal: A Safe and Practical Guide to Making and Using
Herbal Remedies. Barnes and Noble Publishing, 1999.
ORGANIZATIONS
Hobbs, Christopher. Herbal Advisor. http//www. AllHerb.com.
Joan Schonbeck
Chest pain see Angina
Chickenpox
Definition
Chickenpox (varicella) is a common and extremely
infectious childhood disease that also occasionally af-
fects adults. It produces an itchy, blistery rash that typi-
cally lasts about a week and is sometimes accompanied
by a fever or other symptoms.
Description
About four million Americans contract chickenpox
each year, resulting in roughly 5,000-9,000 hospitaliza-
tions and 100 deaths. Chickenpox is caused by the vari-
428
cella-zoster virus (a member of the herpes virus family),
which is spread through the air or by direct contact with
an infected person. Once someone has been infected
with the virus, symptoms appear in about 10-21 days.
The period during which infected people can spread the
disease is believed to start one or two days before the
rash appears until all the blisters have formed scabs,
usually four to seven days after the rash breaks out. For
this reason, doctors recommend keeping children with
chickenpox away from school for about a week.
Chickenpox has been a typical part of growing up
for most children in the industrialized world (although
this may change because of the new varicella vaccine).
The disease can strike at any age, but by ages nine or 10
about 80-90% of American children have already been
infected. U.S. children living in rural areas and many
foreign-born children are less likely to be immune. Be-
cause almost every case of chickenpox leads to lifelong
protection, adults account for less than 5% of all cases in
the United States. Study results reported by the Centers
for Disease Control and Prevention (CDC) indicate that
more than 90% of American adults are immune to the
chickenpox virus. Adults, however, are much more likely
than children to suffer dangerous complications. More
than half of all chickenpox deaths occur among adults.
Causes & symptoms
A case of chickenpox usually starts without warning
or with only a mild fever and a slight feeling of unwell-
ness. Within a few hours or days small red spots begin to
appear on the scalp, neck, or upper half of the trunk. After
a further 12-24 hours the spots typically become itchy,
fluid-filled bumps called vesicles, which continue to ap-
pear for the next two to five days. In any area of skin, le-
sions of a variety of stages can be seen. These blisters can
spread to cover much of the skin, and in some cases may
also be found inside the mouth, nose, ears, vagina, or rec-
tum. Some people develop only a few blisters, but in most
cases the number reaches 250-500. The blisters soon
begin to form scabs and fall off. Scarring usually does not
occur unless the blisters have been scratched and become
infected. Occasionally a minor and temporary darkening
of the skin (called hyperpigmentation) is noticed around
some of the blisters. The degree of itchiness can range
from barely noticeable to extreme. Some chickenpox suf-
ferers also have headaches, abdominal pain, or a fever.
Full recovery usually takes five to 10 days after the first
symptoms appear. The most severe cases of the disease
tend to be found among older children and adults.
Some groups are at risk for developing complica-
tions, the most common of which are bacterial infec-
tions of the blisters, pneumonia, dehydration, en-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
cephalitis, and hepatitis. Immediate medical help should
always be sought when anyone in these high-risk groups
contracts the disease. These include:
• Infants. Complications occur much more often among
children less than one year old than among older chil-
dren. The threat is greatest to newborns, who are more
at risk of death from chickenpox than any other group.
Children born to mothers who contract chickenpox just
prior to delivery face an increased possibility of dan-
gerous consequences, including brain damage and
death. If the infection occurs during early pregnancy,
there is a small (less than 5%) risk of birth defects.
• Immunocompromised children. Children whose im-
mune systems have been weakened by a genetic disor-
der, disease, or medical treatment usually experience
the most severe symptoms of any group. They have the
second-highest rate of death from chickenpox.
•Adults and children 15 and older. The typical symp-
toms of chickenpox tend to strike this group with
greater force.
Diagnosis
Where children are concerned, especially those with
recent exposure to the disease, diagnosis can usually be
made at home, by a school nurse, or by a doctor over the
telephone if the child’s parent or caregiver is unsure that
the disease is chickenpox. A doctor should be called im-
mediately if:
• The child’s fever goes above 102°F (38.9°C) or takes
more than four days to disappear.
• The child’s blisters appear infected. Signs of infection
include pus drainage or excessive redness, warmth, ten-
derness, or swelling.
• The child seems nervous, confused, unresponsive, or
unusually sleepy; complains of a stiff neck or severe
headache; shows signs of poor balance or has trouble
walking; finds bright lights hard to look at; is having
breathing problems or is coughing a lot; is complaining
of chest pain; is vomiting repeatedly; or is having con-
vulsions. These may be signs of Reye’s syndrome or
encephalitis, two rare but potentially very dangerous
conditions.
Treatment
Treatment focuses on reducing symptoms of chick-
enpox. The patient should drink plenty of fluids and eat
simple, nutritious foods. Soups (especially mung bean),
herbal teas, and fruit juices are good choices.
Applying wet compresses or bathing the patient in
cool or lukewarm water once a day can help the itch.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
A five-year-old girl with chickenpox. The first symptom of
the disease is the rash that is evident on the girl’s back and
neck. The rash and the mild fever that accompanies it
should disappear in a week or two. (Photograph by Jim
Selby, Photo Researchers, Inc. Reproduced by permission.)
Adding four to eight ounces of baking soda or one or two
cups of oatmeal to the bath is helpful. Only mild soap
should be used and patting, not rubbing, is recommended
for drying the patient. The patient should not scratch the
blisters as this can lead to infection or scarring. For ba-
bies, light mittens or socks on the hands can help guard
against scratching. If mouth blisters are present, cold
drinks and soft, bland foods can make eating less painful.
Supplements
Vitamin A may help to heal skin. Vitamin C and
bioflavinoids help to reduce fever and stimulate the im-
mune system. Zinc stimulates the immune system and
promotes healing. Zinc can cause nausea and vomiting.
Calcium and magnesium help to relieve restlessness
and sleeping difficulties. Magnesium has a laxative ef-
fect at high doses.
429
Chickenpox
Chickenpox
Herbals and Chinese medicine
The following herbals are ingested to treat chicken-
pox:
• Echinacea and goldenseal (Hydrastis canadensis ) sup-
port the immune system, and soothe skin and mucous
membranes. Echinacea is also an antiviral.
• Chamomile tea is a sleep aid.
• Chinese cucumber ( Trichosanthes kirilowii ) root tea is
used to relieve symptoms of chickenpox.
• Elder flower, peppermint, and yarrow reduce fever.
• Garlic has antiviral activity.
• Mullein ( Verhascum thapsus ) treats chickenpox.
•Yin Qiao Jie Du Wan (Honeysuckle and Forsythia
Pill).
• Ban Lan Gen Chong Ji (Isatis Infusion).
The following herbals are used externally to treat
chickenpox:
• Aloe leaf, calendula, and plantain relieve the itching
of the chickenpox rash.
• Turmeric powder mixed with lime juice treats chicken-
pox rash.
• Garlic clears skin infection.
Other remedies
Homeopathic remedies are selected on a case by
case basis. Some common remedy choices are apis,
aconitum, belladonna, calendula, antimonium tartar-
icum, pulsatilla.A'/izrv toxicodendron, and sulphur.
The acupressure points Four Gates, Large Intestine
11, Spleen 10, and Stomach 36 help alleviate symptoms
associated with chickenpox.
Allopathic treatment
Treatment usually focuses on reducing discomfort
and fever. Because chickenpox is a viral disease, antibi-
otics are ineffective. Antibiotics may be prescribed if the
blisters become infected. Calamine lotion helps to re-
duce itchiness. Painful genital blisters can be treated
with an anesthetic cream recommended by a doctor or
pharmacist.
Fever and discomfort can be reduced by aceta-
minophen (Tylenol) or other medications that do not
contain aspirin. Aspirin (or any aspirin- containing med-
ications) must not he used with chickenpox, because it
increases the chances of developing Reye’s syndrome.
The best idea is to consult a doctor or pharmacist if one
is unsure about which medications are safe.
430
Immunocompromised chickenpox sufferers are
sometimes given the antiviral drug acyclovir (Zovirax).
Zovirax also lessens the symptoms of chickenpox in oth-
erwise healthy children and adults.
Expected results
Most cases of chickenpox run their course within a
week. The varicella-zoster virus lies dormant in the
nerve cells, where it may be reactivated years later by
disease or age-related weakening of the immune system.
The result is shingles (herpes zoster), a very painful rash
and nerve inflammation, that strikes about 20% of the
population, particularly people 50 and older.
Prevention
A substance known as varicella-zoster immune globu-
lin (VZIG), which reduces the severity of chickenpox
symptoms, is available to treat persons at high risk of devel-
oping complications. It is administered by injection within
96 hours of known or suspected exposure to the disease.
A vaccine for chickenpox (Varivax) has been found
to prevent the disease in 70-90% of the vaccinated popu-
lation, to reduce the severity of disease in the remaining
cases. CDC and the American Academy of Pediatricians
recommend vaccination of all children (with some ex-
ceptions) at 12-18 months of age. For older children, up
to age 12, the CDC recommends vaccination when im-
munity cannot be confirmed. Vaccination is also recom-
mended for any older child or adult considered suscepti-
ble to the disease, particularly those who face a greater
likelihood of severe illness or transmitting infection. A
single dose of the vaccine is sufficient for children up to
age 12; older children and adults receive a second dose
four to eight weeks later.
Resources
BOOKS
Pattishall, Evan G., III. “Chickenpox.” In Primary Pediatric
Care, edited by Robert A. Hoekelman, et al. St. Louis:
Mosby, 1997.
Ying, Zhou Zhong, and Jin Hui De. “Common Diseases of Pe-
diatrics.” In Clinical Manual of Chinese Herbal Medicine
and Acupuncture. New York: Churchill Livingston, 1997.
PERIODICALS
Kump, Theresa. “Childhood Without Chickenpox? Why Par-
ents Are Still Wary of This New Vaccine.” Parents. (April
1996): 39-40.
Napoli, Maryann. "The Chickenpox Vaccine.” Mothering.
(Summer 1996): 56-61.
Shapiro, Eugene D.,and Phillip S. LaRussa. "Vaccination for
Varicella — Just Do It V' Journal of the American Medical
Association 278 (1997): 1529-1530.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Dehydration — Excessive water loss by the body.
Immune system — A biochemical complex that
protects the body against pathogenic organisms
and other foreign bodies.
Immunocompromised — Having a damaged im-
mune system.
Pus — A thick yellowish or greenish fluid contain-
ing inflammatory cells. Usually caused by bacteri-
al infection.
Reye's syndrome — A rare but often fatal disease
that involves the brain, liver, and kidneys.
Shingles — A disease (also called herpes zoster) that
causes a rash and a very painful nerve inflammation.
Varicella-zoster immune globulin (VZIG) — A sub-
stance that can reduce the severity of chickenpox
symptoms.
Varicella-zoster virus — The virus that causes
chicken pox and shingles.
Varivax — A vaccine for the prevention of chicken
pox.
Virus — A tiny particle that can cause infections by
duplicating itself inside a cell using the cell's own
machinery.
ORGANIZATIONS
Centers for Disease Control and Prevention. National Immu-
nization Hotline. 1600 Clifton Rd. NE, Atlanta, GA 30333.
(800) 232- 2522 (English). (800) 232-0233 (Spanish).
http://www.cdc.gov.
OTHER
Centers for Disease Control and Prevention/’Prevention of
Varicella: Recommendations of the Advisory Committee
on Immunization Practices (ACIP).” http://aepo-xdv-
www.epo.cdc. gov/wonder/prevguid/m0042990/entire.htm
(12 December 1997).
Zand, Janet. "Chickenpox/" HealthWorld Online. http://www.
healthy.net/library/books/smart/chcknpox.htm.
Belinda Rowland
Chickweed
Description
Chickweed (Stellaria media) is a member of the
Caryophyllaceae, or carnation, family. There are about
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
25 species of Stellaria, including some native varieties,
growing abundantly in the wild in North America.
Chickweed is a European native that has naturalized
throughout the world in fertile, mineral-rich soil. It
thrives in shady, moist locations in gardens, near human
habitations, and on the edge of woods. The herb is often
found growing under the shade of oak trees. Chickweed
is a persistent annual. It self-seeds and may produce as
many as five generations within one season.
The genus name Stellaria refers to chickweed’s tiny,
white, star-shaped flowers. The common name refers to
the herb’s appeal to birds and barnyard fowl, particularly
young chickens. Other common names include Indian
chickweed, stitchwort, starwort, white bird’s eye, chick
wittles, satin flower, adder’s mouth, mouse ear, starweed,
passerina, tongue grass, and winter weed. Chickweed
has been used for centuries. The nutritious herb was fed
to caged birds and rabbits. It was also traditionally pre-
pared as an early spring tonic, eaten fresh or steamed, to
cleanse the kidneys and liver. English physician Nicholas
Culpeper described chickweed as “a fine soft pleasing
herb under the dominion of the Moon.”
Chickweed is a juicy, succulent, low-growing, and del-
icate herb which grows from a slender taproot. The straggly,
weak stems may stretch along the ground for two feet or
more forming dense mats only a few inches off the ground.
The light-green, oval, and entire leaves grow in opposite
pairs about an inch apart along the smooth and branching
stem. A single line of fine white hairs grow along one side
or the other of the thin stems, alternating at the node of each
pair of leaves. Stems are slightly swollen at the joints.
Leaves appear stalkless at the growing tip but the older
leaves develop stalks at least as long as the attached leaf. At
night the half-inch long leaves close in on each other to pro-
tect the developing buds. The tiny white flowers grow
singly in the leaf axils of the upper leaves. The five petals
are deeply incised, and smaller than the pointed green sepa-
ls. Blossoms open in the sun and close on cloudy, gray days
and throughout the night hours. Minuscule seed capsules,
with a barely-perceptible toothed edge, follow the blos-
soms. In damp weather the “teeth” swell, effectively closing
the capsule to protect the ripening seed. The tiny yellow-or-
ange seeds continue to ripen even after the herb is harvest-
ed. Chickweed self-seeds freely in cool, moist habitats.
General use
The entire chickweed plant is edible. The stems and
leaves are used in medicinal preparations. Herbalists,
however, disagree about the medicinal potency of chick-
weed. One writer, a professor of pharmacognosy, dis-
missed chickweed as a “worthless weed” and an “ineffec-
tive herb.” Other writers and herbalists praise the diminu-
tive herb for providing “optimum nutrition” and for its
431
Chickweed
Chickweed
“unsurpassed” ability to cool fevers and infections. The
English physician Nicholas Culpeper, writing in the sev-
enteenth century, credited chickweed as beneficial for
“all pains in the body that arise of heat.” Taken as an infu-
sion, chickweed acts internally to cool inflammation of
the digestive and respiratory system. It has been used to
treat bronchitis, pleurisy, colitis, gastritis, asthma, and
sore throat. The herb’s diuretic action helps eliminate
toxins from the system and reduce retention of fluids.
Chickweed contains mucilage, saponins, silica,
coumarins, flavonoids (including glycoside rutin), triter-
penoids, and carboxylic acids. The herb is rich in miner-
als, including copper and iron, and vitamins A, B, and C.
Gathered fresh, chickweed is beneficial in poultice
form to ease rheumatic pain and to treat boils and ab-
scesses. The herb can also be used to draw out splinters
and the stingers of insects and to dissolve warts. Its vul-
nerary (wound-healing) action speeds the healing of cuts
and wounds. Its emollient qualities soothe itching and ir-
ritation of eczema or psoriasis. An infusion may be added
to bath water for soothing relief of inflamed skin. It also
provides relief to swollen and painful hemorrhoids.
Another species of chickweed, 5. dichotoma , known
as yin chai hu is used in Chinese medicine to stop nose-
bleed, to reduce heavy menstrual bleeding, and to bring
down fevers. The species 5. alsine is also used in Chi-
nese medicine as a medicinal remedy for treating colds,
snakebites, and even traumatic injury.
Preparations
Gather chickweed from young plants before or dur-
ing flowering and throughout the year. Snipping the
stems will encourage growth of new branches for later
harvest. The freshly harvested herb will keep for several
days if refrigerated. The fresh herb may be eaten in sal-
ads, or very, very lightly steamed as a potherb. Chick-
weed has a somewhat bland taste, so other edible greens
may be added to the pot to enhance the flavor.
Infusion: Place 2 oz of fresh chickweed leaves and
stems in a warmed glass container. Bring 2.5 cups of
fresh, nonchlorinated water to the boiling point, and add
it to the herbs. Cover and infuse the tea for about 10 min-
utes. Strain and drink warm. The prepared tea will store
for about two days in a sealed container in the refrigera-
tor. Chickweed tea may be enjoyed by the cupful up to
three times a day. A strong infusion may be used as a skin
wash or bath additive to soothe itching and inflamed skin.
Poultice: Chop fresh chickweed leaves and stems in
sufficient quantity to cover the area being treated. Sprinkle
the herb with water and place over the area. Cover the
herbal mass with a strip of wet cotton gauze to hold the
poultice in place. When gathering the older, tougher plant,
432
KEY TERMS
Diuretic — A substance which tends to increase
the flow of urine.
Pleurisy — Inflammation of the pleura (lining of the
chest cavity) usually caused by a lung infection.
the herb may be simmered either in water alone or in a
50/50 mixture of water and vinegar for about five minutes.
Apply to the skin after the mixture has sufficiently cooled.
Tincture: Combine four ounces of finely-cut fresh or
powdered dry herb with one pint of brandy, gin, or vodka,
in a glass container. The alcohol should be enough to
cover the plant parts. Place the mixture away from light
for about two weeks, shaking several times each day.
Strain and store in a tightly-capped, dark glass bottle. A
standard dose is 1—4 ml of the tincture three times a day.
Precautions
The wind-blown pollen of chickweed may aggravate
hay fever. Chickweed is considered safe for all external
applications. There was a report in 1980 of “temporary
paralysis” after ingestion of large amounts of the infused
herb, however there are no other documented reports of
toxicity. The PDR For Herbal Medicines reports no
health hazards when this herb is taken “with the proper
administration of designated therapeutic dosages.”
Side effects
None reported.
Interactions
None reported.
Resources
BOOKS
Duke, James A. The Green Pharmacy. Emmaus, Penn.: Rodale
Press, 1997.
Hutchens, Alma R. A Handbook Of Native American Herbs.
Boston: Shambhala Publications, Inc., 1992.
McIntyre, Anne. The Medicinal Garden. New York: Henry Holt
and Company, 1997.
Ody, Penelope. The Complete Medicinal Herbal. New York:
Dorling Kindersley, 1993.
PDR for Herbal Medicines New Jersey: Medical Economics
Co., 1998.
Polunin, Miriam, and Christopher Robbins. The Natural Phar-
macy. New York: Macmillan Publishing Company, 1992.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Tyler, Varro E. Herbs of Choice, The Honest Herbal. New
York: Pharmaceutical Products Press, 1993.
Weiss, Gaea, and Shandor Weiss. Growing & Using The Heal-
ing Herbs. New York: Wings Books, 1992.
Clare Hanrahan
Chicory
Description
Chicory ( Cichorium intybus) is a herb and root that has
been known for its curative benefits since the first century
A.D.. It is a member of the Asteraceae family. A scraggly
plant with blue flower heads, chicory flourishes in the wild,
as well as in gardens all over the world. It may be found in
Europe, the Near East, northern and southern Africa, Aus-
tralia, New Zealand, and North and South America.
The dried leaves and roots of the chicory plant are col-
lected in autumn for medicinal purposes. When flowering,
the whole plant is collected and dried. With a height that
may reach up to 5 ft (1.5 m), chicory can be recognized by
its oblong leaves that resemble a crosscut saw or slit, with
numerous stiff hairs on the underside. Chicory, whose
common names include succory, chicory root, chicory
herb, blue sailors, wild chicory, or hendibeh, is well known
for its bitter taste and use as a coffee substitute.
General use
The ancient Egyptians ate large amounts of chicory
because it was believed that the plant could purify the
blood and liver, while others have relied on the herb for
its power to cure “passions of the heart.” Chicory contin-
ues to be a popular herbal remedy due to its healing ef-
fects on several ailments.
Chicory is taken internally for the following disorders.
• jaundice
• spleen problems
• gallstones
• rheumatism
• gout
• loss of appetite
In addition, the leaves of chicory may also be used
as compresses to be applied externally to ease skin in-
flammations and swellings.
According to folklore, chicory was recommended as
a laxative for children, and it is also believed to increase
the flow of bile. As a mild diuretic, it increases the elimi-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Biodegradable — Capable of being broken down
by the actions of living organisms. Inulin from
chicory roots can be used to produce biodegrad-
able substances used in industry.
Diuretic — A medicine or agent that increases the
body's output of urine.
Infusion — A liquid extract of a herb or other plant
prepared by steeping or soaking the plant material in
water. Chicory can be taken at home as an infusion.
Inulin — A starchlike complex sugar obtained from
chicory roots that is used to improve the texture of
processed foods.
Prebiotic — A type of nondigestible substance
found in chicory and some other plants that sup-
ports the growth and activity of beneficial bacteria
in the colon.
Premenstrual syndrome (PMS) — A group of symp-
toms that occur several days prior to the begin-
ning of menstruation, including irritability, emo-
tional tension, anxiety, and mood changes such as
depression, headache, breast tenderness with or
without swelling, and water retention. Symptoms
usually subside shortly after the onset of the flow.
Sedative — A drug or agent that calms or soothes.
Chicory by itself has a sedative effect on the body.
nation of fluid from the body, leading to its use as a
treatment for rheumatism and gout.
Women who suffer from premenstrual syndrome
(PMS) may find that regular use of chicory root as a bitter
and a liver tonic may assist in maintaining hormone bal-
ance and lessening the symptoms of PMS. In addition, al-
tering the diet by eating a “bitter” salad that includes
fresh dandelion, chicory, and sorrel is believed to
strengthen the liver and discourage the growth of Candida.
Chicory also supports the body’s ability to absorb
calcium, a nutrient that helps build and maintain strong
teeth and bones. Raftilin inulin and raftilose oligofructose
are fibers extracted from chicory root that cannot be di-
gested by the small intestine. Instead, they are fermented
by bacteria in the large intestine, leading to the increased
absorption of calcium and other minerals. Oligofructose
is an example of a prebiotic, or nondigestible food ingre-
dient that benefits health by supporting the growth of one
or several types of bacteria in the colon.
A study published in 2002 indicates that inulin ap-
pears to lower the risk of colon cancer. The precise na-
ture of its protective effects is not yet known, however.
433
Chicory
Chicory
In addition to enhancing digestive processes, chico-
ry helps to keep the liver healthy. The inclusion of chico-
ry root supplements in the diet supports the proper me-
tabolism of cholesterol.
Preparations
While the medicinal uses of chicory are numerous,
the plant is also often used as a food additive, as a flavor-
ing agent, and in meals. Inulin can be used to improve
the texture of processed foods as well as sweeten them.
It can also be used to make biodegradable nonfood sub-
stances with many industrial applications. This versatili-
ty is important to environmentalists because chicory is a
renewable natural resource.
Wild and cultivated chicory leaves may be added to
salads or sauteed and served alone. Moreover, the roast-
ed and ground root of the plant is a common addition to
coffee in Europe and in the United States.
Studies have shown that chicory complements coffee
when it is used as a supplement due to its lactucin and
lactucopicrin. These two substances are responsible for
the bitter taste of chicory, and may serve to counteract the
stimulating effects of caffeine. Chicory by itself actually
has a sedative action on the central nervous system.
434
Chicory is available over the counter in bulk as
green leaves and dried roots. To prepare the herb as a tea,
also known as an infusion, for home use: steep 1 tsp (5
ml) rootstock or dried herb with 0.5 cup (4 fl oz) water
and strain after 10 minutes. To treat jaundice, spleen
problems, gallstones, or gastritis, drink 8-12 oz (225-
350 ml) of chicory tea per day.
As a dietary supplement, 1 tsp (5 ml) of juice from
chicory stems may be squeezed by hand and taken in
milk or water three times a day.
Precautions
Chicory has shown to be safe for a variety of med-
icinal uses and as a food source. There are no neces-
sary precautions to observe when including the herb in
the diet.
Side effects
There are no known health hazards or side effects
when chicory is added to the diet. The only possible
minor side effect is skin irritation. If the hands become
irritated after handling chicory, it is best to cover them
with gloves and treat the affected area as needed.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Resources
BOOKS
The Editors of Time-Life Books. “Chicory.” The Medical Advi-
sor: The Complete Guide to Alternative & Conventional
Treatments. Richmond, VA: Time-Life Inc., 1996.
Fleming, Thomas. “Cichorium Intybus.” PDRfor Herbal Med-
icines, First Edition. Montvale, NJ: Medical Economics
Company Inc., 1998.
PERIODICALS
Chow, J. “Probiotics and Prebiotics: A Brief Overview.” Jour-
nal of Renal Nutrition 12 (April 2002): 76-86.
Crawford, Sharon. “High Herbs: For Plant Medicine Go to the
Mountains.” Alive (May 31, 1997): 44M5.
Franck, A., and A. Franck. “Technological Functionality of In-
ulin and Oligofructose.” British Journal of Nutrition 87
(March 2002): Supplement 2, 287-291.
Pool-Zobel, B., B. Pool-Zobel, J. Van Loo, et al. “Experimental
Evidences on the Potential of Prebiotic Fructans to Re-
duce the Risk of Colon Cancer.” British Journal of Nutri-
tion 87 (March 2002): Supplement 2, 273-281.
Stengler, Mark. “Blast Cholesterol.” Alive (June 30, 1999): 20-21.
Stevens, C. V., A. Meriggi, and K. Booten. “Chemical Modification
of Inulin, a Valuable Renewable Resource, and its Industrial
Applications.” Biomacromolecules 2 (Spring 2001): 1-16.
ORGANIZATIONS
American Botanical Council. P. O. Box 201660. Austin, TX
78720-1660.
Beth Kapes
Rebecca J. Frey, PhD
Chigong see Qigong
Childbirth
Definition
Childbirth, or parturition, is the process of labor that
dilates the cervix, as well as the delivery of the baby and
placenta through the birth canal.
Description
Most babies are born following approximately nine
calendar months of pregnancy. Delivery between 37—42
weeks of gestation is considered normal and full-term. A
baby born prior to 37 weeks of gestation is considered
premature, or preterm. After 42 weeks, it is considered
postterm. Each of the latter circumstances is considered
a higher risk delivery.
Labor occurs in three stages. The first is the dilation
of the cervix, the second is the delivery of the baby, and
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Stage 1 : Dilation of the cervix. (Illustration by Hans & Cas-
sidy. The Gale Group.)
the third is the expulsion of the placenta. However, ap-
proximately 25% of babies born in the United States are
surgically delivered by Caesarean section. This can be a
necessary and even life-saving procedure, but this per-
centage is probably much larger than it could be with
better management of labor and more informed birthing
consumers.
A 2001 report showed that older pregnant women
are more likely to deliver via Caesarean and also may
more likely required induced labor. At one time, “once a
Caesarean, always a Caesarean” meant a woman could
not deliver vaginally after having a Caesarean, but that is
no longer true for everyone. Women who have had previ-
ous surgical deliveries are increasingly choosing vaginal
birth after Caesarean (VBAC). Having a sympathetic, in-
formed caregiver and preparation helps achieve this goal.
The first stage of labor is the time that is required
for the cervix to reach full dilation. It includes latent
(early), active, and transition phases. The latent phase of
labor, when the cervix progresses from being closed to 3
cm open, may last for days or longer. For some women,
latent labor is not a distinguishable phase, and for others
it leads immediately into active labor. The latent phase is
often exciting for the mother, who wonders if her baby is
finally going to be born. Contractions during this phase
are not very painful. Active labor ensues around the time
the cervix reaches 3 cm dilation, and continues until ap-
proximately 7 cm dilation. At this stage, labor contrac-
tions are powerful, and require the mother’s concentra-
tion. The length of this stage is also variable, and is usu-
ally longer for first-time mothers than for those having
subsequent babies. Active labor is followed by transition.
This is the shortest and most intense stage of labor, when
many women express feelings of despair, or “not being
435
Childbirth
Childbirth
Stage 2: Expulsion of the fetus. (Illustration by Hans & Cas-
sidy. The Gale Group.)
able to do it anymore.” At the end of transition, the
cervix is fully dilated to 10 cm, and pushing can begin.
The second stage of labor is pushing the baby out
through the vagina (birth canal). Contractions are gener-
ally less frequent than in the first stage of labor, but are
very strong and long lasting. Many women find it a relief
to be able to push. In the unmedicated mother, pushing is
reflexive and instinctual. The pressure of the baby’s head
on stretch receptors in the maternal pelvis triggers the
urge to push. Pushing is another phase where nature
gives credit to the woman who has had a previous birth.
First-time mothers generally push for about 60 minutes;
subsequent births require an average of only 15 minutes.
The third stage of labor is the delivery of the placen-
ta, which often goes unnoticed by the mother who is at-
tending to her newborn. After the baby is delivered, the
uterus should continue to contract in order to push out
the placenta. This organ functioned to bring the baby
nourishment from the mother throughout the pregnancy,
and return the child’s waste products to the mother to be
excreted. If contractions become sluggish or stop before
the placenta is delivered, breastfeeding the baby can trig-
ger the release of the hormone oxytocin to stimulate the
uterus to contract again. Alternatively, artificial oxytocin
(pitocin) can be given by injection.
Causes & symptoms
The onset of spontaneous labor may be marked by
irregular contractions, not very different from the Brax-
ton-Hicks contractions that are common throughout late
pregnancy. In approximately 10% of spontaneous labors,
436
rupture of membranes (“water breaking”) may occur be-
fore the onset of contractions. Since prolonged rupture
of membranes prior to delivery presents a risk of infec-
tion, the care provider for the mother should be contact-
ed whether or not she is experiencing contractions.
Even experienced mothers sometimes have difficulty
telling when labor begins, as prelabor may occur on and
off for days or longer before settling into a regular pattern.
In general, the contractions associated with labor will
gradually get more frequent, more regular, longer, and
stronger. Walking or changing activity will not alter them.
These contractions are effective at changing the cervix,
which will become appreciably lower, thinner, and more
dilated. By contrast, contractions of prelabor stay about
the same intensity and frequency. A change of activity will
often make them disappear. These contractions may be
uncomfortable, and may even cause some mild cervical
changes, but there is not a change on an hourly basis.
Diagnosis
For women who choose to deliver in a hospital, a di-
agnosis of active labor is generally made if contractions
are regular and strong, and the cervix is effacing and/or
dilating noticeably on an hourly basis. A woman who ar-
rives at the hospital reporting regular contractions who
has no complicating factors is generally observed for at
least an hour to see whether her labor will progress.
Monitors that fit around the abdomen measure the fetal
heart rate, and the nature of the contractions. A nurse
will check the position and station of the baby, as well as
the effacement, dilation, and position of the mother’s
cervix. Admission is generally made regardless of
progress if the water has broken (rupture of mem-
branes), or if there are complications, such as high ma-
ternal blood pressure, more than one fetus, fetal distress,
abnormal fetal presentation, or excessive bleeding.
Women delivering before 37 weeks or after 42 weeks of
gestation are also well-advised to deliver in a hospital.
Treatment
For a routine, uncomplicated labor and delivery, the
primary treatment required is assistance with comfort
measures. What each mother finds comforting is very in-
dividual. At some point during the pregnancy, it is a
good idea to make a list of things to try to relieve pain
during labor, in the event that one or two favored tech-
niques don’t work. A mother who generally enjoys mas-
sage may suddenly discover that it is distracting to be
touched during active labor; one who plans to rely on
medication could have an epidural that does not take, or
be laboring too quickly for it to be allowed. Having a list
of comfort measures to refer to will be useful and reas-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
suring for most laboring women. Reassurance is impor-
tant, as relieving stress during labor allows it to progress
more quickly and with less pain. Many women find it
helpful to employ an experienced doula, or birth assis-
tant, to provide comfort, reassurance, and information.
Fear of the unknown can certainly contribute to in-
creased pain. Expectant parents should learn all they can
about the process of childbirth. Many good reference books
are available. Taking Lamaze classes lends a personal
touch, and many couples enjoy the camaraderie of sharing
the learning experience with other expectant families. Even
though labor can take unexpected turns, being aware of the
options at each stage will lend some perception of control.
Making a list of birth preferences can be helpful in defining
what the parents desire at the birth, but flexibility is impor-
tant to avoid disappointment if every expectation is not met.
Acupuncture
A skilled acupuncturist may be able to offer some
relief of labor pain, particularly for women who have
previously found acupuncture to be helpful with other
types of pain.
Massage therapy
Some women find massage or therapeutic touch to
be quite relaxing during labor. Contractions are some-
times felt quite intensely in the back, and a combination
of massage and counterpressure can offer relief. Foot
massage may also be comforting, both during pregnancy
and labor. There is a great temptation for the laboring
woman to tense her abdomen against a contraction. The
contraction will be more effective and less painful with
effleurage (light stroking) of the area, and a verbal re-
minder to let the abdomen hang heavy and relax. The
jaw area is also frequently clenched, and benefits from
relaxation. Gentle touch and massage of any area that
appears tense will help to relieve stress. This is a good
technique to practice before labor begins.
Music
The sounds of a favorite piece of music can be an
excellent aid to relaxation. Instrumentals are generally
preferable to singing. Soothing sounds or tunes that
evoke happy memories are helpful. Some women enjoy
tapes of nature sounds.
Hydrotherapy
A warm tub or shower may be one of the most under-
estimated methods of relieving the pain of labor. Warmth
encourages muscle relaxation, which in turn decreases anx-
iety. The water in a tub also supports the mother’s body. In
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Stage 3: Expulsion of the placenta. (Illustration by Hans &
Cassidy. The Gale Group.)
a jetted tub, position and water pressure can be adjusted to
soothe areas that are cramping or painful. This may be par-
ticularly comforting for back labor. In a birthing pool or
large tub, the mother is free to move around and find a posi-
tion that optimizes her comfort. The relaxation brought on
by water can make for a shorter, more comfortable labor.
Aromatherapy
Some essential oils are particularly recommended
during birth for those women who enjoy the scents. They
can be added to a diffuser or a crock-pot of water in the
birthing area, emitted from a scented candle, or concen-
trated drops of the scent can be placed on the pillow and
bed linens. Clary sage and lavender are popular choices,
but any scent that is pleasant to the mother may be used.
Visualization
The use of visualization, or guided imagery, can be
powerful to promote relaxation and the progress of labor.
One exercise that can be practiced in advance of labor is
choosing a place or image that the mother associates
with comfort, security, and serenity. This place can be
imagined and explored at any time to help relieve stress.
If the details of this visualization are shared with some-
one who will be present during labor, that person can
help to evoke those feelings during times of pain or
stress. Another popular visualization is that of a flower
blooming. The cervix can be envisioned as a flower bud
that gradually opens to allow the baby to descend. Other
scripts for guided imagery can be practiced to relieve
stress and reduce pain.
Increasingly, women (not in high-risk pregnancies)
desire a more “low-tech” approach to labor and choose a
nurse midwife to assist them rather than a physician. For
thousands of years, midwives have given women support
437
Childbirth
Childbirth
and care through the birthing process. In 1998, a nurse-
midwife rather than a physician attended almost 9% of
births, which is more than twice the number in 1989.
Nurse-midwives committed to helping meet mothers’ in-
dividual needs and to give them freedom of choice dur-
ing birth. They work to provide a natural childbirth and
to help the woman prevent complications before, during,
and after the birth. Those wishing to use midwives
should check with the obstetrician and also determine if
the midwife is certified (CNM). More and more obstetri-
cian practices also employ or work with nurse-midwives.
Allopathic treatment
Modern pain relief for childbirth generally involves
the use of medication. Although medication has evolved
from the days of mothers being put under “twilight
sleep” for a normal vaginal birth, the use of chemical
pain relief is not without risk.
Undoubtedly one of the most common pain relief
methods during labor is the epidural. This technique in-
volves the injection of anesthetic medication through a
catheter into the epidural space in the back. Epidurals
often provide excellent relief of pain from contractions,
episiotomy, and perineal repair. They do not impair the
mother’s mental alertness, although she may sleep if labor
to that point has been long and arduous. The disadvan-
tages of epidurals include possible prolonging of labor,
impaired ability to push, inability to move around, possi-
ble need for bladder catheterization and accompanying
risk of infection or injury, maternal low blood pressure,
maternal fever, spinal headache from inadvertent injec-
tion into the subdural space, and patchy or ineffective
blocks. Low blood pressure can result in nausea and
dizziness, as well as fetal distress. Supplemental oxygen
may be given to the mother to alleviate this effect. Allergic
reactions to the anesthetic agents occur rarely. The woman
who wishes to have an epidural needs to have IV access,
IV fluids in advance to help prevent low blood pressure,
and fetal monitoring. The woman’s inability to move
around and change positions because of the tubes and
wires can impede the progress of labor. If labor slows, it
may be augmented by the injection of pitocin. Assisted
delivery via forceps or vacuum extractor may be neces-
sary if the mother finds herself unable to push effectively.
Injectable narcotic pain medications are also avail-
able. They can be given by either intramuscular (IM) or
intravenous (IV) routes. When given intravenously, the ef-
fects are felt sooner and are shorter in duration. These
medications are more likely to affect the fetus, and are
generally not given late in labor. Some women say that
their pain is not greatly diminished, but that they are better
able to rest between contractions. Others experience side
438
effects, such as nausea, vomiting, and dizziness that they
feel negate any benefit that they get from the medication.
Prevention
Techniques that are used to prevent pregnancy are
known as contraception. Some methods require a prescrip-
tion, including those involving hormones, diaphragms, cer-
vical caps, or intrauterine devices (IUDs). Hormonal birth
control is available as a daily pill, an injection, or an im-
plant. Consultation with a health care professional will de-
termine the appropriateness of these methods. Conditions
including clotting diseases, breast cancer, and liver dis-
ease will preclude hormonal forms of birth control. Signifi-
cant side effects may occur even in women who are good
candidates for these methods. Timing of taking the daily
birth control pills is important, and back-up methods
should be available if doses are missed. Diaphragms and
caps are both barriers used next to the cervix along with a
spermicide. For both methods, there is a pregnancy rate be-
tween 8% and 27% in the first year. The IUD is a uniquely
long-term device. It is placed by a medical professional,
and depending on the type, can retain effectiveness for as
long as 10 years. It is not recommended for women who
have ever had pelvic inflammatory disease, or for those
who are not in a mutually monogamous relationship. The
pregnancy rate in the first year for IUD users is around 3%.
Several popular forms of birth control are nonpre-
scriptive. Barrier method materials, such as condoms,
foam, and spermicides are available over the counter.
Condoms have the distinction of being the only type de-
signed for males. Used correctly, they are highly effec-
tive in preventing pregnancy. They have no side effects,
and latex varieties have the additional advantage of pro-
viding some protection against sexually transmitted dis-
eases. Average pregnancy rates are around 12%.
Periodic abstinence, sometimes called natural fami-
ly planning, requires training and attentiveness to physi-
cal signs. A variety of methods are available, and may in-
clude monitoring of cycle days, basal body temperature,
cervical mucus characteristics, and other symptoms re-
lated to the timing of ovulation. Effectiveness can be as
great as 93%, but it requires significant commitment for
the couple to faithfully monitor signs and abstain from
intercourse for at least one week of every cycle. Women
with irregular cycles or unreliable signs have the most
unplanned pregnancies with these methods.
Resources
BOOKS
Levchuck, Caroline M., Jane Kelly Kosek, and Michele Dro-
han. “Certified Nurse-Midwife.” In Healthy Living. UXL,
2000 .
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Braxton-Hicks — Mild, painless contractions of
prelabor.
Episiotomy — Incision into the perineum to allow
for easier passage of the baby.
Gestation — Time of development in the uterus.
Parturition — Childbirth.
Sears, William, and Martha Sears. The Birth Book. Boston: Lit-
tle, Brown and Company, 1994.
Stoppard, Miriam. New Pregnancy and Birth Book. New York:
The Ballentine Publishing Group, 1999.
PERIODICALS
Ecker, Jeffrey L., et al. “Increased Risk of Caesarean Delivery
with Advancing Maternal Age: Indications and Associated
Factors in Nulliparous Women.” American Journal of Ob-
stetrics and Gynecology 185, no. 4 (October 2001):
883-885.
ORGANIZATIONS
Association of Labor Assistants and Childbirth Educators
(ALACE) (formerly Informed Birth & Parenting). P.O.
382724. Cambridge, MA, 0228-2724. (617) 441-2500 or
local (818) 358-2318.
International Childbirth Education Association (ICEA). P.O.
Box 20048. Minneapolis, MN 55420-0048. (612) 854-
8660. <http://www.icea.org>.
Judith Turner
Teresa G. Odle
Childhood nutrition
Definition
Childhood nutrition involves making sure that chil-
dren eat healthy foods to help them grow and develop
normally, as well as to prevent obesity and future disease.
The traditional or mainstream approach to good
childhood nutrition is to follow suggestions based on di-
etary guidelines that are appropriate for a child’s age and
development level and that have been developed and rec-
ommended by government, research, and medical pro-
fessionals. The guidelines include selections from differ-
ent food groups to provide the vitamins and minerals
young bodies need for natural growth and activity. The
U.S. Department of Agriculture’s (USDA’s) Food Guide
Pyramid recommends how many servings a day a child
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
should eat of each food group, such as milk, vegetables,
fruits, fats, and meats, and asserts that by sticking close-
ly to the guidelines, parents can ensure their children get
a well-balanced diet that supplies the vitamins, minerals
and calories they need to support growing bodies and ac-
tive lifestyles. However, in this age of what has been
called “advanced medicine,” there are those who seek to
understand why so many among us, especially children,
suffer from so much serious illness.
Origins
Humans, unlike plants, cannot manufacture the nu-
trients they need to function. Each culture over centuries
has developed its own traditional diet. In western civi-
lization's modern times, many of these diets have devel-
oped into convenient, fatty and sugary foods, leading to
obesity even in children and teens.
Advice on nutritional choices predates recorded lan-
guage, but the first science-based approach to a healthy
diet probably began just over 100 years ago. W. O. Atwa-
ter, the first director of the Office of Experiment Stations
in the U.S. Department of Agriculture (USDA) and a pi-
oneer in the field of nutrition investigation, developed
some of the components needed for a food guide. He
created food tables with data on protein, fat, carbohy-
drate, mineral matter, and fuel value for common foods.
Food guides with food groups similar to those used
today first appeared in USDA publications in 1916 and
were developed by nutrition specialist Caroline L. Hunt.
Interestingly, the first daily food guide was published
under the title Food for Young Children. In the early
1930s, the Depression caused economic restraints on
families and the USDA responded with advice on how to
select healthy foods more cheaply. In 1941, the Food and
Nutrition Board of the National Academy of Sciences re-
leased the first recommended dietary allowances (RDAs)
for calories and essential nutrients. The nine nutrients in-
cluded on the list were protein, iron, calcium, vitamins
A, C, and D, thiamin, riboflavin, and niacin.
Throughout the years following the release of the
first guidelines, recommendations were debated and re-
vised. The new food guide was first presented in 1984 as
a food wheel. The USDA first used a pyramid to repre-
sent the food groups in 1992 after intensive research on
the most effective way to visually communicate healthy
eating by portion and food choice. Although it has been
modified over the years, the pyramid has continued to
represent the food groups and a new revision of the
guidelines has been planned for 2005.
Annemarie Colbin was brought up on a European
vegetarian diet before she came to the United States in
1961. In her search for optimum health and the ability to
439
Childhood nutrition
Childhood nutrition
control how one feels by what one eats, she became a
professional cook, lecturer, founder of the Natural
Gourmet Cookery School in New York City, and author
of best-selling books Food and Healing, The Book of
Whole Meals, and The Natural Gourmet, as well as arti-
cles appearing in the New York Times and Cosmopolitan.
In Chapter One of Food and Healing, Colbin looks
at the health of children and she points out that:
• A child born today can expect to live 26 years longer
than a child born in 1900, but a person who has already
reached 45 today can expect to live only four or five
years longer than a person born in 1900.
• The following childhood problems that were rare in
1900 are now so prevalent that they are called “the new
morbidity (an unsound, gruesome condition)”: learning
difficulties, behavioral disturbances, speech and hearing
difficulties, faulty vision, serious dental misalignment.
• The average child loses three permanent teeth to decay
by age 1 1, eight or nine by age 17, and 94% of adoles-
cents have cavities in their permanent teeth.
• Among children, tuberculosis is on the rise
• By the mid-1980s, cancer as a killer of children and
adolescents was surpassed by only accidents and vio-
lence.
Colbin cites statistics linking children to emotional
disorders and violence, indicating that at any given time,
as much as a quarter of our population is estimated to suf-
fer from depression, anxiety, or other emotional disor-
ders; that suicide is the ninth leading cause of death for
all age groups; and that there may be as many as four mil-
lion cases of child abuse every year, at least 2,000 of
which result in death. She then states, “All this violence is
no longer viewed as purely psychological. A growing
body of research links mood, violent behavior, and even
criminal behavior with various physiological imbalances:
an over-active thyroid, an excess of testosterone (male
hormones), allergies, low blood sugar. Lead poisoning,
vitamin deficiencies, and of course alcohol and drugs all
alter physiology as well as mood. Behavioral problems
have even been associated with a lack of natural light, in-
sofar as light plays a vital role in the metabolism of calci-
um, a mineral widely regarded as ‘nature's tranquilizer.’”
Based on these statistics and many more that she
cites, Colbin contends that proper nutrition plays a key
role in disease prevention. She indicates that she sees
three major errors in our contemporary assumptions
about health and illness: the belief that physiological
symptoms such as headaches, fevers, etc. are mistaken
reactions of the body to normal stimuli; the belief that
surgical intervention or chemical substances, natural or
artificial in origin, can restore health by stopping the dis-
440
ease process; and the belief that dietary habits are unre-
lated to symptoms or illnesses. Although the last belief is
slowly changing, it has a long way to go. For example,
she points out, many people are still buying antacids for
digestive distress without changing their diet.
Benefits
The Food Guide Pyramid and other healthy eating
recommendations generally apply to children age two
and older. When used as a starting point for planning
family meals and snacks, applying these sensible recom-
mendations to children’s daily diets can encourage good
eating habits at an early age. This will help children de-
velop mentally and physically according to growth charts
and other measurements set by pediatricians (physicians
who specialize in caring for children) and will help pre-
vent future problems with overeating or with eating disor-
ders. Many nutritional experts agree that if children eat a
balanced diet that includes all of the recommended food
groups, they will not need to take vitamin/mineral supple-
ments. Also, eating a balanced diet with a variety of foods
will give children the energy they need to stay physically
active, which is important to their growth and mental
health, and in keeping obesity in check.
Description
In spite of recommendations, the diet quality of
most children is not what it should be. The USDA sur-
veyed American children ages two to nine in 1998 and
found that up to 8% of them had a poor diet, while as
many as 80% of those ages seven to nine had a diet that
needed improvement. The Centers for Disease Control
(CDC) defines childhood obesity at a level above the
95th percentile of body mass index for his or her age
group. Body mass index (BMI) is a measurement system
used to assess if a child (or adult) is underweight, over-
weight, or at risk for becoming overweight. Pediatricians
use height and weight measurements taken at a child’s
regular checkups to determine his or her BMI. To help
guide parents and others in making good nutritional
choices to keep BMI in line with normal growth and just
to keep children healthy, the American Medical Associa-
tion (AMA) suggests the following food choices for chil-
dren, based on the USDA guidelines.
Children two to five years of age
The AMA and USDA recommend food guidelines
for young children similar to those for older children and
adults, but with smaller portions. When looking at a
range of portion sizes, parents and those who care for
young children should choose the smaller portion sizes
for children age two or three, and go with a slightly larg-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
er portion for children who are age four or five. Daily
recommendations include:
• four to five servings of breads, cereals, rice, pasta
• two or more servings of vegetables
• two or more servings of fruit
• three to four servings of dairy products
• two or three servings of meat, fish, poultry, legumes
(beans, lentils, peas)
After age two, a child needs less fat than an infant —
about 30% of daily calories. After age three, fiber be-
comes more important in a child’s diet and can impact
future heart health.
Calcium requirements steadily increase as children
get older, from 500 mg a day at age three to 800 mg a
day at age four to eight. There is more calcium in the
body than any other mineral. Calcium works together
with phosphorus (two parts calcium to one part phospho-
rus) for healthy bones and teeth and works together with
magnesium (two parts calcium to slightly over one part
magnesium) to prevent cardiovascular (blood vessels of
the heart) and other degenerative diseases. In order for
calcium to be absorbed by the body, it must also have
sufficient amounts of vitamins C, D and A. In addition to
food sources, an hour of sunshine each day can also pro-
vide a child with his/her daily vitamin D requirement.
Children six to twelve years of age
By the time children reach age five or six, they
begin to tell parents what foods they like. Parents and
those who care for the children can help select foods
from each recommended group that a child will enjoy.
Calorie requirements and portion sizes increase as chil-
dren get older: between ages six and ten, boys and girls
need between 1,600 and 2,400 calories each day. Be-
cause of puberty and adolescent growth, between ages
10 and 12, girls need about 200 more calories a day.
Boys will begin needing about 500 more calories a day
after age 12. The following servings per day are recom-
mended for children ages six to twelve:
• six to 1 1 servings of breads, cereals, rice, pasta
• three to five servings of vegetables
• two to four servings of fruit
• three or four servings of dairy products
• two or three servings of meat, fish, poultry, legumes
By age six, children still need only about 30% of
calories from fat. Nutritionists say that by adding five to
the child’s age, parents can estimate the number of fiber
grams a child needs each day. Calcium requirements
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
continue to rise, from 800 mg a day at ages four to eight
to 1,300 mg each day for children beginning at age nine.
Preparations
Getting children to eat the right foods is easy if they
begin good eating habits at a young age and if they are of-
fered a variety of healthy foods. Many books, magazines,
and web sites offer tips on making healthy foods interest-
ing. Some suggestions for each food group follow.
• breads, cereals, and pastas including whole grain
breads, unsweetened cereals, unrefined rice, whole
grain crackers, cornbread, rice cakes
• vegetable servings from cooked or raw vegetables such
as asparagus, beets, broccoli, carrots, corn, green and
red peppers, green beans, kale, peas, pumpkin, squash,
sweet potato, tomato, zucchini, or vegetable juice
• good fruit choices such as apples, applesauce, bananas,
cantaloupe, apricots, peaches, unsweetened fruit cock-
tail, plums, grapefruit, kiwi, nectarines, strawberries,
watermelon, and fresh fruit juices
• milk, low-fat yogurts and cheeses are good dairy
sources, as are low-fat cottage cheese, custard, ice
milk, and occasional ice cream servings
• meat, fish, poultry, and legume choices include lean
meats, dried beans, peanut butter, shellfish, dried peas,
lentils, tofu, and reduced-fat cold cuts
To reduce fat in a child’s diet, parents can switch to
low-fat or non-fat milk; remove skin from poultry or trim
fat from red meat; reduce use of margarine and butter;
use low-fat cooking methods such as baking, broiling,
and steaming; and serve foods rich in fiber. Fresh salads
can improve fiber in diet, as can adding oat or wheat
bran to baked foods. Good, easy-to-assimilate sources of
calcium for children, besides milk and cheeses, are tofu
made with calcium sulfate; soup made with fish, fowl or
beef bones and one tablespoon of wine vinegar to draw
out the calcium into the broth; canned salmon and sar-
dines with bones; sesame seeds and tahini (ground
sesame seed butter); beans and nuts; calcium-fortified
fresh orange juice; greens, especially broccoli, collards,
kale, mustard, turnip tops, parsley, watercress and dande-
lion; and cooked sea vegetables if children like them.
In Food and Healing, Annemarie Colbin explains
what sugar is and why it causes so much damage to the
health of children and adults. White sugar, like white rice
and white flour, goes through an industrial refining
process: its juice is extracted from sugar cane, then fil-
tered and boiled until it has been separated from all of its
water, minerals, vitamins, protein and fiber, all of which
the body needs to digest and metabolize the sugar. Be-
cause it lacks those nutrients, refined sugar becomes
441
Childhood nutrition
Childhood nutrition
what Colbin calls a “naked carbohydrate,” and so the
body will draw them from other foods in the same meal
or the body’s tissues. Thus when refined white sugar is
consumed, there is loss of stored B vitamins, calcium,
phosphorus, iron, and other nutrients from the body. The
loss of calcium stored in teeth weakens them and makes
them more susceptible to bacterial attack/cavities. Also,
this nutrient loss from refined sugar consumption can
produce hunger for the missing nutrients and provoke
great sugar-eating binges. On food labels, sugar is often
identified as lactose, maltose, fructose, sucrose, and oth-
ers. Glucose is the name of sugar found in the blood.
Colbin points out that if you eat meat, you need to
digestively balance it with white sugar and vice versa,
and that serious problems arise when the amount of
sugar eaten is more than the amount needed to balance
the meat. Sugar is as addictive as a drug because eating a
small amount creates a desire for more sugar and be-
cause quitting sugar “cold turkey” brings on withdrawal
symptoms that can last for an extended period of time.
Typical withdrawal symptoms include strong cravings,
fatigue, depression, mood swings, and sometimes
headaches. Excessive sugar consumption is believed to
be involved in such very common problems as hypo-
glycemia or hyperinsulinism, diabetes, heart disease,
dental caries, high cholesterol, obesity, indigestion, my-
opia (nearsightedness), seborrheic dermatitis, gout, ge-
netic narrowing of pelvic and jaw structures, crowding
and malformation of teeth, hyperactivity, lack of concen-
tration, depression, and anxiety. Colbin notes that these
problems result when the sugar intake provides more
“naked carbohydrates” than are needed to balance the
animal protein intake. Since white flour also provides
additional “naked carbohydrates,” only a small amount
of sugar can create an excess amount in the body.
It is important that children eat three meals a day
and not skip breakfast. Studies have shown that children
and teens that skip breakfast have more trouble concen-
trating, do not perform as well in school, and often have
later problems with heart disease. Obesity is common in
children who skip breakfast.
While the obesity problem in today’s youth can be
blamed on a number of factors, including larger food
portions for adults and children, convenient salty and
sugary snack foods, and cheap and convenient fast food,
much attention has been focused on the role of the na-
tion’s schools. There are fewer physical education class-
es because of more emphasis on academic classes and
those gym classes that remain have too much standing
around and not enough activities that interest the chil-
dren, say some experts. School lunches generally have
not provided healthy or balanced nutrition but instead
have consisted of highly refined, processed foods that
442
are full of additives and simple carbohydrates, which do
not provide good nutrition or energy. In addition, many
schools also offer “snack bars” or vending machines
with sodas and sugary, fatty, or salty snacks. Many chil-
dren have been choosing these snacks over the prepared
school lunches.
To counter this problem in schools, the Healthy
Schools Summit was held in October 2002. It consisted
of representatives from more than 30 national education,
fitness, nutrition, and health organizations, as well as 450
school administrators, government leaders, food service
directors, counselors, dietitians, nurses, and health and
fitness teachers. Since that time, many school districts
around the country have been working to improve their
physical education programs and to remove or change the
selections in vending machines and snack bars on school
campuses. Parents can check with their children’s schools
or pack healthy lunches from home with foods their chil-
dren like to ensure they eat well while at school.
Children who are very active and participate in orga-
nized sports need a particularly healthy diet. For extended
energy, they should eat many complex carbohydrates, such
as unrefined rice, whole grain pasta and bread, and whole
grain cereal. While all children need to drink plenty of
water, those who participate in sports need to drink even
more. Some experts say an easy formula to remember is
one cup of fluid for every one-half hour of physical activity.
At home, some parents choose convenient snack and
fast foods because often, both parents work long hours.
Along with bigger portions and increased time spent in
front of the television instead of out being physically ac-
tive, today’s youth are becoming obese from receiving
and growing accustomed to less nutritional foods. Many
experts say that getting children up off the couch and
watching their snack choices helps. Also, many sources
can help parents find healthier alternatives to fast food
meals for their families. Suggestions include cooking
healthy meals on weekends and freezing them for busy
weekdays and looking for cookbooks or online sources
of quick and healthy recipes. Simply cooking with less
fat and using baking, roasting or poaching methods in-
stead of frying helps children and adults. Also, offering
children healthy snacks to last them until mealtime will
keep them from reaching for poor snack choices and
make them less likely to overeat at the evening meal.
For a variety of reasons, some children follow vege-
tarian diets. Some people are concerned that a vegetarian
diet is harmful for children, but generally, if a child aged
two or older still follows the recommended Food Guide
Pyramid and makes good food choices, a vegetarian diet
can be healthy. In fact, 2% of children ages six to 17
never eat meat, fish, or poultry. If a vegetarian child
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
needs a vitamin or mineral supplement, a physician or
professional nutritionist can help determine the proper
level of supplement needed.
Precautions
Parents are sometimes cautioned by nutritional ex-
perts not to turn mealtimes and eating into a battle of
wills. Offering a variety of healthy choices allows chil-
dren to select favorite foods from among those that are
good for them and to balance foods containing a number
of vitamins and minerals. Research in 2004 showed that
taste for certain foods probably develops while people are
still infants, in fact, infants in the study who had been ex-
posed to the flavor of carrots through their mothers’
breast milk later ate more of a carrot-flavored cereal that
those who had not been exposed to carrots as infants. The
researchers said that encouraging children to eat more
fruits and vegetables as early as possible was helpful.
Many physicians and medical researchers have cau-
tioned parents not to turn to fad diets for their children’s
weight problems. Many of the diets and diet products on
the market have not been proven by clinical studies to be
effective in the long term for adults and therefore they
certainly have not been proven safe or effective as a solu-
tion to weight problems in children. The best solution for
childhood obesity is a combination of activity, a bal-
anced diet that follows the AMA/USDA guidelines for
food groups and portions, and involvement of a physi-
cian, dietician, or other trained professional as needed. A
further caution concerning dieting is the concern that as
young children enter adolescence, too much worry about
weight and appearance can cause social anxieties and
lead to eating disorders such as anorexia and bulimia.
When changing a young child’s diet, it should be
done slowly, particularly when introducing fiber, and
with the help of a physician, dietician, or nutritionist Too
much fiber can interfere with the body’s absorption of
vitamins and minerals.
Children who do not eat enough food and do not get
enough nutrition suffer from severe undernourishment,
or malnutrition. Each year, more than six million chil-
dren under the age of five years die around the world as a
result of hunger. Malnutrition also can make a child
more susceptible to a number of diseases. Worldwide, it
is estimated that food insecurity affects 815 million
households, mostly in developing countries. However, in
2003, a report showed that at least 10% of U.S. house-
holds also don’t have enough food and about 3% report
hunger at home. In this case, it is not the sort of hunger a
person feels when they eat a late lunch but the kind of
painful sensation someone gets from repeated or invol-
untary lack of food.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
There are parents and health professionals, both tra-
ditional and alternative, who feel children should have
vitamin/mineral supplements to stay healthy. However,
there are also parents and health professionals who be-
lieve that when children eat a balanced diet of whole-
some foods, they seldom need vitamin supplements; that
individual vitamins and minerals should be taken, like
medicine, when a deficiency has been created by a diet
imbalance; and that when such a deficiency has been
corrected, they should be discontinued.
If children are not eating a healthy diet and are being
given a vitamin/mineral supplement, it is important to
keep chewable vitamins out of reach of young children,
as their appealing taste may be irresistible and dosage
needs to be controlled according to directions. Children
with poor appetites or erratic eating habits also may bene-
fit from vitamins and minerals. It is best to check with a
pediatrician, dietician or nutritionist for dosing.
Some parents and health professionals feel that veg-
etarian children may benefit from vitamin/mineral sup-
plementation because they may lack some iron and zinc
normally obtained through meat products and/or fish.
Other substantial sources of iron are eggs, whole-grain
breads and cereals, leafy and other vegetables, potatoes,
fruit and milk. Foods containing vitamin C (broccoli,
Brussels sprouts, collards, kale, parsley, sweet peppers,
strawberries, grapefruit, melons, tangerines, potatoes,
and more) will increase absorption of iron in non-animal
foods. Vegetarian sources of zinc are eggs, legumes, and
whole grains. Zinc deficiency has been found in popula-
tions whose intake is derived solely from cereal sources,
but in recent studies, vegetarians had adequate zinc lev-
els. Those children who avoid dairy products, although it
is difficult to get enough, may get calcium from broccoli,
leafy green vegetables like kale, canned salmon and sar-
dines including the bones, and soy products. If a child’s
physician or qualified nutritionist feels a supplement is
necessary, he/she should recommend the dosage.
Children often don’t recognize feelings of thirst and
have to be encouraged to drink before becoming thirsty.
If a child’s urine is clear or the color of pale lemonade,
he or she is drinking enough fluids. Dark urine the color
of apple juice indicates too little hydration and the child
is in danger of dehydration or heatstroke.
Side effects
Only the fat-soluble (capable of being dissolved in
fat or oil) vitamins A, D, K and E have side effects that
are potentially, though rarely, toxic (poisonous).
In their book The Real Vitamin & Mineral Book,
Sheri Lieberman and Nancy Bruning state, “The facts are
that only a few vitamins and minerals have any known
443
Childhood nutrition
Childhood nutrition
toxicities, all of which are reversible, with the exception
of vitamin D. Anything can be harmful if you take
enough of it — even pure water. But vitamins and minerals
are among the safest substances on earth. The amounts
needed to become toxic are enormous.” They add that
being on medication or having a medical condition can
influence vitamin/mineral requirements and indicate that
when one’s physician is not well-versed in nutrition, it is
ideal to have him work with a qualified nutritionist.
With regard to vitamin D, they indicate, “According
to several studies, up to 1,000 IU per day of vitamin D
appears to be safe. Both the beneficial and adverse ef-
fects of exceeding this amount are controversial. Over-
dosing of vitamin D is irreversible and may be fatal.
Symptoms of too much vitamin D are nausea, loss of ap-
petite, headache, diarrhea, fatigue, restlessness, and cal-
cification of the soft tissues (insoluble lime salts in tis-
sue) of the lungs and the kidneys, as well as the bones.”
Vitamin D (400 IU) is usually sold with vitamin A
(5,000 IU) in a tiny tablet or capsule.
Lieberman and Bruning say that active vitamin A
from fish liver oil or synthetic palmitate is stored in the
liver; that 15,000 IU would cause problems in infants;
but that 100,000 IU of active vitamin A would have to be
taken daily for months before any signs of toxicity (state
of being poisonous) appear. Vitamin A in the form of
beta-carotene can be taken without any risk of toxicity.
At doses of 800-1,200 IU per day, Lieberman/Brun-
ing found no well-documented toxicity of vitamin E. At
doses of over 1,200 IU per day, adverse effects such as
flatulence, diarrhea, nausea, headache, heart palpita-
tions, and fainting have been reported, but were com-
pletely reversible when dosage was reduced.
Vitamin K is easily obtained by the body from a
healthy diet and deficiencies are rare, especially in chil-
dren. It is given prophylactically to newborn infants to
prevent hemorrhage and before surgery to people with
blood-clotting problems. Lieberman/Bruning describe
the major effect of too much vitamin K as an anemia
where red blood cells die more quickly than usual and
cannot be replaced by the body.
Some children have severe food allergies. It is im-
portant to watch for signs of allergies in very young chil-
dren in particular, since they are eating many foods for
the first time. Signs of food allergies can range from
mild to severe. A child may, for instance, eat peanuts or
shellfish and immediately show signs of a severe reac-
tion, such as swelling and trouble breathing. Other food
allergies may be less obvious but may occur from com-
mon foods found in many everyday products such as
milk, eggs, wheat, or soy. If a child appears to have a se-
vere reaction and has trouble breathing, the parent or
444
caregiver should seek immediate medical attention, since
the allergic reaction may be serious. If a child has ongo-
ing problems such as eczema or other allergic reactions
or signs of intolerance to foods, the parent may choose to
seek help from a registered dietician and/or an allopathic
physician who specializes in allergies. The allopathic
physician may test the child first to determine the source
of the allergies. The dietician will work with the family
to help plan ways to meet nutritional needs while avoid-
ing foods that cause allergic reaction or intolerance.
The parent of an allergic child can also choose to
seek help from a homeopathic or naturopathic physician.
Andrew Weil, M.D., author of Spontaneous Healing , a
New York Times number one bestseller that sold well
over one million copies, believes that the body can heal
itself and believes allergies are learned responses of the
immune system to environmental agents that are not nec-
essarily harmful. Weil says treatment should focus on
calming an over-reactive immune system in order to alle-
viate allergy symptoms. Allergies can and are frequently
“healed.” However, traditional allergy medications tend
to be “more or less” toxic to the body and can increase
an allergic response over time.
To increase the likelihood of spontaneous healing.
Dr. Weil made the following recommendations. Dietary
modification to reduce allergic responses: following a
low-protein diet; cutting down on animal protein in gen-
eral; eliminating cow’s milk and products made from it
because they are known to irritate the immune system;
and eating organically grown foods as much as possible
to avoid agricultural chemicals that cause immune system
reaction. Regular use of quercetin, a natural product from
buckwheat and citrus fruits, that stabilizes cell mem-
branes that release histamine, which is involved in many
allergic reactions. Quercetin is a preventative and Dr.
Weil recommends it be used regularly. The recommended
dose is 400 mg twice a day between meals. For hay fever,
the freeze-dried extract of the herb stinging nettle, one to
two capsules every two to four hours as needed, he says
will control symptoms with none of the toxicity of anti-
histamines or steroids. He also recommends a safe nasal
spray, Nasalcrom, which works like quercetin. In the
home, environmental methods like installing air filters
can reduce allergic effects on and relieve the immune sys-
tem. And finally, some allergic reactions indicate that
high brain levels are involved in misdirected immune sys-
tem response, and mind/body intervention is suggested.
Research & general acceptance
The AMA has based many of its food choices on the
Dietary Guidelines for Americans, which were developed
through research by the U.S. Department of Agriculture and
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
the U.S. Department of Human Services. Input for the
guidelines comes from a number of resources, including na-
tional surveys from the Centers for Disease Control (CDC).
As for children and the general public, accepting the
importance of nutrition is another story. A 2003 study
from the American Dietetic Association reported that
preteens and their parents weren’t concerned about pre-
teens’ weight being a health risk. Children and parents
related obesity more to food than to physical activity and
many overweight children said they didn’t have much
opportunity for physical activity.
Training & certification
Qualified dieticians and nutritionists may have a
bachelor’s, master’s or a doctoral degrees in nutrition
and dietetics from an accredited college. They also are
required to constantly update their knowledge with con-
tinuing education. Through the American Dietetic Asso-
ciation, these professionals can gain certification in their
fields, including a certificate of training in childhood and
adolescent weight management. Pediatricians obtain
M.D. or D.O degrees and some specialize in childhood
diseases and treatment, in the field of alternative medi-
cine, parents may choose to seek treatment from natur-
opaths and homeopaths.
Andrew Weil, M.D. in Spontaneous Healing points
out the benefits of naturopathic medicine by saying that
naturopaths go beyond the impression that they are 'New
Age.’ “Naturopathy comes from the old tradition of Eu-
ropean health spas with their emphasis hydro (water)
therapy, massage, and nutritional and herbal treatment.”
Naturopaths are well trained in the sciences and have
more experience with nutritional and herbal medicine
that allopathic physicians may not have. Naturopathy is
based on a general philosophy that focuses on the body’s
natural healing potential in an attempt to circumvent the
use of drugs and surgery; however, naturopathic physi-
cians may focus on different styles, using such therapies
as acupuncture, bodywork, herbalism, and homeopathy.
They are licensed in only a few states in the United
States, mostly in the West. According to Dr. Weil, “Good
naturopaths are worth consulting for childhood illnesses,
recurrent upper respiratory infections and sinusitis, gy-
necological problems, and all ailments for which con-
ventional doctors have only suppressive treatments.
Naturopaths can be valuable as advisors to help people
design healthy lifestyles.” To find a naturopathic physi-
cian in their area, parents can contact the American As-
sociation of Naturopathic Physicians, 601 Valley Street,
Suite 105, Seattle, Washington 98109, (206) 298-0126.
With regard to homeopathy, Dr. Weil also has positive
feedback for the discipline. Homeopathy is a system that
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
has a two hundred year old history. Homeopaths use dilut-
ed natural remedies work on the body’s energy field to en-
courage healing. Homeopathic physicians can be M.D.s,
osteopaths, naturopaths, chiropractors, or lay persons. If a
parent wishes to consult an alternative practitioner for
homeopathic advice, the National Center for Homeopathy
can be contacted at 801 North Fairfax Street, Suite 306,
Alexandria, Virginia 22314, (703) 548-7790.
Resources
BOOKS
Colbin, Annemarie. Food and Healing. New York: Ballantine
Books. 1986, 1996.
Colbin, Annemarie. The Book of Whole Meals. New York: Bal-
lantine Books, 1983.
Colbin, Annemarie. The Natural Gourmet. New York: Ballan-
tine Books, 1989.
Dufty, William. Sugar Blues. New York: Warner Books, 1978.
Estella, Mary. Natural Foods Cookbook. New York: Harper &
Row, 1985.
Hewitt, Jean. The New York Times Natural Foods Cookbook.
New York: Avon Books, 1972.
Kordich, Jay. The Juiceman’ s Power of Juicing. New York:
Warner Books, 1993.
Lappe, Frances Moore. Diet for a Small Planet. New York:
Ballantine Books, 1991.
Lieberman, Sheri, and Nancy Bruning. The Real Vitamin and
Mineral Book. New York: Avery Publishing Group, Inc.,
1990.
Mindell, Earl, Ph.D, R.Ph. Vitamin Bible for the 21st Century.
New York: Warner Books, 1999.
Walker, Norman W., D.Sc. Fresh Vegetable and Fruit Juices.
Prescott, Arizona: Norwalk Press, 1970.
Weil, Andrew, M.D. Spontaneous Healing. New York: Ballan-
tine Books, 1995.
PERIODICALS
Berler, Ron. “The Problem is Big: More Kids than Ever are
Overweight. We’ll Tell You About the Crisis, Offer Some
Solutions, and Explain Why Controlling Your Weight Can
Make You a Better Athlete.” Sports Illustrated for Kids
(October 1, 2003):60.
“Food Insecurity." Pediatrics (February 2003):357-358.
"Kids Don’t Think Obesity is a Health Problem." Nutrition
Today (July-August 2003): 115-116.
McCook, Alison. “Food Taste Acceptance ‘Programmed’ in In-
fancy.” Reuters Health ( April 5, 2004).
ORGANIZATIONS
American Academy of Pediatrics. 141 Northwest Point Boule-
vard, Elk Grove Village, IL 60007-1098. (888) 227-1770.
<http://www.aap.org/family>.
American Herbalists Guild. P.O. Box 1683. Soquel, CA 95073.
408-464-2441.
American Holistic Medical Association. 5728 Old McLean Vil-
lage Drive. McLean, VA 22101-3906. (703) 556-9728.
445
Childhood nutrition
Chills
KEY TERMS
Anorexia — An eating disorder that involves loss of
appetite that results in the inability to eat.
Bulimia — Sometimes called binge eating, this eat-
ing disorder consists of cravings for foods that
often result in periods of continuous eating fol-
lowed by purging (forced vomiting or diarrhea)
and depression or food-deprivation, etc.
Gout — A metabolism defect resulting in overpro-
duction of uric acid and pain in one or a few joints,
hypoglycemia — A condition of abnormally low
blood sugar.
Malnutrition — Any disorder of nutrition caused by
insufficient or unbalanced diet that can result in
impaired absorption or use of foods.
Megavitamin therapy — Also called orthomolecu-
lar medicine, megavitamin therapy provides large
doses of vitamins and minerals to treat certain
conditions or diseases.
Seborrheic dermatitis — A skin condition charac-
terized by loose, greasy, or dry white to yellowish
scales with or without reddened skin.
International Food Information Council. 1 100 Connecticut Av-
enue, NW, Suite 430, Washington, DC, 20036. (202) 296-
6540. <http://www.ific.org>.
KidsHealth/Nemours Foundation. 4600 Touchton Road East,
Building 200, Suite 500, Jacksonville, FL 32246. <http://
www.kidshealth.org>.
U.S. Department of Agriculture and U.S. Department of Health
and Human Services. (888) 878-3256. <http://www.usda.
gov/FoodAndNutrition>.
OTHER
BMI For Children and Teens. National Center for Chronic Dis-
ease Prevention and Health Promotion, [cited June 16,
2004]. <http://www.cdc.gov/nccdphp/dnpa/bmi/bmi-for-age.
htm>.
Healthy Food Choices: Six to 12 Years. American Medical Asso-
ciation. [cited June 16, 2004]. <http://www. medem.com>.
Healthy Food Choices: Two to Five Years. American Medical
Association, [cited June 16, 2004]. <http://www. medern.
com>.
Report Card on the Diet Quality of Children Ages Two to Nine.
Publication of the USDA Center for Nutrition Policy and Pro-
motion. [cited June 16, 2004]. <http://www.cnpp.usda.gov>.
Ruth Ann Carter
Chili pepper see Cayenne
446
Chills
Definition
Chills is the common name for a feeling of coldness
accompanied by shivering and possibly fever.
Causes & symptoms
Chills may occur due to the following reasons:
• Exposure to extremely low outside temperature.
• Insufficient protection from cold temperature or weather.
• Age, as newborns and elders are intolerant of cold tem-
perature.
• Anemia, particularly in women who frequently com-
plain of cold intolerance. The condition is frequently
found in females of reproductive age due to significant
monthly blood loss during menses.
• Stress or poor health condition.
• Malnutrition. Poor diet and/or B-complex vitamin defi-
ciency often makes a person more sensitive to cold
temperature.
• Hypothyroidism. Hypothyroidism is one of the most
common reasons for cold intolerance in women.
• Diabetes.
• Poor immune function as in AIDS or cancer patients.
In these patients, chills and shivering may be signs of
infections (most likely), tumors, drug-induced fever, or
malnutrition.
• Infections. Chills and fever are often caused by the
common cold or viral infections. However, they may
also be due to something more serious such as cystitis
(bladder infection), septicemia (blood infections),
pneumonia, meningitis, malaria or tuberculosis.
• Medications. Certain medications such as beta interfer-
ons can cause chills as side effect.
• Unknown infections or diseases.
Diagnosis
Those suffering from chills should investigate possi-
ble causes if the symptoms persist or are accompanied
by fever and/or night sweat. They may be a sign or
symptom of something serious and may require medical
attention. Doctor can make accurate diagnosis of under-
lying diseases through detailed questioning about the
chills, accompanying symptoms if any, patient’s diet,
daily stress, and lifestyle. In addition, doctors may order
blood tests for anemia, hypothyroidism, or infections if
these conditions are suspected.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Treatment
Alternative treatment of chills includes protecting
oneself from inclement weather conditions, drinking
warm teas, and making appropriate dietary changes.
Ayurvedic treatment might include fomenation therapy,
called svedana, to aggravate the fatty tissue and force ex-
cess sweat out of the body. Svedana is used to relieve
bodily stiffness, heaviness, and coldness.
In traditional Chinese medicine, those complain-
ing of chills should follow a diet of “warming” foods and
avoid “cold” foods. Reference to cold or warming does
not mean the actual temperature of the food, but its inter-
nal effect. In general, the Chinese recommend cooked
rather than cold, raw foods for this condition. The
Ayurvedic formula for producing internal heat is trikodu ,
made of equal parts of ginger, black pepper, and long
pepper (pippali, native to India and Java), and alleviating
coldness and stagnation in the body.
Nutritional therapy
The following dietary changes are recommended to
help prevent chills and cold intolerance:
• Limiting alcohol and caffeine intake and refraining
from smoking tobacco products. These chemicals in-
crease cold intolerance.
• Drinking warm tea with or without herbs such as gin-
ger (a warming herb used in Chinese and Native
American medicine) or chamomile.
• Taking daily multiple vitamin/mineral supplement or
B-complex vitamins with C. People who are deficient
of B-vitamins often are sensitive to cold temperature.
Allopathic treatment
Persons should consult their doctors if cold intoler-
ance is severe or if chills are often followed by persistent
fever or night sweats. They may be signs or symptoms of
serious conditions or infections. Hypothyroidism or poor
thyroid function should also be ruled out in women com-
plaining of cold sensitivity.
If cold intolerance is accompanied by other signs
and symptoms of thyroid deficiency such as lethargy,
obesity, and depression, persons should consult their
doctor for treatment of hypothyroidism. Thyroid supple-
ment may be necessary.
Patients should also be concerned if chills frequent-
ly occur with fever. Fever may be the body’s response to
infections. Persistent chills, night sweat, fever, and rapid
weight loss should be brought to a doctor’s attention.
They may be symptoms of cancer or infections such as
AIDS or tuberculosis. Chills and fever in immunodefi-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Anemia — A condition in which there is a low
number of red blood cells or hemoglobin resulting
in paleness and weakness.
Hypothyroidism — Deficiency of thyroid gland ac-
tivity. This is often due to low production of thy-
roxine, an inactive iodine continuing a hormone
that aids in regulating metabolism. In its severe
form, it may cause obesity, loss of hair, enlarge-
ment of the tongue, thickening of the skin, and
physical and mental sluggishness.
Reye's syndrome — Acute and often fatal child-
hood syndrome marked by encephalopathy (brain
disease), hepatitis (inflammation of the liver), and
fatty accumulations in the viscera (many of the
soft parts and internal organs). It may start as a
mild illness with respiratory and gastrointestinal
symptoms for a few days, terminating in rapid
brain swelling, hepatomegaly (enlargement of the
liver), and convulsions, even coma.
cient patients are often signs of infections that can be se-
rious in patients with weakened immune systems.
Fever and chills can often be treated with over-the-
counter medication such as acetaminophen or ibuprofen.
Aspirin should not be given to a child for fear of Reye’s
syndrome. Patients should be given soups, fruit juices, or
water to replace fluid loss due to fever. If fever is high
(more than 104°F [40°C]), occurs in newborns (less than
three months old) or lasts longer than 48 hours, a physi-
cian should be contacted.
Prevention
Wearing appropriate clothes for the weather, eating
nutritious foods, and taking dietary supplements may
help prevent chills in some people.
Resources
BOOKS
The Burton Goldberg Group. “Chills.” In Alternative Medi-
cine: The Definitive Guide. Tiburon. CA: Future Medical
Publishing, Inc., 1999.
Yoder, Ernest. “Disorders due to Heat and Cold.” In Cecil Text-
book of Medicine, 2nd ed. Philadelphia: W.B. Saunders
Company, 2000.
ORGANIZATIONS
National Cancer Institute. Building 31, Room 10A24, 9000
Rockville Pike, Bethesda, MD 20892. (800) 422-6237.
447
Chills
Chinese foxglove root
OTHER
Strange, Carolyn J. “Fighting the (I’m) Cold War.” iVHlage.com
http://onhealth.com/women/columnist/item, 46788. asp.
PDQ. “Fever, Chills and Sweats.” CBS Health Watch http://cbs.
medscape.com.
Mai Tran
Chinese angelica see Dong quai
Chinese bupleurum see Chinese
thoroughwax
Chinese gentiana see Gentiana
Chinese medicine see Traditional Chinese
medicine
Chinese tea see Green tea
Chinese wolfberry see Lycium fruit
Chinese foxglove root
Description
Chinese foxglove root is a perennial herb found in
northern China. It grows 6-8 in (15-20 cm) tall and has
long oval leaves that are covered with fine hairs, fluted
flowers that are reddish orange tinted with purple, and a
round fruit. The root is thick and reddish yellow. Chinese
foxglove root is collected in the fall. Its Latin name is
Rehmannia glutinosa and it is also called Rehmannia
chinensis.
General use
In China, Chinese foxglove root is used as a remedy
for many different ailments: blurred vision, chronic fever,
constipation, heart palpitations, hearing problems, hot
flashes, insomnia, light-headedness, low back pain,
menstrual irregularity and uterine bleeding (especially
after childbirth), night sweats, restlessness, and stiff
joints. It is also used to combat the effects of aging. Its ef-
fectiveness in treating these ailments has not been verified.
Preparations
Chinese foxglove root is washed and dried in the
sun. It is sold in large, fleshy brownish-yellow chunks
and tastes sweet and moist. The root is used in two stages
of preparation: dried and cooked. To make dried Chinese
foxglove root, called sheng di huang or dry Rehmannia,
the fresh root is removed from the sand, washed well,
then dried in the sun during the winter. Cooked Chinese
448
foxglove root, called slut di huang or cooked Rehmannia,
is prepared by steaming the fresh root until it is cooked,
letting it dry, then steaming and drying it again several
times. Cooking Chinese foxglove root is said to enhance
the herb’s properties as a blood tonic. To combat the ef-
fects of aging, the root is prepared with cardamon so that
it is easier to digest and used as a tonic. The raw form of
the root is a cooler herb and used for symptoms of heat.
The cooked root is more of a blood tonic.
Chinese medicine practitioners also make special
preparations of Chinese foxglove root for specific ail-
ments. It can be mixed with gelatin for coughing and
vomiting blood, nosebleeds, and bleeding from the
uterus. It can be mixed with cornus and Chinese yam or
freshwater turtle shell as a remedy for symptoms such as
forgetfulness, insomnia, and lightheadedness. Rehman-
nia is the main ingredient in the Chinese six flavor
Rehmannia tonic used for ailments and discomfort such
as frequent urination, infertility, impotence, and weak
and painful knees.
Both cooked Chinese foxglove root and the raw version
are available in Chinese pharmacies, Asian markets, and
some Western health food stores. There are no formal guide-
lines for recommended doses of Chinese foxglove root.
Precautions
People who have digestive problems, especially
those who tend to have gas or become bloated, should
use Chinese foxglove root with care; the cooked root can
swell the belly and cause loose stools. There is no infor-
mation available on what happens to people who take an
overdose of Chinese foxglove root.
Side effects
The use of Chinese foxglove root can cause diar-
rhea, nausea, and abdominal pain. Many Chinese
herbalists include grains-of-paradise fruit, a kind of
cardamon, in their Chinese foxglove root preparations to
prevent these side effects.
Interactions
No interactions due to use of Chinese foxglove root
have been reported.
Resources
BOOKS
Reid, D. A Handbook of Chinese Healing Herbs. Boston:
Shambhala Pubns., Inc., 1995.
Sifton, David W., ed. The PDR Family Guide to Natural Medi-
cines & Healing Therapies. New York: Three Rivers Pr.,
1999.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Palpitation — A heartbeat that is irregular or too
fast.
OTHER
China-Med.net. Traditional Chinese Medicine. “Radix Rehm-
anniae." Paracel@clarityconnect.com. http://www.chma-
med.net/herb_search.html. (May 2000).
Lori De Milto
Chinese massage
Definition
Chinese massage is the name for a family of mas-
sage therapies practiced within traditional Chinese
medicine. In traditional Chinese practice, massage is
one of the fundamental treatment modalities, along with
dietary regulation, herbal medicine, acupuncture/moxi-
bustion, and therapeutic exercise.
Origins
Massage as a part of Chinese medical treatment
goes back about 4,000 years. Written massage textbooks
began to appear as early as the fourth century B.c., along
with the earliest Chinese medical texts. Massage appears
to have developed alongside both therapeutic exercise
(qigong) and acupuncture, as it depends on the same
understanding of the meridians and the flow of qi in the
human body. The type of massage known as qi healing,
or curing with external qi, was developed by master
teachers of qigong.
Benefits
Chinese massage is not intended to be an experience
of pampering or relaxation. It is a form of deep tissue
therapy that conveys the following benefits:
• speeding the healing of injuries and clearing bruises
• stimulating blood circulation and regulating the ner-
vous system
• removing scar tissue
• easing emotional distress
• curing some conditions affecting the internal organs
• increasing flexibility in the joints and improving posture
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• relieving chronic pain
• maintaining wellness and functioning as a form of pre-
ventive care
• improving athletic performance
• strengthening the body’s resistance to disease
Other benefits include the fact that some forms of
Chinese massage do not require extensive training and
can be used at home.
Description
Theoretical background
The techniques of Chinese massage are inseparable
from the philosophical belief system that underlies tradi-
tional Chinese medicine. Chinese massage is holistic in
its orientation, which means that massage is understood
to affect the patient’s entire being, not just his or her
physical body.
Several concepts are important in understanding all
the major forms of Chinese massage, including qi,jing
luo, xue, and jin.
Qi, sometimes spelled chi or ki, is the basic life en-
ergy animating the universe as well as human beings.
The word can be translated into English as “breath” or
“air.” Qi can be transferred or transmuted. In humans,
the digestive tract extracts the qi from food, while the
lungs extract it from the air. When these two forms of qi
meet in the bloodstream, they form human qi, which
then circulates throughout the body.
The meridians or channels ( jing luo ) are a network
of energy pathways that link and balance the various or-
gans. The meridians have four functions: to connect the
internal organs with the exterior of the body, and connect
the person to the environment and the universe; to har-
monize the yin and yang principles within the body’s or-
gans and Five Substances; to distribute qi within the
body; and to protect the body against external imbal-
ances related to weather. When the jing luo are blocked
so that qi and blood cannot circulate, the person experi-
ences physical pain.
The acupoints (xue) are locations on the body where
qi tends to collect and can be manipulated or redirected.
They are connected to different body organs through the
meridians.
The soft and connective tissues (jin ) and the joints
all affect the flow of qi along the meridians. Thus one
function of Chinese massage is to relax the patient’s jin.
In general, Chinese massage emphasizes movement
and communication. The basic purpose of massage is to
restore free movement to the patient's qi and blood. Chi-
449
Chinese massage
Chinese massage
nese massage therapists use a range of techniques to ac-
complish this: they press, knuckle-roll, squeeze, knead,
dig, drag, pluck, tweak, hammer, push, stretch, hammer,
vibrate, knock, and even tread on the body with their feet.
Massage accomplishes its purpose in three ways: it
“jump-starts” the activity of qi and blood, it regulates their
movement and disperses stagnation, and it removes exter-
nal causes of blockage (cold and damp). Since Chinese
practitioners regard massage as affecting all dimensions of
the patient’s being, they think of it as involving communi-
cation between the therapist’s qi and the patient’s qi. In
Tui na massage, the patient is allowed or even encouraged
to talk while the therapist is working. This practice often
helps the patient to release stored-up feelings.
Tui na massage
Tui na massage takes its name from two Chinese
words that mean “lift and press.” It requires the con-
trolled use of very deep but constantly moving pres-
sure, repeated hundreds of times. The practitioner push-
es hard with the ball of the thumb, then rubs lightly
around the area being treated. A therapist using this
form of massage might spend as much time on one of
the patient’s joints or limbs as a Western therapist
would spend massaging the entire body. Tui na is used
to treat a wide variety of conditions that would require
a team of physiotherapists, chiropractors, and physi-
cians specializing in sports medicine to treat in the
West. One Chinese medical book lists over 140 condi-
tions that can be treated with Tui na, including disor-
ders of the internal organs as well as sprains, pulled
muscles, arthritis, and sciatica, a pain in the lower back
and back of the thighs.
Chinese pediatric massage
Chinese pediatric message, or xiao er tui na, is a
form of Tui na massage adapted to the special needs of
children from birth to 12 years of age. The Chinese be-
lieve that a child’s energy system is different from an
adult’s because children have fewer physical and emo-
tional barriers in place. Their qi is therefore more acces-
sible to treatment. The acupoints and techniques used in
pediatric massage are different from those used with
adults. A massage oil, typically sesame oil, is often used
with children. The sessions are much shorter than those
for adults, usually only 15-20 minutes, but they may be
repeated several times a day for children who are seri-
ously ill. Pediatric massage is used to treat such chronic
conditions as asthma, bedwetting, and nightmares as
well as teething, colic, nausea, fever, constipation, and
the common cold. Parents often learn the basic tech-
niques of pediatric massage as preventive health care for
their children or to treat minor illnesses.
450
An mo massage
An mo is a type of massage used for health mainte-
nance and to restore vitality. Its name means “press and
stroke” in Chinese. It can be used at home but is also part
of martial arts, qigong, and athletic training. An mo dif-
fers from Tui na massage in that it is a full-body bal-
anced treatment. An mo combines yang techniques to
break up stagnant qi and activate its flow, followed by
yin techniques to soothe and calm the body. An mo has a
set pattern of movements and techniques that the thera-
pist follows, but these can be adjusted to the patient’s
needs. A session of An mo massage may last as long as
two hours, particularly if there is a strong qi communica-
tion between the therapist and the patient.
Dian xue massage (acupressure)
Dian xue, or “point press,” is familiar to many West-
erners as acupressure. It uses the same acupoints on the
body as acupuncture, but relies on pressure from the fin-
gers rather than needles. Dian xue can be used by mas-
sage therapists to stimulate two different acupoints, one
with each hand, while the area of the body between the
points is stretched or twisted to maximize the flow of qi.
Dian xue can be given in the home, and is sometimes
used by acupuncturists when needles cannot be used.
Qi healing massage
The Chinese name of this form of massage is wai qi
liao fa, or “curing with external qi.” In qi healing, a
qigong master who has practiced the art for many years
transmits qi directly to the patient. Qi healing massage
represents one strand of Chinese traditional practice in
which healers passed on their own discoveries of the
healing arts only to their closest disciples.
Preparations
Chinese massage is usually given with the patient
lying on one side on a couch or seated on a chair or
stool. The patient typically wears thin cotton clothing,
particularly if the massage is being given in a public hos-
pital or clinic. In smaller communities, the practitioner
may work directly on the patient’s skin. Touching the
skin directly is thought to improve communication with
the patient’s qi; it also allows the application of herbal
preparations to the skin.
Tui na massage is preceded by taking a full case his-
tory using the traditional four examinations of Chinese
medicine (verbal interview; visual observation, which in-
cludes close examination of the tongue; listening to the
patient’s breathing and coughing; and touching, which in-
cludes taking twelve separate pulses). The massage thera-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
pist uses the information from the four examinations to
identify the root complaint, the underlying pattern caus-
ing it, and the principles that will govern the treatment.
Precautions
Apart from giving a case history prior to receiving
Tui na massage, no special precautions are necessary.
Side effects
Side effects are usually limited to some soreness, par-
ticularly after the first session of Tui na massage. This dis-
comfort usually goes away after several more sessions. Pe-
diatric massage is said to have few or no side effects. On
rare occasions, patients have experienced headaches or mild
stomach upset. These side effects are attributed to the im-
balance or stagnation in the patient’s qi prior to treatment.
Research & general acceptance
In recent years, Chinese massage has become wide-
ly accepted in the West. A growing number of Western
practitioners are not only studying Chinese massage, but
also obtaining their training and certification in Shanghai
and other centers of traditional Chinese medical educa-
tion. Many alternative treatment centers in the United
States now offer Chinese massage along with Western
forms of bodywork. Still another indication of the wider
acceptance of Chinese forms of treatment is the emer-
gence of hybrid massage therapies that combine Chinese
techniques with those derived from other Oriental tradi-
tions of massage or from Western practices.
Training & certification
In China itself, massage is part of the curriculum of
traditional Chinese schools of medicine, since it is an
important aspect of primary health care. Graduates of
these schools must pass rigorous examinations and gov-
ernment licensing procedures before setting up their
practices. In addition, it is common for Chinese physi-
cians to visit other practitioners as patients in order to
learn about specialized techniques for treating specific
conditions with massage. Lastly, many Chinese physi-
cians come from families that have produced several
generations of healers; younger practitioners often learn
the techniques of massage from older family members.
The master/apprentice model of teaching is still followed
in traditional Chinese medical training.
Resources
BOOKS
Chinese Massage Therapy: A Handbook of Therapeutic Mas-
sage. Compiled at the Anhui Medical School Hospital,
China. Translation. Boulder, CO: Shambhala, 1983.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Acupoint — A point or site on the body where qi
tends to accumulate. Acupoints are pressed or
manipulated in Chinese massage in order to acti-
vate or redirect the patient's qi.
An mo — A form of Chinese massage that treats the
whole body and emphasizes balancing yin and
yang techniques in the treatment. Its name means
"press and stroke" in Chinese.
Dian xue — The Chinese name for acupressure.
This form of massage can be done at home as well
as by a trained therapist.
Qi — The Chinese word for life energy. Since tradi-
tional Chinese medicine understands pain to be
the result of blocked or stagnant qi, all forms of
Chinese massage are intended to restore free
movement to the patient's qi and blood.
Tui na — A form of Chinese massage that focuses
on a part of the patient's body in order to treat in-
juries and chronic pain. Its name means "lift and
press" in Chinese.
Mercati, Maria. The Handbook of Chinese Massage: Tui Na
Techniques to Awaken Body and Mind. Rochester, VT:
Healing Arts Press, 1999.
Reid, Daniel P. Chinese Herbal Medicine. Boston: Shambhala,
1993.
Stein, Diane. “Chinese Healing and Acupressure.” In All
Women Are Healers: A Comprehensive Guide to Natural
Healing. Freedom, CA: The Crossing Press, 1996.
Svoboda, Robert, and Arnie Lade. Tao and Dharma: Chinese
Medicine and Ayurveda. Twin Lakes, WI: Lotus Press,
1995.
ORGANIZATIONS
American Association of Oriental Medicine (AAOM). 433
Front Street, Catasauqua, PA 18032. (610) 266-2433.
American Foundation of Traditional Chinese Medicine
(AFTCM). 505 Beach Street, San Francisco, CA 94133.
(415) 776-0502. Fax: (415) 392-7003. aftcm@earthlink.net.
Rebecca J. Frey, PhD
Chinese system of food cures
Definition
The Chinese system of food cures regards dietary
regulation as preventive medicine as well as a corrective
451
Chinese system of food cures
Chinese system of food cures
measure to be undertaken once someone falls ill. Diet is
one of four major treatment modalities in traditional
Chinese medicine, the other three being acupuncture/
moxibustion, herbal medicine, and massage, plus reme-
dial physical exercise.
Origins
The selection of foods in the diet as part of a life-
long program of health maintenance and treatment of ill-
ness has been a part of Chinese medicine from its begin-
nings. The first extensive written Chinese medical trea-
tises (as the West understands the term) date from the
Han dynasty (206 b.c.-a.d. 220), but the use of food as
preventive medicine probably goes several thousand
years further back. Legends says that tribal shamans and
holy men who lived as hermits in the mountains of China
as early as 3500 B.c. practiced what was called the “Way
of Long Life.’’ This regimen included a diet based on
herbs and other plants, qigong exercises, and special
breathing techniques that were thought to improve vitali-
ty and life expectancy.
After the Han dynasty, the next great age of Chinese
medicine was under the Tang emperors, who ruled from
a.d. 608 to a.d. 906. The first Tang emperor established
China's first medical school in a.d. 629. This period pro-
duced China’s earliest expert on dietary therapy, Sun
Simiao. He specialized in the treatment of diseases
caused by malnutrition and wrote several works on diet
and health. Sun Simaio’s principle of using diet and
lifestyle changes as the first line of treatment for illness
has governed traditional Chinese practice ever since. Ac-
cording to Sun Simaio, only when dietary treatment is
not enough to cure the patient should the doctor turn to
acupuncture and herbal medicines.
Benefits
The benefits of traditional Chinese dietary treatment
are many years of vigorous good health. According to
the Nei Jing , China’s oldest medical classic, the
metaphor is that human beings are constituted to live for
a hundred years, barring accidents or violence. Diet and
good digestion are considered the most important ways
to maintain physical strength and vitality.
Description
Chinese food cures are based on the philosophical
principles of Taoism and its teachers' observations about
nature. Some of its concepts are difficult for Westerners
to understand because they rely on symbols and images
rather than scientific measurements and theories. In gen-
eral, Chinese medicine regards the human organism as
452
an integrated entity within itself and as linked to the fam-
ily, society, and the natural order by a pattern of symbol-
ic connections.
The cosmic and natural order
In early Chinese philosophy, the Tao, or universal
first principle, generated a duality of opposing principles
that underlie all the patterns of nature. These principles,
yin and yang, are mutually dependent as well as polar
opposites. Yin represents everything that is cold, moist,
dim, responsive, slow, heavy, and moving downward or
inward; while yang represents heat, dryness, brightness,
activity, rapidity, lightness, and upward or outward mo-
tion. The dynamic interaction of these two principles is
reflected in the cycles of the seasons, the human life
cycle, and other natural phenomena.
In addition to yin and yang, Taoist teachers also be-
lieved that the Tao produced a third force, primordial en-
ergy or chi (also spelled qi or ki. the Japanese term). The
interplay between yin, yang, and chi gave rise to the Five
Elements of water, wood, fire, earth, and metal. These
entities are all reflected in the structure and functioning
of the human body.
The human being
Traditional Chinese physicians did not learn about
the structures of the human body from dissection (al-
though they did perform some animal studies) because
they thought that cutting open a body insulted the per-
son’s ancestors. Instead they built up an understanding of
the location and functions of the major organs over cen-
turies of observation, and then correlated them with the
principles of yin, yang, chi, and the Five Elements. Thus
wood is related to the liver (yin) and the gall bladder
(yang); fire to the heart (yin) and the small intestine
(yang); earth to the spleen (yin) and the stomach (yang);
metal to the lungs (yin) and the large intestine (yang);
and water to the kidneys (yin) and the bladder (yang).
The Chinese also believed that the body contains Five
Essential Substances, which include blood, spirit, vital
essence (a principle of growth and development pro-
duced by the body from chi and blood), fluids (all body
fluids other than blood, such as saliva, spinal fluid,
sweat, etc.), and chi.
A unique feature of traditional Chinese medicine is
the meridian system. Chinese doctors viewed the body as
regulated by a network of energy pathways called meridi-
ans that link and balance the various organs. The meridi-
ans have four functions: to connect the internal organs
with the exterior of the body, and connect the person to the
environment and the universe; to harmonize the yin and
yang principles within the body’s organs and Five Sub-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
stances; to distribute chi within the body; and to protect
the body against external imbalances related to weather
(wind, summer heat, dampness, dryness, cold, and fire).
The composition and use of foods
Chinese food cures operate within this system of
cosmic principles, symbolic correlation of internal or-
gans with the five elements, and the meridian system.
Food serves several functions in traditional Chinese
medicine. It supplies nutritional energy to the body to re-
plenish chi. It is also used by the body to produce vital
essence and blood. Lastly, foods can be chosen to regu-
late the balance of yin and yang and the five elements
within the body and to direct the flow of chi to different
parts of the body.
Chinese medicine classifies foods according to four
sets of categories:
• Temperature. Foods are classified as cold or cool (yin);
or warm or hot (yang).
• Taste. There are five tastes correlated with the Five Ele-
ments: sour (wood); bitter (fire); sweet (earth); pungent
(metal); and salty (water).
• Direction of action. Pungent, salty, and bland foods are
thought to have an ascending or floating action that
redirects chi upward, while sour, bitter, and sweet
foods are thought to have a descending or sinking ac-
tion that moves the chi downward.
• The organ or meridian affected by the food.
Chinese medicine uses foods to keep the body in in-
ternal harmony and in a state of balance with the external
environment. In giving dietary advice, the Chinese
physician takes into account the weather, the season, the
geography of the area, and the patient’s specific imbal-
ances (including emotional upsets) in order to select
foods that will counteract excesses or supply deficient el-
ements. Basic preventive dietary care, for example,
would recommend eating yin foods in the summer,
which is a yang season. In the winter, by contrast, yang
foods should be eaten to counteract the yin temperatures.
In the case of illness, yin symptom patterns (fatigue,
pale complexion, weak voice) would be treated with
yang foods, while yang symptoms (flushed face, loud
voice, restlessness) would be treated by yin foods. In ad-
dition, cravings for specific foods or flavors point to de-
ficiencies to be remedied. Thus someone who wants a lot
of hot drinks probably has a “cold” illness, while some-
one who refuses beverages has a “damp” disease.
Chinese medicine also uses food as therapy in com-
bination with exercise and herbal preparations. One as-
pect of a balanced diet is maintaining a proper balance of
rest and activity as well as selecting the right foods for
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
the time of year and other circumstances. If a person
does not get enough exercise, the body cannot transform
food into chi and vital essence. If they are hyperactive,
the body consumes too much of its own substance. With
respect to herbal preparations, the Chinese used tonics
taken as part of a meal before they began to use them as
medicines. Flerbs are used in Chinese cooking to give the
food specific medicinal qualities as well as to flavor it.
For example, ginger might be added to a fish dish to
counteract the cold of the fish. Food and medical treat-
ment are closely interrelated in traditional Chinese medi-
cine. A classical Chinese meal seeks to balance not only
flavors, aromas, textures, and colors in the different
courses that are served, but also the energies provided
for the body by the various ingredients.
Preparations
A traditional Chinese physician will examine a pa-
tient carefully before giving advice about diet. The diag-
nosis is based on four types of examination: visual ob-
servation, which includes examining the shape, color,
and coating of the tongue as well as observing the com-
plexion and taking the pulse; listening to the voice and
breathing; inquiring about the patient’s symptoms, food
preferences, emotions, bowel habits, and sleeping pat-
terns; and palpating (feeling) the patient’s abdomen and
key points along the meridians. The doctor will suggest
changes in diet that will return the patient to inner bal-
ance and harmony with the environment according to the
patterns he detects.
Precautions
The most important precaution for Westerners who
are interested in Chinese food therapy is to consult an
experienced practitioner of Chinese medicine. The sys-
tem is complex and based on principles that differ from
Western systems of thought. These factors make self-
evaluation quite difficult.
Side effects
There are no known side effects from using the Chi-
nese system of food cures as part of a wellness program
under the guidance of an experienced practitioner.
Research & general acceptance
Research in the West has been largely confined to
study of the herbs used in traditional Chinese medicine
as distinct from food cures. Alternative practitioners in
the West, however, have shown considerable interest in
incorporating Chinese food cures into other systems, in-
453
Chinese system of food cures
Chinese thoroughwax
KEY TERMS
Chi (Qi or Ki) — The universal life-force or energy.
The quality, quantity, and balance of a person's
chi determines his or her state of health and
longevity.
Five Elements — The five basic substances (water,
wood, fire, earth, and metal) that symbolize the
fundamental qualities of the universe. In Chinese
food cures, the five elements are correlated with
the internal organs of the body and with the five
basic food tastes.
Five Substances — The basic entities in the human
body that serve its development and maintenance.
They include chi, vital essence, spirit, blood, and
fluids.
Meridians — Pathways of subtle energy that link
and regulate the various structures, organs, and
substances in the human body.
Taoism — The system of thought that looked at hu-
mans in relation to the whole universe. It had a
big influence on Chinese medicine.
Yin and yang — In Chinese thought, the two pri-
mordial opposing yet interdependent cosmic
forces.
eluding color therapy and women’s folk medicine. One
school of color therapy classifies foods as yin or yang
according to their color and recommends certain color
combinations to correct energy imbalances in the body.
Training & certification
In contemporary China, traditional medicine is prac-
ticed alongside Western methods of diagnosis and treat-
ment. Some Chinese medical schools still offer courses
in Chinese medicine. Practitioners of traditional medi-
cine must pass rigorous examinations and be licensed by
the government. They usually obtain their clinical expe-
rience by serving apprenticeships under experienced
doctors.
Resources
BOOKS
Chiazzari, Suzy. “Color and Food.” In The Complete Book of
Color. Part 3. Boston: Element Books Inc., 1999.
Reid. Daniel P. Chinese Herbal Medicine. Boston: Shambhala,
1993.
Stein, Diane. “Chinese Healing and Acupressure.” In All
Women Are Healers: A Comprehensive Guide to Natural
454
Healing, chapter 4. Freedom, CA: The Crossing Press,
1996.
Svoboda, Robert, and Arnie Lade. Tao and Dharma: Chinese
Medicine and Ayurveda. Twin Lakes, WI: Lotus Press,
1995.
ORGANIZATIONS
American Foundation of Traditional Chinese Medicine
(AFTCM). 505 Beach Street. San Francisco, CA 94133.
(415) 776-0502. Fax: (415) 392-7003. aftcm@earthlink.
net.
Rebecca J. Frey, PhD
Chinese thoroughwax
Description
Chinese thoroughwax is an herb that is often called
bupleurum, referring to the scientific naming of the
species Bupleurum chinense and Bupleurum falcatum.
Another name for the herb is hare’s ear, and in tradition-
al Chinese medicine the herb is called chai-hu.
Chinese thoroughwax (bupleurum) is a perennial
flowering plant that grows from one to three feet tall.
The leaves are long and slender, and the plant has yellow
flowers in the summer months. It grows naturally in
China, Japan, and Korea, and in other countries in north-
ern Asia and northern Europe. The root of the plant is
pale red, and is the part that is used medicinally. It tastes
slightly bitter and pungent, and is believed to have cool-
ing properties in the body.
One of the major herbs in traditional Chinese medi-
cine, Chinese thoroughwax is used in several traditional
formulas for liver problems, fevers, and inflammation.
Chinese herbalists prescribe it for conditions that are as-
sociated with stagnation of qi, or chi (life energy) in the
liver. Chinese thoroughwax is a major ingredient in a
widely used Oriental medicinal formula called in Japan-
ese shosaikoto, which also contains Korean ginseng,
licorice root, ginger root, and other herbs. The Chinese
name for the formula is xiao chai hu tang. This formula
is almost 2,000 years old and is used for situations when
someone gets a old or flu but never quite gets completely
better, like some kinds of chronic fatigue syndrome.
Bupleurum has received attention most recently by re-
searchers in China and Japan. Several studies that have
shown significant findings have been translated into Eng-
lish. Professor Shibata of Tokyo University isolated a sub-
stance in Chinese thoroughwax he termed saikogenin,
which is in a class of biologically active chemicals called
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
saponins. In laboratory tests, saikogenin has shown potent
anti-inflammatory properties, which recommend it for
treating skin infections and other disorders in which in-
flammation and swelling are problematic. Saikogenin has
been shown to increase the effectiveness of cortisone
drugs, which are pharmaceutical steroids prescribed for
arthritis, asthma, inflammation and other conditions. Bu-
pleurum significantly increased the action of the cortisone
drug prednisone in some laboratory tests. Another benefit
of bupleumm is that it has been shown to protect the adren-
al glands from the damaging effects of cortisone drugs.
Bupleurum extract has been shown in human studies
to improve the symptoms of hepatitis, or viral infection
of the liver. Other studies have pointed to its effective-
ness as an antipyretic (fever-reducing agent), a mild tran-
quilizer, an antibiotic and antiviral agent, and as an im-
mune system stimulant. A Japanese study published in
2002 suggests that bupleurum may be effective in the
treatment of gastric ulcers. Chinese thoroughwax has
also been shown to increase the efficiency of the
chemotherapy drug 5-FU. It should be noted that Chi-
nese thoroughwax has been generally most effective in
tests when used in conjunction with other herbs in tradi-
tional Chinese herbal formulas.
General use
Traditional Chinese medicine recommends Chinese
thoroughwax for chest congestion, respiratory problems,
and for chills and fevers, including those associated with
malaria and blackwater fever. It is used to treat fevers
that have associated symptoms of bitter taste in the
mouth, irritability, nausea, and abdominal pains, and is
sometimes prescribed for dizziness and vertigo that
occur with chest pain. Chinese thoroughwax is used in
tonics to strengthen the lungs and sense organs, and to
tone the leg muscles. Chinese thoroughwax is used to
strengthen the liver and to treat liver problems, such as
hepatitis and alcohol-related liver damage (cirrhosis).
For women, Chinese thoroughwax is used in formu-
las to regulate menstrual cycles in cases of amenorrhea
(loss of menstrual cycle), to reduce the symptoms of
PMS, and as a tonic for the female reproductive system.
Chinese thoroughwax can be taken as an herbal supple-
ment with corticosteroid drugs, to reduce the risks of
damage to the adrenal glands. Some Chinese medicinal
formulas containing Chinese thoroughwax (including
xiao chai hu tang) are used for cancer treatment and as
herbal support during chemotherapy.
Preparations
Chinese thoroughwax is available as dried root and
capsules in herb stores, health food stores, and Chinese
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
markets. It is also available in several formulated Chi-
nese medicines. To prepare a daily serving of tea, 3-12 g
of the dried root can be simmered for over an hour in a
quart of water. For more extreme cases of fever and he-
patitis, two servings of the tea can be drunk daily.
Side effects
Chinese thoroughwax can cause nausea, dizziness,
sweating, and intestinal discomfort when taken in exces-
sively high dosages.
Interactions
Chinese thoroughwax is frequently prescribed with
licorice root and Korean ginseng. In the traditional and
often used Oriental medicine called shosaikoto in Japan-
ese or xiao chai hu tang in Chinese, Chinese thorough-
wax is blended with licorice, jujube fruit, ginger root,
Korean ginseng, Chinese skullcap root, and half summer
root ( Pinellia ternata). Herbalists often recommend that
Chinese thoroughwax be combined with lycii berries to
counteract its drying effects in the body. For cases of
vertigo and chest pain, and as a liver tonic, bupleurum
can be taken with white peony root, bitter orange fruit,
and licorice. For menstruation problems, bupleurum
may be combined with white peony and mint.
Bupleurum has been reported to have negative inter-
actions with interferon, which is a protein produced by
animal cells when they are invaded by a virus. Interferon
is frequently used to treat hepatitis, and patients who are
receiving interferon for this disease should not take
herbal formulations containing bupleurum.
Resources
BOOKS
Lu, Henry C. Chinese Herbal Cures. New York: Sterling, 1994.
Reid, Daniel. Chinese Herbal Medicine. Boston: Shambhala,
1996.
Teeguarden, Ron. Chinese Tonic Herbs. New York: Japan Pub-
lications, 1995.
PERIODICALS
Matsumoto, T., X. B. Sun, T. Hanawa, et al. “Effect of the An-
tiulcer Polysaccharide Fraction from Bupleurum falcatum
L. on the Healing of Gastric Ulcer Induced by Acetic Acid
in Rats.” Phytotherapy Research 16 (February 2002): 91-
93.
Park, K. H., J. Park, D. Koh, and Y. Lim. “Effect of Saikos-
aponin-A, a Triterpenoid Glycoside, Isolated from Bu-
pleurum falcatum on Experimental Allergic Asthma.”
Phytotherapy Research 16 (June 2002): 359-363.
ORGANIZATIONS
American Association of Oriental Medicine. 5530 Wisconsin
Avenue, Suite 1210, Chevy Chase, MD 20815. (301) 941-
1064. <www.aaom.org>.
455
Chinese thoroughwax
Chinese yam
KEY TERMS
Interferon — A protein produced by animal cells
that have been invaded by a virus, frequently used
in the treatment of hepatitis. It has been reported
to cause negative interactions with bupleurum.
Qi, or chi — Universal life energy, according to tra-
ditional Chinese medicine, that is found in the
body, air, food, water, and sunlight.
Saikosaponins — Chemical compounds found in
bupleurum that have anti-inflammatory effects.
Traditional Chinese medicine — Ancient Chinese
healing system involving acupuncture, herbal
remedies, dietary therapies, and other healing
techniques.
Rocky Mountain Herbal Institute. P. O. Box 579, Hot Springs,
MT 59845. (406) 741-3811. <www.rmhiherbal.org>.
Douglas Dupler
Rebecca J. Frey, PhD
Chinese yam
Description
Chinese yam (Dioscorea opposite/) is a root that is
used in traditional Chinese medicine. The Chinese
pharmaceutical name for this herbal is Rhizoma
dioscoreae. Other names for Chinese yam include
dioscorea and shan yao. Chinese yam is native to China,
Japan, Korea, and Taiwan, where it can be found grow-
ing wild on hill slopes and in valleys. It is also propagat-
ed for medicinal and dietary uses.
The genus name Dioscorea is dedicated to the
Greek physician and naturalist, Diosorides. There are be-
tween 600 and 800 different species of Dioscorea, mak-
ing it one of the largest genera of the plant kingdom.
Many species in this genus are grown and collected for
their medicinal properties. Sweet potatoes are often
called yams, although they are different plants.
The Chinese yam plant is a climbing vine that sup-
ports itself by coiling around the branches of other vege-
tation. The plant can be 9.75 ft (3 m) high and 5 ft (1.5
m) wide. Chinese yam has heart-shaped leaves and it
produces small white flowers which have a cinnamon-
like aroma. Small tubers (called tubercles) form in the
456
axials (the angles between the leaves and the stem).
These pea-sized tubercles are harvested in the late sum-
mer or early fall and are used to propagate the plant.
Chinese yam plants take three or four years to reach
maturity, although fairly large roots may be harvested from
well developed plants after the first year. Chinese yam is a
spindle-shaped, thick, hard root or tuber that is white on
the inside. However, cultivated forms from China or Japan
may have different root shapes. The yam may be up to 1 yd
(about 1 m) in length. Chinese yam is dug up in the winter.
After the rough bark is removed, the root is washed and al-
lowed to dry in either the shade or the sun. The dried root
is rehydrated in water and then cut into slices.
Chinese yam contains large amounts of mucilage.
Mucilage is a thick, slimy substance produced by plants.
It has a soothing effect on mucous membranes, such as
the tissues that line the respiratory passages. This may
explain why Chinese yam is effective at relieving cough.
General use
Traditional Chinese medicine classifies Chinese yam
as neutral and sweet. It serves to tonify and augment the
spleen and stomach; augment the lung yin and tonify the
lung qi; and stabilize, tonify, and bind the kidneys. Chi-
nese yam enters through the spleen, lung, and kidney
channels (meridians). It is used as a tonic (restores tone to
tissues). Chinese yam is used to treat weak digestion with
fatigue and diarrhea, general weakness, frequent urina-
tion, decreased appetite, leukorrhagia (excessive vaginal
discharge), premature ejaculation, the symptoms associ-
ated with diabetes, and chronic wheezing (whistling
sound caused by breathing difficulty) and coughing.
Chinese yam should not be taken if the patient’s
symptoms include abdominal swelling and pain.
Preparations
Chinese yam may be found in the dried or fresh
form or as a powder. It is available in Asian food stores,
Chinese pharmacies, and may be found in certain health
food stores.
Chinese yam is taken by mouth for all indications. A
tea (infusion) may be prepared by steeping slices of the
root in boiling-hot water. The dosage is 10-30 g of root
or 6-10 g of powder.
Combinations
It is common in traditional Chinese medicine to mix
herbs to treat specific sets of symptoms. Chinese yam
may be combined with the following to treat certain
symptoms as shown:
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• poria and white atractylodes for loose, watery stools.
• codonopsis root for general weakness, fatigue, and
poor appetite.
• Chinese foxglove root and cornus for lightheadedness,
forgetfulness, insomnia, and related symptoms.
• ginseng {ren shen), white atractylodes rhizome ( bai
zhu), and poria (filling ) for weakness of the spleen and
stomach characterized by poor appetite, lassitude (ex-
haustion, weakness), and diarrhea.
• white atractylodes rhizome, poria, and euryale seed
(< qian shi ) for excessive dampness because of deficien-
cy of the spleen characterized by white leukorrhagia
and lassitude.
• phellodendron bark ( huang bai ) and plantain seed (che
qian zi) for excessive dampness changing into heat
characterized by yellow vaginal discharge.
• dogwood fruit (shan zhu yu ) and dodder seed (tu si zi)
for deficient kidneys characterized by lower back pain
and leukorrhagia.
• astragalus root ( huang qi), trichosanthes root (tian hua
fen), pueraria root ( ge gen), and fresh rehmannia root
(, sheng di huang) for the thirst, excessive drinking and
eating, lassitude, and frequent urination associated with
diabetes.
• dogwood fruit and prepared rehmannia root (shu di
huang) for frequent nighttime urination because of de-
ficient kidneys.
• bitter cardamon (yi zhi ren) and mantis egg case (sang
piao xiao) for frequent urination because of deficient
kidneys.
• glehnia root (sha shen), schisandra fruit ( wu wei zi),
and ophiopogon root ( mai dong) for deficient lungs
characterized by chronic cough
Precautions
Species of Dioscorea that are edible have opposite
leaves (leaves on the stem are directly across from one
another), whereas species that are poisonous have alter-
nate leaves (leaves on the stem are not directly across
from one another).
Women who are pregnant or lactating should con-
sult with a physician before using Chinese yam.
Side effects
There are no side effects associated with the use of
Chinese yam.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Mucilage — A thick, slimy, adhesive substance pro-
duced by certain plants. It consists of gum that is
dissolved in the plant's juices.
Tonic — An agent that restores normal tone to tis-
sues. Tonics are used to treat indigestion, general
debility, and other disorders.
Traditional Chinese medicine — The medicine
practiced in China since ancient times which uti-
lizes herbal remedies, acupuncture, cupping, and
other treatment modalities.
Tubercles — Small, pea-sized tubers that grow on
Dioscorea plants in the angles between the leaves
and the stem. They are used in the cultivation of
Chinese yam.
Interactions
Chinese yam should not be taken with kan-sui root.
As of mid-2000, there were no indications of any inter-
actions between Chinese yam and any drug or other
herbal medicine.
Resources
BOOKS
“Chinese Yam.” In The Alternative Advisor: The Complete
Guide to Natural Therapies and Alternative Treatments.
Alexandria, VA: Time-Life Books, 1999.
OTHER
Decne. “Dioscorea batatas.” http://www.gardenbed.eom/D/1402.
cfm.
“Rhizoma Dioscoreae.” http://www.healthlink.us-inc.com/
publiclibrary/htm-data/htm-herb/bhp623.htm.
Belinda Rowland
Chiropractic
Definition
Chiropractic is from Greek words meaning done by
hand. It is grounded in the principal that the body can
heal itself when the skeletal system is correctly aligned
and the nervous system is functioning properly. To
achieve this, the practitioner uses his or her hands or an
adjusting tool to perform specific manipulations of the
vertebrae. When these bones of the spine are not correct-
457
Chiropractic
Chiropractic
Esophagus
Abdominal
blood vessel
Sympathetic
nervous -
system
Stomach
Pancreas
Small intestine
Rectum
i e 7r v sexua| ° r !
Bladder
Spinal
cord
Points on the spine that correspond to various organs and
their functions according to chiropractic medicine.
(Illustration by GGS Information Services, Inc. The Gale Group.)
ly articulated, resulting in a condition known as subluxa-
tion, the theory is that nerve transmission is disrupted
and causes pain and illness manifested in the back as
well as other areas of the body.
Chiropractic is one of the most popular alternative
therapies currently available. Some would say it now quali-
fies as mainstream treatment as opposed to complementary
medicine. Chiropractic treatment is covered by many in-
surance plans. It has become well-accepted treatment for
acute pain and problems of the spine, including lower back
pain and whiplash. Applications beyond that scope are not
supported by current evidence, although there are ongoing
studies into the usefulness of chiropractic for such prob-
lems as ear infections, dysmenorrhea, infant colic, mi-
graine headaches, and other conditions. Patients continue
to visit chiropractors with complaints of headaches and
pain or injury to the neck, middle back, arms, or legs.
458
Origins
Spinal manipulation has a long history in many cul-
tures but Daniel D. Palmer is the founder of modern chi-
ropractic theory, dating back to the 1890s. A grocer and
magnetic healer, he applied his knowledge of the ner-
vous system and manual therapies in an unusual situa-
tion. One renowned story concerns Harvey Lillard, a jan-
itor in the office where Palmer worked. The man had
been deaf for 17 years, ever since he had sustained an in-
jury to his upper spine. Palmer performed an adjustment
on a painful vertebra in the region of the injury and Lil-
lard ’s hearing was reputedly restored. Palmer theorized
that all communication from the brain to the rest of the
body passes through the spinal canal, and areas that are
poorly aligned or under stress can cause physical symp-
toms both in the spine and in other areas of the body.
Thus the body has the innate intelligence to heal itself
when unencumbered by spinal irregularities causing
nerve interference. After his success with Lillard, other
patients began coming to him for care, and responded
well to adjustments. This resulted in Palmer’s further
study of the relationship between an optimally functional
spine and normal health.
Palmer founded the first chiropractic college in
1897. His son, B. J. Palmer, continued to develop chiro-
practic philosophy and practice after his father’s death.
B. J. and other faculty members were divided over the
role of subluxation in disease. B. J. saw it as the cause of
all disease. The others disagreed and sought a more ra-
tional way of thinking, thus broadening the base of chi-
ropractic education. From 1910-1920, many other chiro-
practic colleges were established. Other innovators, in-
cluding John Howard, Carl Cleveland, Earl Homewood,
Joseph Janse, Herbert Lee, and Claude Watkins also
helped to advance the profession.
The theories of the Palmers receive somewhat
broader interpretation today. Many chiropractors believe
that back pain can be relieved and health restored
through chiropractic treatment even in patients who do
not have demonstrable subluxations. Scientific develop-
ment and research of chiropractic is gaining momentum.
The twenty-first century will likely see the metaphysical
concepts such as innate intelligence give way to more
scientific proofs and reform.
Many people besides the Palmers have contributed
to the development of chiropractic theory and technique.
Some have gone on to create a variety of procedures and
related types of therapy that have their roots in chiro-
practic, including McTimoney-Corley chiropractic, cran-
iosacral manipulation, naprapathy, and applied kinesiol-
ogy. Osteopathy is another related holistic discipline
that utilizes spinal and musculoskeletal manipulation as
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Chiropractor with a patient. (Custom Medical Stock Photo, Inc. Reproduced by permission.)
a part of treatment, but osteopathic training is more simi-
lar in scope to that of an M.D.
Benefits
Most people will experience back pain at some time
in their lives. A 2002 review reported that lower back re-
gion pain accounted for 68 percent of patient visits to
chiropractors. Injuries due to overexertion and poor pos-
ture are among the most common. Depending on the
cause and severity of the condition, options for treatment
may include physical therapy, rest, medications, surgery,
or chiropractic care. Chiropractic treatment carries none
of the risks of surgical or pharmacologic treatment. Prac-
titioners use a holistic approach to health, which is ap-
preciated by most patients. The goal is not merely to re-
lieve the present ailment, but to analyze the cause and
recommend appropriate changes of lifestyle to prevent
the problem from recurring again. They believe in a
risk/benefit analysis before use of any intervention. The
odds of an adverse outcome are extremely low. Chiro-
practic has proven in several studies to be less expensive
than many more traditional routes such as outpatient
physical therapy. Relief from some neuromuscular prob-
lems is immediate, although a series of treatments is
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
likely to be required to maintain the improvement.
Spinal manipulation is an excellent option for acute
lower back pain, and may also relieve neck pain as well
as other musculoskeletal pain. Although most back pain
will subside eventually with no treatment at all, chiro-
practic treatment can significantly shorten the time it
takes to get relief. Some types of headache can also be
successfully treated by chiropractic.
Description
Initial visit
An initial chiropractic exam will most often include
a history and a physical. The patient should be asked
about the current complaint, whether there are chronic
health problems, family history of disease, dietary habits,
medical care received, and any medications currently
being taken. Further, the current complaint should be de-
scribed in terms of how long it has been a problem, how
it has progressed, and whether it is the result of an injury
or occurred spontaneously. Details of how an injury oc-
curred should be given. The physical exam should evalu-
ate by observation and palpation whether the painful area
has evidence of inflammation or poor alignment. Range
459
Chiropractic
Chiropractic
DANIEL PALMER 1845-1913
Chiropractic inventor, Daniel David Palmer, was
born on March 7, 1845, in Toronto, Ontario. He was
one of five siblings, the children of a shoemaker and his
wife, Thomas and Katherine Palmer. Daniel Palmer and
his older brother fell victim to wanderlust and left Cana-
da with a tiny cash reserve in April 1865. They immi-
grated to the United States on foot, walking for 30 days
before arriving in Buffalo, New York. They traveled by
boat through the St. Lawrence Seaway to Detroit,
Michigan. There they survived by working odd jobs and
sleeping on the dock. Daniel Palmer settled in What
Cheer, Iowa, where he supported himself and his first
wife as a grocer and fish peddler in the early 1 880s. He
later moved to Davenport, Iowa, where he raised three
daughters and one son.
Palmer was a man of high curiosity. He investigated
a variety of disciplines of medical science during his
lifetime, many of which were in their infancy. He was
intrigued by phrenology and assorted spiritual cults, and
for nine years he investigated the relationship between
magnetism and disease. Palmer felt that there was one
thing that caused disease. He was intent upon discover-
ing this one thing, or as he called it: the great secret.
In September 1 895, Palmer purported to have cured
a deaf man by placing pressure on the man's displaced
vertebra. Shortly afterward Palmer claimed to cure an-
other patient of heart trouble, again by adjusting a dis-
placed vertebra. The double coincidence led Palmer to
theorize that human disease might be the result of dislo-
cated or luxated bones, as Palmer called them. That
same year he established the Palmer School of Chiro-
practic where he taught a three-month course in the
simple fundamentals of medicine and spinal adjustment.
Palmer, who was married six times during his life,
died in California in 1913; he was destitute. His son,
Bartlett Joshua Palmer, successfully commercialized the
practice of chiropractic.
Gloria Cooksey
of motion may also be assessed. In the spine, either hypo-
mobility (fixation) or hypermobility may be a problem.
Laboratory analysis is helpful in some cases to rule out
serious infection or other health issues that may require
referral for another type of treatment. Many practitioners
also insist on x rays during the initial evaluation
Manipulation
When spinal manipulation is employed, it is gener-
ally done with the hands, although some practitioners
460
may use an adjusting tool. A classic adjustment involves
a high velocity, low amplitude thrust that produces a usu-
ally painless popping noise, and improves the range of
motion of the joint that was treated. The patient may lie
on a specially designed, padded table that helps the prac-
titioner to achieve the proper positions for treatment.
Some adjustments involve manipulating the entire spine,
or large portions of it, as a unit; others are small move-
ments designed to affect a single joint. Stretching, trac-
tion, and slow manipulation are other techniques that can
be employed to restore structural integrity and relieve
nerve interference.
Length of treatment
The number of chiropractic treatments required will
vary depending on several factors. Generally longer-term
treatment is needed for conditions that are chronic, se-
vere, or occur in conjunction with another health prob-
lem. Patients who are not in overall good health may also
have longer healing times. Some injuries will inherently
require more treatments than others in order to get relief.
Care is given in three stages. Initially appointments are
more frequent with the goal of relieving immediate pain.
Next, the patient moves into a rehabilitative stage to con-
tinue the healing process and help to prevent a relapse.
Finally, the patient may elect periodic maintenance, or
wellness treatments, along with lifestyle changes if need-
ed in order to stay in good health.
Follow-up care
Discharge and follow-up therapy are important. If
an injury occurred as a result of poor fitness or health, a
program of exercise or nutrition should be prescribed.
Home therapy may also be recommended, involving
such things as anti-inflammatory medication and appli-
cations of heat or ice packs. Conscious attention to pos-
ture may help some patients avoid sustaining a similar
injury in the future, and the chiropractor should be able
to discern what poor postural habits require correction. A
sedentary lifestyle, particularly with a lot of time spent
sitting, is likely to contribute to poor posture and may
predispose a person to back pain and injury.
Types of practitioners
Some practitioners use spinal manipulation to the ex-
clusion of all other modalities, and are known as straight
chiropractors. Others integrate various types of therapy
such as massage, nutritional intervention, or treatment
with vitamins, herbs, or homeopathic remedies. They also
embrace ideas from other health care traditions. This
group is known as mixers. The vast majority of chiroprac-
tors, perhaps 85%, fall in this latter category.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Preparations
Patients should enter the chiropractic clinic with an
open mind. This will help to achieve maximum results.
Precautions
Chiropractic is not an appropriate therapy for dis-
eases that are severely degenerative and may require
medication or surgery. Many conditions of the spine are
amenable to manipulative treatment, but that does not in-
clude fractures. The practitioner should be informed in
advance if the patient is on anticoagulants, or has osteo-
porosis or any other condition that may weaken the
bones. There are other circumstances that would con-
traindicate chiropractic care, and these should be detect-
ed in the history or physical exam. In addition to frac-
tures, Down syndrome, some congenital defects, and
some types of cancer are a few of the things that may
preclude spinal manipulation. On rare occasions, a frac-
ture or dislocation may occur. There is also a very slim
possibility of experiencing a stroke as a result of spinal
manipulation, but estimates are that it is no more fre-
quent than 2.5 occurrences per one million treatments.
Be wary of chiropractors who insist on costly x rays
and repeated visits with no end in sight. Extensive use is
not scientifically justifiable, especially in most cases of
lower back pain. There are some circumstances when x
rays are indicated, including acute or possibly severe in-
juries such as those that might result from a car accident.
Side effects
It is not uncommon to have local discomfort in the
form of aches, pains, or spasms for a few days following
a chiropractic treatment. Some patients may also experi-
ence mild headache or fatigue that resolves quickly.
Research & general acceptance
As recently as the 1970s, the American Medical As-
sociation (a national group of medical doctors) was quite
hostile to chiropractic. AMA members were advised that
it was unethical to be associated with chiropractors. For-
tunately that has changed, and as of the year 2000, many
allopathic or traditionally trained physicians enjoyed
cordial referral relationships with chiropractors. The
public is certainly strongly in favor of chiropractic treat-
ment. An estimated 15% of people in the United States
used chiropractic care in 1997. Chiropractors see the
lion's share of all patients who seek medical help for
back problems.
Research has also supported the use of spinal ma-
nipulation for acute low-back pain. There is some anec-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
dotal evidence recommending chiropractic treatment for
ailments unrelated to musculoskeletal problems, but
there is not enough research-based data to support this.
On the other hand, a chiropractor may be able to treat
problems and diseases unrelated to the skeletal structure
by employing therapies other than spinal manipulation.
Although many chiropractors limit their practice to
spine and joint problems, others claim to treat disorders
that are not closely related to the back or musculoskeletal
system. These include asthma, bed-wetting, bronchitis,
coughs, dizziness, dysmenorrhea, earache, fainting,
headache, hyperactivity, indigestion, infertility, mi-
graine, pneumonia, and issues related to pregnancy.
There are at least three explanations for possible efficacy
for these conditions. One is that the problem could be
linked to a nerve impingement, as may be possible with
bed-wetting, dizziness, fainting, and headache. In a sec-
ond group, chiropractic treatment may offer some relief
from complicating pain and spasms caused by the disease
process, as with asthma, bronchitis, coughs, and pneumo-
nia. The discomforts of pregnancy may also be relieved
with gentle chiropractic therapy. A third possibility is that
manipulation or use of soft-tissue techniques may direct-
ly promote improvement of some conditions. One partic-
ular procedure, known as the endonasal technique, is
thought to help the eustachian tube to open and thus im-
prove drainage of the middle ear. The tube is sometimes
blocked off due to exudates or inflammatory processes.
This can offer significant relief from earaches. Some
headaches also fall in this category, as skilled use of soft
tissue techniques and adjustment may relieve the muscle
tension that may initiate some headaches.
Dysmenorrhea, hyperactivity, indigestion, and infer-
tility are said to be relieved as a result of improved flow
of blood and nerve energy following treatment. Evidence
for this is anecdotal at best, but manipulation is unlikely
to be harmful if causes treatable by other modalities have
been ruled out.
For conditions such as cancer, fractures, infectious
diseases, neurologic disease processes, and anything that
may cause increase orthopedic fragility, chiropractic
treatment alone is not an effective therapy, and may even
be harmful in some cases. Those who have known circu-
latory problems, especially with a history of thrombosis,
should not have spinal manipulation.
Training & certification
Chiropractors are licensed by the state in which they
practice. Matriculation at a certified school of chiroprac-
tic requires at least two years of science-based under-
graduate work, and most applicants have completed a
bachelor’s degree. Chiropractic college is an additional
461
Chiropractic
Chlamydia
KEY TERMS
Adjustment — A specific type of manipulation of
the spine designed to return it to proper structural
and functional form.
Allopathic — Conventional practice of medicine
generally associated with M.D. physicians.
Dysmenorrhea — Painful menstruation.
Osteoporosis — A condition of decreased bone
density, causing increased bone fragility, that is
most common in elderly women.
Subluxation — Misalignment between vertebrae
that structurally and functionally impairs nerve
function.
four-year program, and graduates receive a D.C. (doctor
of chiropractic) degree. Chiropractic education empha-
sizes knowledge of anatomy, physiology, diagnostic
skills, neurology, and radiology. As of the year 2000,
there were 16 chiropractic colleges in the United States.
Following graduation, the doctors must pass both nation-
al board and state board exams in order to be licensed. A
minimum number of continuing education hours per
year may be required in some states in order to maintain
licensure. Practitioners may also opt for a program to be-
come a diplomate of a more specialized group. Require-
ments for these groups vary rather vastly, from a pro-
gram similar to a traditional residency down to some that
require a minimal number of hours of continuing educa-
tion. Some of the specialties offered are radiology, ortho-
pedics, sports injuries, nutrition, neurology, and internal
medicine. Most chiropractors do not specialize.
Resources
BOOKS
Cassileth, Barrie. The Alternative Medicine Handbook. New
York: W. W. Norton & Co., Inc., 1998.
Dillard, James and Terra Ziporyn. Alternative Medicine for
Dummies. Indianapolis: IDG Bks. Worldwide, 1998.
Leach, Robert. The Chiropractic Theories: Principles and
Clinical Applications, 3rd ed. Philadelphia: Lippincott
Williams & Wilkins, 1994.
Rondberg, Terry. Chiropractic First. Chandler, AZ: The Chiro-
practic Journal, 1996.
Woodham, Anne and David Peters . Encyclopedia of Healing
Therapies. New York: DK Publishing, Inc., 1997.
PERIODICALS
Hansen, Daniel T. “Applying Technology Assessment to Chiro-
practic Techniques.” Topics in Clinical Chiropractic (Sep-
tember 2002): 1-9.
ORGANIZATIONS
American Chiropractic Association. 1701 Clarendon Blvd., Ar-
lington, VA 22209. (800)986-4636. http://www.amerchiro.
org /.
Judith Turner
Teresa G. Odle
Chlamydia
Definition
Chlamydia is the most common sexually transmitted
disease (STD) in the United States, with about three mil-
lion new cases diagnosed in the country each year. The
disease is caused by a bacterium called Chlamydia tra-
chomatis. The following areas in the body can be affected:
• cervix
• fallopian tubes, which carry ova (eggs) from the ovaries
to the uterus
• urethra, which carries urine from the bladder to outside
the body
• epididymis, a small organ attached to the testicles that
is responsible for sperm production
• prostate gland, a gland at the base of the penis which
provides nutrients for sperm
• anus
• throat
• eyes
In addition, Chlamydia trachomatis also causes lung
and eye infections in newborns whose mothers have a
chlamydial infection during the last part of their preg-
nancy.
Description
Chlamydia is most often found in sexually active
adolescents aged 15-19. Data gathered by the Centers
for Disease Control (CDC) suggest that sexually active
girls in this age group may account for up to 46% of
chlamydial infections.
According to the CDC, approximately 40% of
women infected with chlamydia will develop pelvic in-
flammatory disease (PID). If untreated, 18% of women
with PID will have chronic inflammatory pain. In addi-
tion, chlamydia may cause extensive damage to the fal-
lopian tubes. Scarring can block the tube and prevent the
egg from being fertilized. As a result, one of every five
462
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
women with PID will not be able to conceive. Tube scar-
ring may also cause the fertilized egg to be trapped in-
side the tube, unable to reach the uterus. When the fertil-
ized egg develops inside the tube rather than in the
uterus, the condition is called tubal pregnancy. The con-
dition is potentially fatal if the tube ruptures. In America,
tubal pregnancy is the number one cause of death of
women in early pregnancy.
Causes & symptoms
Cause
Chlamydia is caused by a bacterial parasite called
Chlamydia trachomatis. The organism lives inside hu-
mans, who act as hosts. It is dependent on humans for
energy because it is unable to produce energy for itself.
C. trachomatis often causes genital and urinary tract in-
fections in sexually active men and women.
Mode of transmission
A person can be infected with C. trachomatis by:
• having sex (oral, genital, or anal) with an infected part-
ner
• sharing infected sex toys
• passing through the infected birth canal of a mother
who has chlamydia
• sex abuse in children
Risk factors
The following are risk factors for contracting
chlamydia infections:
•Age. Young sexually active people aged 15-19 are
most frequently affected.
• Race. Blacks contract this disease more often than
whites or Hispanics.
• Marital status. Chlamydia is most often found in single
women. Married women have the lowest risk.
• Behavioral factors. Douching increases risk of chlamy-
dial infections. Smoking also increases one’s risk of
contracting this disease. Those who have sex with
many different partners or with strangers are at high
risk. Also at increased risk are those who have unpro-
tected sex with partners of unknown disease status. Pre-
vious induced abortions also increase a woman’s
chance of getting this disease.
• Socio-economic status. Poor, uneducated women living
in big cities are more often affected by this disease.
• Postpartum period. Increased risk of contracting
chlamydia is observed during the period immediately
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
A microscopic image of non-specific urethritis. This sexual-
ly transmitted disease is usually caused by a bacterium of
the genus Chlamydia. (Custom Medical Stock Photo. Repro-
duced by permission.)
after giving birth or undergoing an induced abortion.
This is because the cervix is not entirely closed, allow-
ing more chance for becoming infected.
Symptoms
Approximately 75% of women do not have symp-
toms. If a woman is going to have any symptoms, they
should develop one to three weeks after she is infected.
Her symptoms may include:
• burning pain during urination
• more frequent urination
• abnormal vaginal discharge
• dull pelvic pain
• bleeding between periods and after sexual intercourse
• menstrual bleeding that is heavier than usual
• more painful periods
Chlamydia infection in men may develop in the ure-
thra, epididymis and/or the prostate. Approximately 50%
of infected men do not have any symptoms. If he is going
to have symptoms, they should develop one to three
weeks after he is infected. His symptoms may include:
• burning pain during urination
• more frequent urination
• white or yellow discharge from the penis
• redness at the tip of the penis
• itchy or irritated urethra (urethritis)
• pain and swelling in the testicles (epididymitis)
• pain between the scrotum and anal area and difficult
and frequent urination (prostatitis)
463
Chlamydia
Chlamydia
On rare occasions, chlamydia infection in men and
women can develop outside of the genital areas. These
patients may have infections at the following sites:
• the eyes (due to a contaminated hand touching the
eyes): itching, redness and itching of the eyelids
• the throat (following oral sex with infected men): throat
irritation or no symptoms
• the anus (following anal intercourse with infected
men): rectal bleeding, mucous rectal discharge, diar-
rhea, and pain with bowel movement.
Diagnosis
Diagnosis is based on patients' history, laboratory
testing for chlamydia, and physical exam for men and
pelvic exam for women to determine if the patient is in-
fected and/or the extent of infection.
There are several tests available for chlamydial in-
fection. They often require swipes from the site of infec-
tion or urine samples. Tests for chlamydia include:
• Cell culture test. This old test is reliable but requires
48-72 hours to complete, it is being replaced by faster
and more convenient tests. In 2001, the U.S. Food and
Drug Administration (FDA) receommended routine
screening for chlamydia among sexually active young
women. One year later, they approved a new test called
ThinPrep, a new type of Pap smear that allows doctors to
screen for chlamydia, gonorrhea, and the human papil-
lomavirus at the same time women have annual pap
exams for cervical cancer.
• Direct fluorescent antibody (DFA) staining. This test is
faster than the traditional culture test.
• Enzyme immunoassay (EIA). It is easy to perform and
also faster than the traditional culture test but is not as
accurate.
• DNA probe. This test is expensive but is more specific
and convenient than culture, EIA, or DFA tests. Genital
swipe samples are not necessary. Urine tests can pro-
vide accurate results.
• Nucleic acid amplification (PCR and LCR) tests. These
tests look for genetic material of the organism. These
are the tests of choice because they are the most sensi-
tive (more than 90% accurate) and the most specific.
They are also convenient because they can be performed
on urine samples and do not require a pelvic exam.
In 2002, a presentation to gynecologists pointed out
that more doctors should assume some overlap when pa-
tients present with symptoms of urinary tract infections.
These may signal hidden chlamydia as well. In fact, the
two conditions often can be present at the same time.
464
Treatment
Alternative therapy should be complementary to an-
tibiotic therapy. Because of the potentially serious nature
of this disease, patients should first consult an allopathic
physician to start antibiotic treatment for infections. Tra-
ditional medicine is better equipped to quickly eradicate
the infection while alternative treatments can help the
body fight the disease and relieve symptoms associated
with this disease. Some alternative treatments include
nutritional therapy, herbal remedies, traditional Chi-
nese medicine, and homeopathy.
Nutritional therapy
The following dietary changes may be helpful:
• Following a low-fat, high-fiber diet. The diet should
include a variety of fresh fruits and vegetables. These
foods contain high amounts of phytonutrients and es-
sential vitamins that help keep the body strong and
stimulate the immune system to fight infections.
• Limited intake of fat, sugar, highly processed foods,
caffeine, and alcohol, which depresses the immune
function.
• Taking a multivitamin/mineral supplement daily.
• Drinking cranberry juice. Cranberry juice helps pre-
vent urinary tract infections.
• Taking acidophilus pills to prevent yeast infections
while on antibiotics.
• Eating fresh garlic or taking garlic pills to help fight
infection.
Herbal treatment
Echinacea and berberine-containing herbs such as
saw palmetto ( Serenoa repens) and goldenseal are nat-
ural antibiotics. These herbs can assist the action of pre-
scription antibiotics.
Traditional Chinese medicine
An experienced Chinese herbalist will prepare a
specific herbal mixture based on a patient's specific con-
dition and symptoms.
Homeopathy
A homeopathic practitioner may prescribe a patient-
specific remedy to help reduce some of the symptoms as-
sociated with disease. Remedies for chlamydial symptoms
include Cannabis sativa , Cantharis , and Salidago virga.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Allopathic treatment
Once detected, chlamydia can be easily treated with
antibiotics. However, if not detected early enough, scar-
ring of fallopian tubes (and resulting infertility) may not
be preventable. The two most commonly used drugs are
azithromycin and doxycycline. Azithromycin is a more
expensive drug but is much more convenient to adminis-
ter. Only one dose is needed to treat the disease. Doxycy-
cline is cheaper but needs to be taken twice a day for
more than seven days. Because patients tend to stop tak-
ing drugs after a few days, doxycycline is not as effective
as azithromycin. Therefore, many doctors prefer to give
azithromycin. Patients are advised to refrain from sex for
a full week after taking azithromycin or until they finish
doxycycline treatment.
An infected person should contact all partners with-
in the last two months so that they can be treated for
chlamydia.
Infected pregnant women should be given ery-
thromycin for seven days, instead of other drugs, be-
cause this drug is safer during pregnancy.
Follow-up testing is done four weeks after drug
treatment to see if the infection is eradicated. If tests
continues to be positive, the patient will be given another
course of antibiotics.
Expected results
A woman's prognosis depends on the duration of in-
fection, whether the infection has spread through the
uterus and the fallopian tubes, and the number of previ-
ous chlamydial infections. If caught early, the disease can
be completely cured with antibiotic treatment in seven
days. However, if left untreated, chlamydia can spread
through the uterus to the fallopian tubes and cause chron-
ic pelvic inflammatory disease. Infertility may occur as a
result of serious damage to the female reproductive tract.
Potentially fatal tubal pregnancy is also a risk.
Prevention
Prevention is the most important means of stopping
the spread of this disease. The following practices are
recommended to prevent the spread of this and other sex-
ually transmitted diseases:
• Abstinence. Abstinence is the only 100% way to pre-
vent chlamydia and other STD infections.
• Monogamy. Having a mutually monogamous relation-
ship with an uninfected partner reduces the chance of
getting STD infections.
• Avoiding a sexual relationship with an unknown part-
ner or a partner whose infection status is unknown.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• If having sex with an unknown partner, using a barrier
contraceptive such as a condom (for men) or di-
aphragm (for women) is recommended. However, con-
doms (or diaphragms) are not 100% effective against
chlamydia or other STDs.
• Refraining from douching.
• Avoiding sex soon after giving birth or undergoing an
induced abortion.
• Getting tested for chlamydia at yearly pelvic examina-
tions.
Resources
BOOKS
“Chlamydia.” In The Medical Advisor : The Complete Guide to
Alternative & Conventional Treatment, home ed. Alexan-
dria, VA: Time-Life, Inc., 1997.
“Chlamydia.” In Reader’s Digest Guide to Medical Cures Si-
Treatments. Pleasantville, NY: Reader’s Digest Assn.,
Inc., 1996.
“Chlamydial Infections.” In 1997 Report of the Committee on
Infectious Diseases, 2nd ed. Elk Grove Village, IL: Amer-
ican Academy of Pediatrics, 1997.
Jones, Robert B. and Byron E. Batteiger. "Introduction to
Chlamydial Diseases.” In Mandell, Douglas & Bennett’s
Principles & Practice of Infectious Diseases. 5th ed.
Philadelphia: W. B. Saunders Co., 1999. http://home.md-
consult.com.
“Section I. Screening Part D. Infectious Diseases. Screening
for Chlamydial Infections-Including Ocular Prophylaxis
in Newborns.” In Guide to Clinical Preventive Services:
Report of the U. S. Preventive Services Task Force. 2nd ed.
Philadelphia: Lippincott Williams & Wilkins, 1996.
http://home.mdconsult.com.
The Burton Goldberg Group. “Sexually Transmitted Diseases.”
In Alternative Medicine: The Definitive Guide. Tiburon,
CA: Future Medicine Publishing, Inc., 1999.
Tuomala, Ruth E. and Katherine T. Chen. “Gynecologic Infec-
tions. Part I.” Kistner's Gynecology & Women's Health.
7th ed. St. Louis, MO: Mosby, Inc., 1999.
Zand, Janet, Allan N. Spreen and James B. LaValle. “Chlamy-
dia.” In Smart Medicine for Healthier Living. Garden City
Park, NY: Avery Publishing Group, 1999.
PERIODICALS
“FDA: ThinPrep can Detect Chlamydia, Gonorrhea.” TB &
Outbreaks Week (July 2, 2002): 15.
Johnson, Kate. “Urinary Symptoms? Test for Chlamydia and
UTI (Not Just Vaginal Symptoms).” OB GYN News (Au-
gust 15, 2002): 12.
Torrey, Brian. “FDA Approval of Chlamydia and Gonorrhea
Tests.” American Family Physician (August 15, 2002): 690.
ORGANIZATIONS
CDC National STDs Hotline. (800) 227-8922.
NIH's National Institute of Allergy and Infectious Diseases.
NIAID Office of Communications, 31 Center Drive (MSC-
465
Chlamydia
Chlorella
KEY TERMS
Abstinence — The act of doing without something,
such as sex, voluntarily.
Infertility — Inability to have children, which may
occur as a result of pelvic infections.
Nongonococcal urethritis (NGU) — A sexually
transmitted urethral infection that is not gonor-
rhea.
Pelvic Inflammatory Disease (PID) — An infection
of the uterus, fallopian tubes, and/or ovaries in
women.
Tubal pregnancy — A pregnancy that implants in
the fallopian tube instead of inside the uterus. This
often occurs as a result of sexually transmitted in-
fections such as chlamydia. It is also known as ec-
topic pregnancy
2520), Building 31, Room 7A50, Bethesda, MD 20892-
2520. http://www.niaid.nih.gov/publications/stds.htm.
OTHER
Centers for Disease Control and Prevention. “CDC Fact Sheet:
Some Facts about Chlamydia.” WebMD. http://webmd.
lycos.com/content/dmk/dmk_article_58818.
Nordenburg, Tamar. "Chlamydia’s Quick Cure.” WebMD. http://
webmd.lycos.com/content/dmk/dmk_article_5462446.
Peeling, Rosanna W. “Chlamydiae as Pathogens: New Species
and New Issues.” Meclscape. http://www.medscape.com.
U.S. Department of Health and Human Services. “Counseling
to Prevent HIV Infection and Other Sexually Transmitted
Diseases.” WebMD. http://webmd.lycos.com/content/dmk/
dmk_article_5462254.
Mai Tran
Teresa G. Odle
Chlorella
Description
Chlorella is a type of single-cell green algae. It is a
major component of phytoplankton, which are very
small free-floating aquatic plants found in plankton.
Chlorella is a popular food supplement, especially in
Japan, and is sold as a nutritional supplement in the
United States and Canada. There are several species of
chlorella, but those most commonly found in supple-
ments are Chlorella vulgaris and Chlorella pyrenoidosa.
General use
Chlorella contains high levels of chlorophyll, pro-
tein, iron, vitamins C and B 12 , beta carotene, and 19
amino acids.
Several studies have indicated that chlorella may be
effective in treating some types of cancer, high choles-
terol, hypertension (high blood pressure), fibromyalgia
syndrome, and in boosting the immune system and detox-
ifying the body. As is often the case with alternative ther-
apies, there are several studies that dispute the effective-
ness of chlorella in treating these medical conditions.
Chlorella’s ability to fight cancer cells has been shown
in several scientific studies, although the exact mechanisms
of how it works are not known. Several scientists believe
chlorella stimulates the activity of T-cells — important for
antibody immunity — and macrophages, which are large
cells that protect against infection by removing waste prod-
ucts, harmful microorganisms, and other toxins from the
bloodstream. Increasing the production of T-cells and
macrophages increases interferon levels in the body, en-
hancing the immune system’s ability to fight invading sub-
stances such as viruses, bacteria, and chemicals. Interferon
is an immune related protein produced by the body, which
performs antiviral and antitumor activities.
Studies in laboratory animals suggest some sub-
stances in chlorella may reduce bone marrow suppres-
sion in patients taking the anticancer drug fluorouracil.
In doing this, chlorella may increase the white blood cell
and platelet counts, which reduces the risk of infection
and bleeding, respectively.
Studies have also shown chlorella can significantly
reduce cholesterol levels in laboratory animals. Studies
are currently underway to see if it has the same effect on
human cholesterol levels.
Chlorella may also help reduce blood pressure in
some people with hypertension (high blood pressure). A
study reported in the March 2003 issue of Original In-
ternist showed that treatment with 10 grams of chlorella
daily for three months significantly improved blood
pressure in 25% of the patients.
In a 2000 study, patients with fibromyalgia syn-
drome (a disorder that causes muscle aches, fatigue, and
sleep disorders) were treated with high doses of chlorel-
la. After two months, the study found significant benefits
from chlorella treatment.
Clinical studies of laboratory animals have also
shown that chlorella can protect against gamma radiation
and other toxic drugs and chemicals, including dioxin. In
the intestines, it can deactivate heavy metals such as cad-
mium, lead, and mercury.
466
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Algae — A mainly water-borne organism that pro-
duces energy from light and chlorophyll.
Amino acids — A group of organic compounds that
are vital to living cells.
Cadmium — A heavy metal.
Chlorophyll — A green plant pigment found in
plants, algae, and some bacteria. Chlorophyll is re-
sponsible for capturing the light energy needed for
photosynthesis.
Cholesterol — A compound found in animal tissue,
blood, and fats, of which high levels in the blood
are linked to clogged arteries, heart disease, and
gallstones.
Diabetes — A metabolic disorder in which the body
produces insufficient insulin, or is unable to effec-
tively utilize normal amounts because of insulin
resistance. Type 1 diabetes normally manifests in
children as a pancreatic deficiency. Type 2 (adult
onset diabetes) is usually a consequence of chron-
ic blood sugar dysregulation.
Dioxin — A toxic chemical used in the manufacture
of some pesticides and herbicides.
Fibromyalgia syndrome — Also called fibromyalgia,
a disorder that causes muscle aches, fatigue, and
sleep disorders.
Fluorouracil — An anticancer drug.
Gamma radiation — High energy electromagnetic
waves emitted in some nuclear reactions.
Hypertension — High blood pressure.
Insulin — A hormone that helps muscle and fat
cells take up and sugars, starches, and other foods
for conversion into energy the body needs.
Interferon — An immune protein produced by cells
in the body to fight viral infections.
Macrophages — Large cells that protect against infec-
tion by removing waste products, harmful microor-
ganisms, and other toxins from the bloodstream.
Phytoplankton — Very small free-floating aquatic
plants found in plankton.
Plankton — A mass of tiny animals and plants float-
ing in the sea or in lakes, usually near the surface.
Platelet — The smallest kind of blood cell, usually
found in large quantities, that plays an important
part in blood clotting. Also called thrombocytes.
Spirulina — A nutritionally valuable organism that
is rich in vitamins, minerals, essential fatty acids,
and antioxidants.
T-cells — A type of white blood cell that plays an
important role in the immune system and in com-
bating viral infections and cancers.
Ulcerative colitis — An inflammation in the walls of
the bowel that causes internal sores, called ulcers,
on the lining of the bowel.
Warfarin — A blood-thinning drug, known by the
brand name Coumadin.
The benefits of chlorella have been disputed. Accord-
ing to an equivocal article about chlorella on the American
Cancer Society website, there is no scientific evidence
showing chlorella’s effectiveness against cancer or any
other disease. Limited laboratory and animal research sug-
gests that the algae may have some anticancer properties.
One investigation concluded that a protein extract from
one type of chlorella prevented the spread of cancer cells
in mice. Another study of mice suggested that the extract
decreased the side effects of chemotherapy treatment
without affecting the potency of anticancer medications.
Preparations
Chlorella is available in various forms, including
capsule, tablet, softgel, powder, and liquid. It is found as
a supplement alone or in a combination with other green
food extracts such as wheat grass, barley grass, and
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
spirulina (a nutritionally rich microorganism). Capsules
and tablets are available in doses of 200-500 milligrams
(mg). There is no standard dosage but some herbalists
recommend 3 grams (g) per day. The average cost of a
bottle of 100 capsules (containing approximately 125 mg
each) ranges from $9 to $15.
Precautions
Pregnant and breastfeeding women are advised to use
caution and follow the advice of their healthcare profes-
sional, since the effects of chlorella have not been studied
for these two groups. Caution may also be advised for per-
sons known to be sensitive or allergic to iodine.
Side effects
Although chlorella appears to be safe, no research in
humans has been done to determine if the supplement
467
Chlorella
Cholesterol
causes any negative side effects. Also, no studies have
been done regarding the consequences of long-term use.
Mild side effects that have been reported include bloat-
ing and nausea, which usually disappear after a few days
of use. Some people using chlorella have had allergic re-
actions and adverse reactions to sunlight. Allergic reac-
tion symptoms include difficulty breathing, chest pain,
hives, rash, and itchy or swollen skin. If this happens,
the person should seek medical care immediately.
Interactions
Persons taking the blood-thinning drug known as
Coumadin (generic warfarin) are advised to completely
avoid chlorella, or use caution and follow the advice of
their healthcare professional because some chlorella sup-
plements contain high amounts of vitamin K that may
affect the inhibition of blood clots.
Resources
BOOKS
Bewicke, Dhyana, and Beverly A Potter. Chlorella: The Emer-
ald Food. Berkeley, CA: Ronin Publishing, 1984.
Drucker, Mark. Chlorella: The Key to Health, Vitality, and
Longevity. Greenville, SC: Health & Happiness Publish-
ing, Inc., 2002.
Lee, William H., and Michael E. Rosenbaum. Chlorella. New
York, NY: McGraw&-Hill, 1998.
Ley, Beth M. Chlorella, the Ultimate Green Food: Nature's
Richest Source of Chlorophyll, DNA, and RNA. Aliso
Viejo, CA: BL Publications, 2003.
McCauley. Bob. Confessions of a Body Builder. Rejuvenating
the Body with Spirulina, Chlorella, Raw Foods, & Ionized
Water. Lansing, MI: Spartan Enterprises, Inc., 2000.
PERIODICALS
Hori, Yasuko, et al. “Insulin Resistance is Associated with In-
creased Circulating Level of Thrombin-Activated Fibri-
nolysis in Type 2 Diabetic Patients.” The Journal of Clini-
cal Endocrinology & Metabolism (February 2002):
660-5.
Merchant, Randall E., and Cynthia A. Andre. “Abstract: A Re-
view of Recent Clinical Trials of Chlorella for the Treat-
ment of Fibromyalgia, Hypertension, and Ulcerative Coli-
tis.” Alternative Therapies in Health and Medicine (May-
June 2001): 79-91.
Merchant, Randall E., and Cynthia A. Andre. “Dietary Chlorel-
la for Hypertension." Original Internist (March 2003):
29-40.
Moreno, Bobbi. “Super-Healthy Treasures from the Sea.” Bet-
ter Nutrition (August 1999): 38.
Nick, Gina L. “Addressing Human Exposure to Environmental
Toxins with Chlorella Pyrenoidosa. (Medicinal Properties
of Whole Foods).” Townsend Letter for Doctors and Pa-
tients (April 2003): 28-33.
468
OTHER
Mercola, Joseph, M.D. “Chlorella: A Natural Wonder Food."
Begin Your Journey to Independent Health <http://www.
mercola.com/chlorella/index.htm>.
Ken R. Wells
Cholecalciferol see Vitamin D
Cholesterol
Definition
Cholesterol is a fatty substance found in animal tis-
sue and is an important component to the human body. It
is manufactured in the liver and carried throughout the
body in the bloodstream. Problems can occur when too
much cholesterol forms an accumulation of plaque on
blood vessel walls, which impedes blood flow to the
heart and other organs. The highest cholesterol content is
found in meat, poultry, shellfish, and dairy products.
Description
Cholesterol is the Dr. Jekyll and Mr. Hyde of medi-
cine, since it has both a good side and bad side. It is nec-
essary to digest fats from food, make hormones, build
cell walls, and participate in other processes for maintain-
ing a healthy body. When people talk about cholesterol as
a medical problem, they are usually referring to high cho-
lesterol. This can be somewhat misleading, since there
are four components to cholesterol. These are:
• LDL, the so-called bad cholesterol
• HDL, the so-called good cholesterol
• triglycerides, a blood fat lipid that increases the risk for
heart disease
• total cholesterol
The U.S. Food and Drug Administration (FDA) esti-
mates that 90 million American adults, roughly one-half
of the adult population, have elevated cholesterol levels.
High LDL (low-density lipoprotein) is a major contribut-
ing factor of heart disease. The cholesterol forms plaque
in the heart’s blood vessels, which restricts or blocks the
supply of blood to the heart, and causes a condition
called atherosclerosis. This can lead to a heart attack,
resulting in damage to the heart and possibly death.
In 2001, chemical researchers found a link between
cholesterol and Alzheimer’s disease. Reducing the
amount of cholesterol in the cells appears to block at-
tachment of senile plaques to the brain’s neurons. (The
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
plaques begin the process that eventually kills brain neu-
rons.) More study remains to test the effects of choles-
terol on Alzheimer’s.
The population as a whole is at some risk of develop-
ing high LDL cholesterol in their lifetimes. Specific risk
factors include a family history of high cholesterol, obe-
sity, heart attack or stroke, alcoholism, and lack of regu-
lar exercise. The chances of developing high cholesterol
increase after the age of 45. One of the primary causes of
high LDL cholesterol is too much fat or sugar in the diet,
a problem especially true in the United States. Choles-
terol also is produced naturally in the liver and overpro-
duction may occur even in people who limit their intake
of high cholesterol food. Low HDL and high triglyceride
levels also are risk factors for atherosclerosis.
Causes & symptoms
There are no readily apparent symptoms that indi-
cate high LDL or triglycerides, or low HDL. The only
way to diagnose a problem is through a simple blood
test. However, one general indication of high cholesterol
is obesity. Another is a high-fat diet. In 2001, new re-
search involving twins demonstrated that both genetic
factors and diet contribute to cholesterol levels.
Diagnosis
High cholesterol often is diagnosed and treated by
general practitioners or family practice physicians. In
some cases, the condition is treated by an endocrinolo-
gist or cardiologist. Total cholesterol, LDL, HDL, and
triglyceride levels as well as the cholesterol to HDL ratio
are measured by a blood test called a lipid panel. The
cost of a lipid panel is generally $40-100 and is covered
by most health insurance and HMO plans, including
Medicare, providing there is an appropriate reason for
the test. Home cholesterol testing kits are available over
the counter but test only for total cholesterol. The results
should only be used as a guide and if the total cholesterol
level is high or low, a lipid panel should be performed by
a physician. In most adults the recommended levels,
measured by milligrams per deciliter (mg/dL) of blood,
are: total cholesterol, less than 200; LDL, less than 130;
HDL, more than 35; triglycerides, 30-200; and choles-
terol to HDL ratio, four to one. However, the recom-
mended cholesterol levels may vary, depending on other
risk factors such as hypertension, a family history of
heart disease, diabetes, age, alcoholism, and smoking.
Doctors have always been puzzled by why some
people develop heart disease while others with identical
HDL and LDL levels do not. New studies indicate it may
be due to the size of the cholesterol particles in the
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Types
Levels
Total cholesterol:
Desirable
<200
Borderline
200 to 240
Undesirable
>240
HDL cholesterol:
Desirable
>45
Borderline
35 to 45
Undesirable
<35
LDL cholesterol:
Desirable
<130
Borderline
130 to 160
Undesirable
>160
Ratio of total cholesterol to
HDL cholesterol:
Desirable
<3
Borderline
3 to 4
Undesirable
>4
bloodstream. A test called a nuclear magnetic resonance
(NMR) LipoProfile exposes a blood sample to a magnet-
ic field to determine the size of the cholesterol particles.
Particle size also can be determined by a centrifugation
test, where blood samples are spun very quickly to allow
particles to separate and move at different distances. The
smaller the particles, the greater the chance of develop-
ing heart disease. It allows physicians to treat patients
who have normal or close to normal results from a lipid
panel but abnormal particle size.
Treatment
The primary goal of cholesterol treatment is to
lower LDL to under 160 mg/dL in people without heart
disease and who are at lower risk of developing it. The
goal in people with higher risk factors for heart disease is
less than 130 mg/dL. In patients who already have heart
disease, the goal is under 100 mg/dL, according to FDA
guidelines. Also, since low HDL levels increase the risks
469
Cholesterol
Cholesterol
High cholesterol levels, high
blood pressure, diabetes,
obesity, viruses, cigarette
smoking, etc., cause injuries
to the lining of the artery,
creating areas where higher
levels of lipids are trapped.
Lining of
artery
Monocyte
Muscle
Platelets
The result is a fibrous lesion,
made up in part of muscle
cells, proteins, and collagen,
that has at its center a pool of
lipids and dead cells. Blood
flow can be very nearly cut
off by the blockage.
Foam cell
Further injury is inflicted by foam cells
attempting to remove lipids back to the
lungs, liver, spleen and lymph nodes
by again passing through the lining of
the artery.
Monocytes (the largest of the
white blood cells) and T-cells
are attracted to the injury.
Monocytes, which become
macrophages when they leave
the bloodstream, and T-cells
penetrate the lining of the
artery.The macrophages soak
up lipids, becoming large foam
cells and distorting the inner
surface of the artery. Blood flow
becomes restricted.
When the arterial lining becomes separated
over the growing mass of foam cells, platelets
are attracted to the site and begin the process
of clot formation.
The progression of atherosclerosis. (Illustration by Hans & Cassidy. The Gale Group.)
of heart disease, the goal of all patients is more than 35
mg/dL.
in both alternative and conventional treatment of
high cholesterol, the first-line treatment options are exer-
cise, diet, weight loss, and stopping smoking. Other al-
ternative treatments include high doses of niacin, soy
protein, garlic, algae, and the Chinese medicine supple-
ment Cholestin (a red yeast fermented with rice).
Diet and exercise
Since a large number of people with high choles-
terol are overweight, a healthy diet and regular exercise
are probably the most beneficial natural ways to control
470
cholesterol levels. In general, the goal is to substantially
reduce or eliminate foods high in animal fat. These in-
clude meat, shellfish, eggs, and dairy products. Several
specific diet options are beneficial. One is the vegetarian
diet. Vegetarians typically get up to 100% more fiber and
up to 50% less cholesterol from food than non-vegetari-
ans. The vegetarian low-cholesterol diet consists of at
least six servings of whole grain foods, three or more
servings of green leafy vegetables, two to four servings
of fruit, two to four servings of legumes, and one or two
servings of non-fat dairy products daily.
A second diet is the Asian diet, with brown rice
being the staple. Other allowable foods include fish, veg-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
etables such as bok choy, bean sprouts, and black beans.
It allows for one weekly serving of meat and very few
dairy products. The food is flavored with traditional
Asian spices and condiments, such as ginger, chilies,
turmeric, and soy sauce.
Another regimen is the low glycemic or diabetic
diet, which can raise the HDL (good cholesterol) level
by as much as 20% in three weeks. Low glycemic foods
promote a slow but steady rise in blood sugar levels fol-
lowing a meal, which increases the level of HDL. They
also lower total cholesterol and triglycerides. Low
glycemic foods include certain fruits, vegetables, beans,
and whole grains. Processed and refined foods and sug-
ars should be avoided.
Exercise is an extremely important part of lowering
bad cholesterol and raising good cholesterol. It should
consist of 20-30 minutes of vigorous aerobic exercise at
least three times a week. Exercises that cause the heart to
beat faster include fast walking, bicycling, jogging,
roller skating, swimming, and walking up stairs. There
also are a wide selection of aerobic programs available at
gyms or on videocassette.
Garlic
A number of clinical studies have indicated that gar-
lic can offer modest reductions in cholesterol. A 1997
study by nutrition researchers at Pennsylvania State
University found men who took garlic capsules for five
months reduced their total cholesterol by 7% and LDL
by 12%. Another study showed that seven cloves of fresh
garlic a day significantly reduced LDL, as did a daily
dose of four garlic extract pills. Other studies in 1997
and 1998 back up these results. However, two more re-
cent studies have questioned the effectiveness of garlic in
lowering “bad cholesterol.”
Cholestin
Cholestin hit the over-the-counter market in 1997 as
a cholesterol-lowering dietary supplement. It is a
processed form of red yeast fermented with rice, a tradi-
tional herbal remedy used for centuries by the Chinese.
Two studies released in 1998 showed Cholestin lowered
LDL cholesterol by 20-30%%. It also appeared to raise
HDL and lower triglyceride levels. Although the supple-
ment contains hundreds of compounds, the major active
LDL-lowering ingredient is lovastatin, a chemical also
found in the prescription drug Mevacor. The FDA
banned Cholestin in early 1998 but a federal district
court judge lifted the ban a year later, ruling the product
was a dietary supplement, not a drug. It is not fully un-
derstood how the substance works and patients may want
to consult with their physician before taking Cholestin.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
No serious side effects have been reported, but minor
side effects, including bloating and heartburn, have
been reported.
Other treatments
A study released in 1999 indicated that blue-green
algae contains polyunsaturated fatty acids that lower cho-
lesterol. The algae, known as alga Aphanizomenon flos-
aquae (AFA) is available as an over-the-counter dietary
supplement. Niacin, also known as nicotinic acid or vita-
min B 3 , has been shown to reduce LDL levels by 10-20%,
and raise HDL levels by 15-35%. It also can reduce
triglycerides. But because an extremely high dose of
niacin (2-3 grams) is needed to treat cholesterol problems,
it should only be taken under a doctor’s supervision to
monitor possible toxic side effects. Niacin also can cause
flushing when taken in high doses. Soy protein with high
levels of isoflavones also have been shown to reduce bad
cholesterol by up to 10%. A daily diet that contains 62 mg
of isoflavones in soy protein is recommended, and can be
incorporated into other diet regimens, including vegetari-
an, Asian, and low glycemic. In 2003, research revealed
that policosanol, a substance made from sugar cane wax
or beeswax, lowered LDL cholesterol nearly 27% in study
subjects in a Cuban study.
Allopathic treatment
A wide variety of prescription medicines are avail-
able to treat cholesterol problems. These include statins
such as Mevacor (lovastatin), Lescol (fluvastatin), Prava-
chol (pravastatin), Zocor (simvastatin), Baycol (cervas-
tatin), and Lipitor (atorvastatin) to lower LDL. A group of
drugs called fibric acid derivatives are used to lower
triglycerides and raise HDL. These include Lopid (gemfi-
brozil), Atromid-S (clofibrate), and Tricor (fenofibrate).
A new class of drugs was identified late in 2001 that
work differently from the statin drugs. These drugs rely
on compounds that bind to a sterol that regulates protein
(called SCAP) and speds up removal of cholesterol from
the plasma (the fluid part of the blood.) Doctors decide
which drug to use based on the severity of the choles-
terol problem, side effects, and cost.
Expected results
High cholesterol is one of the key risk factors for
heart disease. Left untreated, too much bad cholesterol
can clog the blood vessels, leading to chest pain (angi-
na), blood clots, and heart attacks. Heart disease is the
number one killer of men and women in the United
States. By reducing LDL, people with heart disease may
prevent further heart attacks and strokes, prolong and
471
Cholesterol
Chondroitin
improve the quality of their lives, and slow or reverse
cholesterol buildup in the arteries. In people without
heart disease, lowering LDL can decrease the risk of a
first heart attack or stroke.
Prevention
The best way to prevent cholesterol problems is
through a combination of healthy lifestyle activities, a
primarily low-fat and high-fiber diet, regular aerobic
exercise, not smoking, and maintaining an optimal
weight. In a small 2003 Canadian study, people who ate
a low-fat vegetarian diet consisting of foods that are
found to help lower cholesterol dropped their levels of
LDL cholesterol as much as results from some statin
drugs. But for people with high risk factors for heart dis-
ease, such as a family history of heart disease, diabetes,
and being over the age of 45, these measures may not be
enough to prevent the onset of high cholesterol. There
are studies being done on the effectiveness of some ex-
isting anti-cholesterol drugs for controlling cholesterol
levels in patients who do not meet the criteria for high
cholesterol but no definitive results are available.
Resources
BOOKS
Bratman, Steven and David Kroll. Natural Pharmacist: Natur-
al Treatments for High Cholesterol. Roseville, CA: Prima
Publishing, 2000.
Ingels, Darin. The Natural Pharmacist: Your Complete Guide
to Garlic and Cholesterol. Roseville, CA: Prima Publish-
ing, 1999.
Murray, Michael T. Natural Alternatives to Over-the-Counter
and Prescription Drugs New York: William Morrow &
Co., 1999.
Trubo, Richard. Cholesterol Cures: From Almonds and Antiox-
idants to Garlic, Golf, Wine and Yogurt. Emmaus, PA: Ro-
dale Press, 1996.
PERIODICALS
“Both Genetics and Diet Influence Cholesterol Levels.” Heart
Disease Weekly (October 14, 2001).
Carter, Ann. “Cholesterol in Your Diet.” Clinical Reference
Systems (July 1, 1999): 282.
“Chemical Engineers Suggest Alzheimer Onset Tied to Choles-
terol.” Pain and Central Nervous System Week (December
24, 2001):3.
“Eating a Vegetarian Diet that Includes Cholesterol-lowering
Foods may Lower Lipid Levels as Much as Some Medica-
tions.” Environmental Nutrition (March 2003):8.
“Researchers Identify New Class of Cholesterol-Lowering
Drugs.” Heart Disease Weekly (December 23, 2001): 14.
Sage, Katie. “Cut Cholesterol with Policosanol: This Supple-
ment Worked Better than a Low-fat Diet in One Study.”
Natural Health (March 2003):32.
Marandino, Cristin. “The Case for Cholesterol.” Vegetarian
Times (August 1999): 10.
472
KEY TERMS
Atherosclerosis — A buildup of fatty substances in
the inner layers of the arteries.
Estrogen — A hormone that stimulates develop-
ment of female secondary sex characteristics.
Glycemic — The presence of glucose in the blood.
Hypertension — Abnormally high blood pressure
in the arteries.
Legumes — A family of plants that bear edible
seeds in pods, including beans and peas.
Lipid — Any of a variety of substances that, along
with proteins and carbohydrates, make up the
main structural components of living cells.
Polyunsaturated fats — A non-animal oil or fatty
acid rich in unsaturated chemical bonds not associ-
ated with the formation of cholesterol in the blood.
Schmitt, B.D. “Treating High Cholesterol Levels.” Clinical
Reference Systems ( July 1, 1999): 1551.
VanTyne, Julia, and Davis, Lori. “Drop Your Cholesterol 25 to
100 Points.” Prevention (November 1999): 110.
ORGANIZATIONS
National Cholesterol Education Program. NHLBI Information
Center, P.O. Box 30105, Bethesda, MD 20824-0105.
http://www.nhlbi.nih.gov.
Ken R. Wells
Teresa G. Odle
Chondroitin
Description
Chondroitin is a substance found in human and ani-
mal cartilage that is used to treat several physical disor-
ders, most importantly arthritis, psoriasis, and cancer. It
is the most plentiful type of glycosaminoglycan (GAG)
found in cartilage. Glycosaminoglycans (GAGs) are
complex carbohydrates that are found in the various
types of connective tissue in the body. GAGs account for
5-20% of cartilage tissue. Chondroitin occurs in connec-
tive tissue as a sulfate composed of repeating disaccha-
ride units; the first unit is either glucosamine or galac-
tosamine; the other unit is glucuronic acid.
General use
Chondroitin has been studied in humans for more
than 30 years as a treatment for psoriasis, cancer, and
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
arthritis. It is also used by veterinarians to treat animals
for arthritis. These different applications are derived
from different properties of chondroitin. More recently,
chondroiton has been used in conjunction with another
dietary supplement called glucosamine to help treat joint
pain caused by osteoarthritis and to help stop cartilage
loss in patients with the disease.
Psoriasis
Studies have been conducted in the United States
since 1990 to determine whether chondroitin from shark
cartilage can speed up wound healing in psoriasis and re-
lated conditions. No conclusive findings have been re-
ported.
Cancer
The use of cartilage products to treat cancer is based
on the popular belief that cartilaginous fish (sharks,
skates, and rays) do not get cancer. Samples of these fish
indicate, however, that they do in fact develop a variety
of tumors, mostly soft-tissue cancers.
There are several theories as to why chondroitin and
cartilage products containing it might be useful in treating
cancer. One theory is that they slow down or stop the for-
mation of blood vessels that supply the cancer with oxy-
gen and nutrients. Another theory is that chondroitin
blocks the formation of certain enzymes that tumors pro-
duce to invade surrounding tissue. The third theory sug-
gests that cartilage products stimulate the immune system.
As of late 1999 the National Cancer Institute was conduct-
ing a multicenter clinical trial of liquid cartilage extract.
Osteoarthritis
Chondroitin is best known to the general public as a
remedy for osteoarthritis, which is a form of arthritis
caused by wearing away or degeneration of the cartilage
that cushions the ends of bones. In particular, it is
thought that the drying of cartilage tissue in osteoarthri-
tis is a major cause of tissue destruction. Chondroitin
sulfate is given together with glucosamine, a building
block of GAGs. The chondroitin helps to attract and hold
fluid within cartilage tissue. Tissue fluid keeps cartilage
healthy in two ways: it acts as a shock absorber within
the joints of the body, thus protecting cartilage from
being worn away by the bones; and it carries nutrients to
the cartilage. The cartilage in the joints of the human
body has no blood vessels, so it must receive its nutrients
from tissue fluid.
In addition to drawing tissue fluid into cartilage,
chondroitin is also thought to protect cartilage by:
• Anti-inflammatory activity.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• Inhibiting the activity of enzymes that break down car-
tilage.
• Counteracting enzymes that interfere with the transport
of nutrients to the cartilage.
• Stimulating the production of proteoglycans, gly-
cosaminoglycans, and collagen. These complex mole-
cules are the building blocks of new cartilage.
Several randomized double-blind studies of chon-
droitin in osteoarthritis patients were conducted in France
and Italy in 1998. The European studies demonstrated that
oral as well as injected chondroitin helps to increase joint
mobility and reduce pain. A landmark 2001 study showed
that combining glucosamine and chondroitin worked bet-
ter than either alone in preventing cartilage damage and
that both supplements worked well when taken orally.
Preparations
The normal (non- vegetarian) adult diet already con-
tains a certain amount of chondroitin; it is found in most
animal tissues, particularly the gristle attached to bones.
Chondroitin sulfate can be taken orally as a pill,
powder, or liquid. It can also be administered by injec-
tion. Oral preparations of chondroitin, alone or in combi-
nation with glucosamine, are available in the United
States as over-the-counter (OTC) dietary supplements.
They can be purchased over the internet, at pharmacies,
health food stores, or even some grocery stores. Because
they are marketed as dietary supplements, they do not re-
quire testing or approval by the Food and Drug Adminis-
tration (FDA). At present, there are no specific quality
control requirements or good manufacturing process
(GMP) standards for these products.
There are at present no standard patterns of adminis-
tration for chondroitin as a treatment for psoriasis or can-
cer. When chondroitin is used together with glucosamine
as a treatment for osteoarthritis, the daily dosage is based
on the patient’s weight. Suggested dosages are: 1000 mg
glucosamine + 800 mg chondroitin sulfate for 120 lbs or
less; 1500 mg glucosamine + 1200 mg chondroitin sul-
fate for 120-200 lbs; and 2000 mg glucosamine + 1600
mg chondroitin sulfate for greater than 200 lbs.
For maximum effectiveness, patients are advised to
divide their daily dosage into 2 to 4 doses and take them
throughout the day with food. They are also encouraged
to take vitamin C and manganese supplements since
these substances appear to increase the effectiveness of
the chondroitin.
Precautions
There are two important precautions to take regarding
chondroitin as a dietary supplement for osteoarthritis. The
473
Chondroitin
Christian Science healing
first is to avoid self diagnosing and self medicating. Per-
sons with stiff or sore joints should consult a medical doc-
tor (M.D.), osteopathic physician (D.O.), or naturopathic
physician (N.D.) for an evaluation to be sure that the prob-
lem is indeed osteoarthritis. Gout, bursitis, rheumatoid
arthritis, fibromyalgia, and several other conditions can
also cause pain and stiffness in the joints. These conditions
are not helped by chondroitin. The supplement has not
been studied in children or in pregnant or nursing women.
The second precaution is to purchase chondroitin
made by a reliable manufacturer. The lack of govern-
ment regulation of products sold as dietary supplements
means that that there is no guarantee that claims made on
the label are accurate. Thus a product that claims to con-
tain chondroitin may not actually contain it, may not
contain the amount that it claims to, or may not be free
from contamination and safe to use. One helpful guide-
line is to look for the words pharmaceutical grade on the
label. This standard ensures that the product is pure and
that it contains the stated amount of chondroitin. A table
of laboratory-tested chondroitin or glucosamine/chon-
droitin products and their manufacturers can be found in
The Arthritis Cure by Jason Theodosakis, et al. listed in
the resources section below.
With regard to potential overdose problems, chon-
droitin sulfate appears to be nontoxic. One six-year study
of people taking doses of 1.5-10 grams per day of chon-
droitin found no toxicity in the subjects.
Side effects
Chondroitin sulfate has no known significant side
effects. Some people report having a bad taste in the
mouth or mild nausea when taking large doses of oral
chondroitin on an empty stomach. Gas or bloating has
also been reported. A few people who have received
chondroitin by injection report a mild soreness around
the injection site.
Interactions
Chondroitin sulfate is not known to cause any sig-
nificant interactions with other medications. A paper pre-
sented at the 1999 annual meeting of the American
Academy of Orthopaedic Surgeons, however, suggests
that because the chondroitin sulfate molecule is similar
to the heparin molecule, its use together with anticoagu-
lant drugs is questionable.
Resources
BOOKS
Paulsen. Douglas F.. PhD. Basic Histology: Examination and
Board Review. Norwalk, CT: Appleton & Lange, 1990.
474
KEY TERMS
Cartilage — A firm, whitish elastic type of connec-
tive tissue found in humans and other animals.
Chondroitin is an important component of cartilage.
Glucosamine — A complex carbohydrate com-
posed of glucose and an amino acid called gluta-
mine. It is an important building block of cartilage
and is often taken together with chondroitin as a
treatment for osteoarthritis.
Osteoarthritis — A degenerative disease of the
joints, characterized by pain and stiffness related
to loss or destruction of the cartilage in the joints.
Psoriasis — An inflammatory disorder of the skin
characterized by scaly patches. Chondroitin is
being studied as a possible treatment for psoriasis.
Theodosakis, Jason. MD, MS, MPH: Brenda Adderley, MHA;
and Barry Fox, PhD. The Arthritis Cure. New York: St.
Martin's Press, 1997.
PERIODICALS
Theodosakis, Jason. “Relief for your Painful Joints (Well-
ness).” Better Nutrition (May 2002):32.
ORGANIZATIONS
National Cancer Institute Cancer Information Service (CIS).
(800) 4-CANCER. TTY: (800) 332-8615. http://www.can-
cernet.nci.nih.gov.
NIH National Center for Complementary and Alternative Med-
icine (NCCAM). NCCAM Clearinghouse, P. O. 8218, Sil-
ver Spring, MD 20907-8218. TTY/TDY: (888) 644-6226.
OTHER
Schenck, Robert C., Jr., MD. Oral Chondroitin Sulfate and
Glucosamine Therapy of Arthritis. Paper presented at the
1999 annual meeting of the American Academy of Or-
thopaedic Surgeons. February 5, 1999.
Rebecca J. Frey, PhD
Teresa G. Odle
Christian Science healing
Definition
Christian Science healing is a method of spiritual
healing based on the beliefs of the Christian Science, or
Church of Christ, Scientist, church. The church’s healing
practices are based on the divine healing work of Jesus.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Adherents hold that the material world is a false reality and
that health is a condition of mind, God, and truth. Thus,
Christian scientists believe that ill health can be cured by
spiritual education, understanding of the truth, and prayer.
Origins
Mary Baker Eddy, the founder of Christian Science,
was born Mary Baker in Bow, New Hampshire, on July
16, 1821, into a family of strict Christian practice and
Puritan values. Baker was ill for much of her childhood
and early adult life. She explored medical therapies pop-
ular in her time, including homeopathy, and found no
relief for her chronic illness.
Between 1862 and 1865 Baker was a patient of a
charismatic healer named Phineas Parkhurst Quimby. A
former hypnotist, Quimby developed a philosophy of
mental healing based on the belief that he had rediscov-
ered the secret of Jesus’ ability to heal the sick. It is
thought that Quimby ’s ideas may have influenced Baker
in the development of her philosophy of Christian Sci-
ence healing, although she herself denied it.
In 1866, the same year that Phineas Quimby died,
Baker suffered a spinal injury from a fall. This proved to
be a critical turning point in her life. Seeking strength in
the Bible to sustain her through the injury. Baker read a
New Testament account of Jesus’ healing. While she was
reading, she experienced a sudden insight into how
Jesus’ healing was accomplished, and as she read, she
found herself suddenly released from her injury and re-
stored to health.
This transformation inspired Baker to spend the next
three years studying the scriptures and codifying her dis-
coveries about healing. She called her discoveries Christ-
ian Science, and believed that she had found the one and
only “truth.” She put her principles into action by heal-
ing others, including those who had illnesses declared by
medical practitioners of the day to be incurable.
As Baker studied the Bible and practiced healing,
she came to believe that she could teach others to heal
following God’s truth as she had discovered it. In 1870
in Lynn, Massachusetts, she taught her first class and
began to develop a following that shared her belief in
Christian Science healing.
In 1875, while still living in Lynn, Mary Baker pub-
lished Science and Health later renamed Science and
Health with Key to the Scriptures. This book, revised by
Baker Eddy over the next 35 years, is the fundamental
document explaining the doctrine of Christian Science
healing.
In 1877 Mary Baker married fellow Christian Scien-
tist Asa Gilbert Eddy and by 1879 had established
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
enough of a following to found the first Church of
Christ, Scientist in Boston, Massachusetts. This church
became her headquarters and is known as the Mother
Church. The regulatory structure of the denomination
was set forth in her book The Manual of the Mother
Church published in 1895.
Throughout the late 1800s, Christian Science con-
tinued to attract converts. Most of these conversions
were brought about by demonstrations of Christian Sci-
ence healing. Eddy also established the Massachusetts
Metaphysical College to teach Christian Science healing.
It is estimated that by 1895 there were about 250 Christ-
ian Science congregations, mainly in New England.
Mary Baker Eddy died on December 3, 1910. At the
time of her death, there were about 1 ,200 Christian Scien-
tist congregations in the United States. By the 1930s the
number had increased to about 2,400. The United States
Bureau of the Census in 1936 estimated church member-
ship in the United States at about 269,000. Meanwhile
congregations were also being established overseas.
After World War II, the number of Christian Science
congregations began to decline. Beginning in the 1980s
the church had to deal with negative publicity from court
cases alleging that the failure of Christian Science parents
to seek conventional medical treatment for children who
had illnesses considered treatable by mainstream medicine
constituted child endangerment. Convictions, many of
which were overturned on appeal, further hurt church
membership. The number of Christian Scientist practition-
ers, as those people whom the Church of Christ, Scientist
officially recognizes as spiritual healers are called,
dropped from about 8,000 in 1960 to about 2,000 in 1998.
Today Mary Baker Eddy is recognized both as a
mind-body healer and as a pioneer in the area of equality
for women. In the Church of Christ, Scientist, men and
women function equally as leaders and healers, an idea
that was revolutionary in Eddy’s lifetime. In 1995 she
was elected to the National Women’s Hall of Fame in
recognition of being the only American woman to found
an internationally established religion.
In addition to its practices of spiritual healing,
Christian Science is best known today for its publishing
activities, spearheaded by the international newspaper
the Christian Science Monitor founded by Eddy in 1908.
Each congregation also provides a public Christian Sci-
ence Reading Room where the public may read Christian
Science literature and ponder spiritual matters.
Benefits
For believers, Christian Science healing brings both
spiritual and physical well being to those who are ill. Its
475
Christian Science healing
Christian Science healing
healing practices make no distinction among different
types of illnesses. It uses no material methods or laying
on of hands to restore people to health and can be prac-
ticed in almost any setting.
Description
To understand Christian Science healing one must also
understand Christian Science theology, because the two are
inextricably linked. On the first page of Science and Health
with Key to the Scriptures Eddy writes, “The prayer that re-
forms the sinner and heals the sick is an absolute faith that
all things are possible to God.. and a spiritual understanding
of Him, an unselfed love.. Prayer, watching, and working,
combined with self-immolation, are God’s gracious means
for accomplishing whatever has been successfully done for
the Christianization and health of mankind.”
Christian Science teaches that the ordinary physical
world that we perceive is a misconception. Matter is not
created by God, but appears because of man’s limited
perception. Jesus, Eddy explains, was able to heal the
sick, the blind, and the lame, because he saw beyond their
material form and saw the spirit essence of the person.
In writing on the human body in Science and Health
with Key to the Scriptures , Eddy states, “To measure in-
tellectual capacity by the size of the brain and strength
by the exercise of muscle, is to subjugate intelligence, to
make the mind mortal, and to place this so-called mind
at the mercy of material organization and non-intelligent
matter. Obedience to the so-called physical laws of
health has not checked sickness. Diseases have multi-
plied since man-made material theories took the place of
spiritual truth. You say that indigestion, fatigue, sleep-
lessness, cause distressed stomachs and aching heads.
Then you consult your brain in order to remember what
has hurt you, when your remedy lies in forgetting the
whole thing; for matter has no sensation of its own and
the human mind is all that can produce pain.”
For believers, Christian Science healing is the tri-
umph of mind over matter and the spiritual over the ma-
terial world. Ill health is simply an illusion. Good health
occurs when the mind achieves awareness of itself,
which is synonymous with awareness of God. The goal
of healing is not to remove physical suffering, but to lead
the ill person to Christ and transform the consciousness
into a more pure and spiritual state that knows God.
Healing is seen as a measure of the depth of one’s sincer-
ity and belief.
Since health does not reside in the body, and is not
controlled by physical laws, Christian Science healing
cannot occur when a person is in a state of moral sinful-
ness or lack of belief. The basis of disease is fear, igno-
rance, or sin. Health is a spiritual fact to be demonstrated.
476
Christian Science teaches that all believers can be
taught to heal. Those people officially sanctioned as heal-
ers by the Church of Christ, Scientist are called Christian
Science practitioners. Practitioners may be either male or
female. These people must pledge to devote themselves
to the practice of healing full time. They may be paid by
their patients for their work. In 2000 there were about
2,000 officially recognized Christian Science practition-
ers in the United States, and that number is declining.
Practitioners do not use any material props or even
touch to heal their patients; only prayer is used. The prac-
titioner approaches the patient with a clear conviction of
the omnipotence of God and the firm belief that God is
good and produces only good things. Practitioners who
hold false beliefs, or error, even unwitting error, blended
with the truth, have weak healing abilities and may be
guilty of malpractice. If the healer realizes the truth, it
will free his patient from symptoms of disease, discord,
and disharmony and lead the patient to Christ. This is said
to leave the patient feeling calm, refreshed, and healthy.
Many converts come to Christian Science through
the demonstration of its power to heal. Traditionally,
Wednesday night meetings are given over to healing testi-
mony and witnessing of the healing power of God’s truth.
Preparations
The purpose of Christian Science healing is not to
free the body from disease, but to lead the patient to a
higher spiritual understanding of God. Patients are best
served if they are receptive to Christian Science beliefs
and practices prior to the start of a healing session.
Precautions
There are no reasons other than disbelief or spiritual
unreadiness not to participate in Christian Science heal-
ing. However, patients that do this must understand that
they may be exacerbating their health problems by deny-
ing themselves access to traditional medical care.
Side effects
No side effects are reported from practicing Christ-
ian Science healing. There is, as noted above, danger
posed by replacing traditional medical care with Christ-
ian Science practices in the case of serious illness.
Research & general acceptance
Christian Science healing is seen by the traditional
medical community as quackery, since it denies any rela-
tionship between the physical universe and illness. It re-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Psychosomatic illness — A condition in which un-
resolved emotional distress manifests as physical
symptoms of illness.
jects the concepts of germs, contagion, and healing
through the application of drugs.
All “proof’ of the effectiveness of Christian Science
healing is anecdotal. Many physicians believe that in
certain cases of psychosomatic illness Christian Science
healing may indeed bring about improvement in symp-
toms, but in diseases with a clear physical origin, it is in-
effective.
Training & certification
The Church of Christ, Scientist recognizes some of
its healers as official practitioners whose full-time job is
healing. About 2,000 were in practice in the United
States in 2000.
Resources
BOOKS
Eddy, Mary Baker. Science and Health with Key to the Scrip-
tures. Boston: Christian Science Publishing Company,
1875 (reprinted 1994).
PERIODICALS
Sheler, Jeffrey L. “Mrs. Eddy's House. U.S. News Online Feb-
ruary 16, 1998. http://www.usnews.com/usnews/issue980
2 16/1 6eddy.htm.
ORGANIZATIONS
Church of Christ, Scientist. http://www.ChristianScience.org.
OTHER
The Mary Baker Eddy Library for the Betterment of Humanity.
http://www.marybakereddy.org:86/.
Virtual Christian Science Reading Room, http://www.mtn.org.
Tish Davidson
Chromium
Description
Chromium is a mineral that is essential to humans. It
is found naturally in a variety of foods, and supplements
are available in capsules or tablets. Supplements are pre-
pared using a number of formulas, including chromium
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
(III), chromium aspartate, chromium chloride, chromium
citrate, chromium nicotinate, chromium picolinate, GTF
chromium, and trivalent chromium.
General use
Chromium supports the normal function of insulin,
which is a hormone secreted by the pancreas. Insulin
helps transport glucose from the bloodstream into liver,
muscle, and fat cells. Once it is inside these cells, the
sugar is metabolized into a source of energy. Insulin is
also involved in regulating protein, fat, and catalytic en-
zyme processes. People with diabetes do not produce in-
sulin (or produce very little) or their bodies cannot proper-
ly use the insulin that is produced. As a result, sugar builds
up in the bloodstream, causing serious health effects. Nu-
merous scientific studies have shown that chromium is
useful in treating insulin resistance (metabolic syndrome)
and diabetes. Diabetic peripheral neuropathy, a form of
nerve damage that is a direct result of diabetes, is indirect-
ly related to a lack of sufficient chromium.
Several studies have shown that chromium supple-
ments may improve insulin sensitivity, and lower blood
glucose and elevated body fat. In February 2004, the
University of Pennsylvania School of Medicine began a
comprehensive study of chromium as a therapy for in-
sulin resistance. This condition occurs when the body
fails to respond properly to the insulin it already pro-
duces. People who are insulin resistant may have the
ability to overcome this problem by producing more in-
sulin. However, if the body cannot produce sufficient
amounts of insulin, glucose levels in the bloodstream
rise, and type 2 diabetes ultimately occurs. It is estimated
that up to 80 million Americans have insulin resistance.
A study conducted by Isala Clinics and University
Hospital Groningen in the Netherlands, and released in
2003, showed that a daily dose of 1,000 micrograms of
chromium significantly reduced blood sugar levels in peo-
ple with poorly controlled type 2 diabetes who use insulin.
Chromium has also been used as an effective treat-
ment for polycystic ovarian syndrome (PCOS), a hor-
monal condition affecting about two million American
women. The condition can lead to infertility if untreat-
ed, and is associated with insulin resistance and type 2
diabetes. A study released in 2003 by the State Universi-
ty of New York at Stony Brook showed that insulin sen-
sitivity increased an average of 35 percent after two
months of daily treatment with 1,000 micrograms (p,g)
of chromium.
Through its involvement with insulin function,
chromium plays an indirect role in lowering blood lipids.
Studies suggest, but have not proven, that chromium sup-
plementation can reduce the risk of cardiovascular (heart)
477
Chromium
Chromium
disease in men, and may decrease total cholesterol and
triglyceride levels. However, several studies contradict
these claims. Studies in animals suggest chromium sup-
plementation may reduce hypertension (high blood pres-
sure). Lipid reduction is secondary to insulin regulation
and control; therefore, persons whose insulin is well reg-
ulated and controlled may not achieve reduced heart dis-
ease risk by taking chromium supplements.
Chromium supplements in high doses — 1,000 p.g or
more a day — are sometimes used in weight loss and
muscle development. However, a number of scientific
studies have found that chromium supplements are not
effective in these areas. In fact, precautions warn against
chromium doses exceeding 1,000 pg per day. Weight
loss and muscle development are secondary to insulin
regulation and control. Therefore, when insulin is well
regulated and controlled, chromium may not impact
weight loss or muscle development.
Preparations
A complete lack of chromium is rare, and the United
States Food and Drug Administration (FDA) has not es-
tablished recommended dietary allowances (RDA) for the
mineral. However, national statistics on the prevalence of
diabetes, heart disease, and obesity suggest that chromi-
um deficiencies may be common. Chromium occurs nat-
urally in meat, seafood, dairy products, eggs, whole
grains, black pepper, and almonds. According to The
PDR Family Guide to Natural Medicines and Healing
Therapies , the usual chromium supplement dose for chil-
dren ages seven and older and adults is 50-200 pg a day
in tablets or capsules. For persons with type 2 diabetes
who are not taking insulin, doses from 200-1,000 pg
daily may be taken. However, persons should only take
doses at these levels after consulting with a physician.
Chromium should not be taken in doses exceeding 1,000
pg a day. The cost of a bottle of 100 tablets or capsules
(200 pg) of chromium picolinate ranges from $5 to $10.
Precautions
Doses of 200-1,000 pg of chromium should be
taken only after consultation with a physician. Pregnant
or breastfeeding women are advised to consult a physi-
cian before taking chromium supplements. Chromium
should not be taken in doses exceeding 1,000 pg a day.
Increased dietary sugar may be associated with higher
urinary excretion of chromium.
Side effects
Several studies have noted occasional reports of irreg-
ular heartbeats with chromium use. Infrequently, chromi-
478
um has been reported to cause such sleep pattern changes
as insomnia and increased dream activity. Irritability has
also been reported. In rare instances, persons may be aller-
gic to a chromium formula. The symptoms of an allergic
reaction include difficulty breathing, chest pain, hives,
rash, and itchy or swollen skin. If this happens, the patient
is advised to seek medical care immediately. High doses
may also cause liver and kidney damage, or gastric irrita-
tion, although these side effects are rare.
Interactions
Persons who are taking antacids are advised to talk
with a physician before taking chromium supplements.
Studies in animals suggest that antacids, especially those
containing calcium carbonate, may reduce the body’s
ability to absorb chromium. Studies have shown that
chromium may enhance the effectiveness of drugs taken
by people who have type 2 diabetes or insulin resistance.
These drugs include glimepiride, glipizide, glyburide, in-
sulin, and metformin. Individuals taking these drugs
should discuss chromium supplementation with a physi-
cian because improved insulin function may necessitate
medication dosage changes.
Resources
BOOKS
Brown, Donald J. Herbal Prescriptions for Health and Heal-
ing: Your Everyday Guide to Using Herbs Safely and Ef-
fectively. Twin Lakes, WI: Lotus Press, 2003.
Evans, Gary. All About Chromium Picolinate : Frequently
Asked Questions. Garden City Park, NY: Avery, 1999.
Icon Health Publications. Chromium Picolinate : A Medical
Dictionary, Bibliography, and Annotated Research Guide
to Internet References. San Diego, CA: Icon Health Publi-
cations, 2003.
Kamen, Betty. The Chromium Connection: A lesson in Nutri-
tion. Novato, CA: Nutrition Encounter Inc., 1995.
Passwater, Richard A. Chromium Picolinate. New York, NY:
McGraw-Hill/Contemporary Books; Reprint Edition,
1995.
PERIODICALS
Biotech Week Editors and Staff. “Company Seeks FDA Ap-
proval of Health Claims for Chromium.” Biotech Week
(January 28, 2004): 308.
“Chromium.” UC Berkeley Wellness Letter (July 2003): 3.
Drug Week Editors and Staff. “Chromium Picolinate May Ben-
efit Patients with Insulin Resistance.” Drug Week (Decem-
ber 26, 2003): 121.
Drug Week Editors and Staff. “Research: Lower Chromium
Levels Linked to Increased Risk of Disease.” Drug Week
(April 2, 2004): 263.
Lamson, Davis W., and Steven M. Plaza. “The Safety and Effi-
cacy of High-Dose Chromium. Alternative Medicine Re-
view (June 2002): 218-236.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Calcium carbonate — A salt that is used in many
antacids.
Diabetes — Several metabolic disorders in which
the body produces insufficient insulin.
Glucose — Sugar.
Hypertension — High blood pressure, which, if un-
treated, can lead to heart disease and stroke.
Insomnia — The inability to sleep.
Insulin — A hormone that helps liver, muscle and
fat cells take up sugars, starches, and other foods
for conversion into energy the body needs.
Insulin resistance — Also called metabolic syn-
drome, a condition in which the body fails to
properly respond to the insulin it produces.
Polycystic ovarian syndrome — PCOS, a hormonal
condition in women that if untreated can lead to
the inability to have children.
Lydic, Michael L., et al. “Effects of Chromium Supplementa-
tion on Insulin Sensitivity and Reproductive Function in
Polycystic Ovarian Syndrome: A Pilot Study.” Fertility
and Sterility (Supplement 3 ) (September 2003): 45 — 46.
Volpe, Stella L., et al. “Effect of Chromium Supplementation
and Exercise on Body Composition. Resting Metabolic
Rate, and Selected Biochemical Parameters in Moderately
Obese Women Following an Exercise Program.” Journal of
the American College of Nutrition (August 2001): 293-306.
Ward, Elizabeth M. “Top 10 Supplements for Men." Men’s
Health (December 2003): 106.
Ken R. Wells
Chronic fatigue syndrome
Definition
Chronic fatigue syndrome (CFS) is a condition that
causes extreme tiredness. People with CFS have debili-
tating fatigue that lasts for six months or longer. CFS
does not have a known cause, but appears to result from
a combination of factors.
Description
CFS is the most common name for this disorder, but
it also has been called chronic fatigue and immune disor-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
der syndrome (CFIDS), myalgic encephalomyelitis, low
natural killer cell disease, post-viral fatigue syndrome,
Epstein-Barr disease, and yuppie flu. Reports of a CFS-
like syndrome called neurasthenia date back to 1869.
Later, people with similar symptoms were said to have
fibromyalgia because one of the main symptoms is
myalgia, or muscle pain. Because of the similarity of
symptoms, fibromyalgia and CFS are considered to be
overlapping syndromes.
In the early to mid-1980s, there were outbreaks of
CFS in some areas of the United States. Although many
CFS patients had high levels of antibodies to the Ep-
stein-Barr virus (EBV), which causes mononucleosis,
many healthy people also had high levels of EBV anti-
bodies. Scientists have also found high levels of other
viral antibodies in the blood of CFS patients. These find-
ings have led many scientists to believe that a virus or
combination of viruses may trigger CFS.
Although CFS can affect people of any gender, age,
race, or socioeconomic group, most patients diagnosed
with CFS are 25-45 years old and female. Estimates of
how many people are afflicted with CFS vary due to the
similarity of CFS symptoms to other diseases and the
difficulty in identifying it. The Centers for Disease Con-
trol and Prevention (CDC) has estimated that 4-10 peo-
ple per 100,000 in the United States have CFS. Accord-
ing to the CFIDS Foundation, about 500,000 adults in
the United States (0.3% of the population) have CFS.
This probably is a low estimate since these figures do not
include children and are based on the CDC definition of
CFS, which is very strict for research purposes.
Causes & symptoms
There is no single known cause for CFS. Studies
have pointed to several different conditions that might be
responsible. These include:
• viral infections
• chemical toxins
• allergies
• immune abnormalities
• psychological disorders
Many doctors and researchers think that CFS may
not be a single illness but a group of symptoms caused
by several conditions. One theory is that a microorgan-
ism, such as a virus, or a chemical injures the body and
damages the immune system, allowing dormant viruses
to become active. When these viruses start growing
again, the immune system may overreact and produce
chemicals called cytokines that can cause flu-like symp-
toms. Immune abnormalities have been found in studies
479
Chronic fatigue syndrome
Chronic fatigue syndrome
Unexplained fatigue
Persistent low-grade fever
Muscle aches and weakness
Insomnia or oversleeping
Swollen lymph nodes
Forgetfulness, confusion
Lack of concentration
Recurrent sore throat
Headaches
Joint pain
Long-lasting symptoms that continue for six months
or longer
of people with CFS, although the same abnormalities are
also found in people with allergies, autoimmune dis-
eases, cancer, and other disorders.
In late 2001, a panel of experts convened and con-
cluded that a virus or bacteria acting on the immune sys-
tem may indeed cause CFS and the experts agreed that
the published evidence is now substantial enough to
prove that the immune system is involved in CFS. They
said infections may also play a role in the condition, but
have still not identified one single agent common to all
patients with CFS and they have encouraged further re-
search. The panel also concluded that reproductive hor-
mones may play a role in the condition, which might ex-
plain a higher prevalence among women.
The role of psychological problems in CFS is very
controversial. Because many people with CFS are diag-
nosed with depression and other psychiatric disorders,
some experts conclude that the symptoms of CFS are
psychological. However, many people with CFS did not
have psychological disorders before getting the illness.
Many doctors think that patients become depressed or
anxious because of the effects of the symptoms of their
CFS. One recent study concluded that depression was
the result of CFS, not its cause.
People with CFS have severe fatigue that keeps
them from performing their normal daily activities. They
may have sleep disturbances that keep them from getting
enough rest or they may sleep too much. When they ex-
ercise or try to be active in spite of their fatigue, people
with CFS experience debilitating exhaustion that can
confine them to bed for days.
Other symptoms of CFS include:
480
• muscle pain (myalgia)
• joint pain (arthralgia)
• sore throat
• headache
• fever and chills
• tender lymph nodes
• trouble concentrating
• memory loss
A recent study at Johns Hopkins University found an
abnormality in blood pressure regulation in 22 of 23 pa-
tients with CFS. This abnormality, called neurally mediated
hypotension, causes a sudden drop in blood pressure when
a person has been standing, exercising, or exposed to heat
for a while. When this occurs, patients feel lightheaded and
may faint. They often are exhausted for hours to days after
one of these episodes. When treated with salt and medica-
tions to stabilize blood pressure, many patients in the study
had marked improvements in their CFS symptoms.
Diagnosis
CFS is diagnosed by evaluating symptoms and elim-
inating other causes of fatigue. Doctors carefully ques-
tion patients about their symptoms, any other illnesses
they have had, and medications they are taking. They
also conduct a physical examination, neurological exam-
ination, and laboratory tests to identify any underlying
disorders or other diseases that cause fatigue. In the
United States, many doctors use the CDC case definition
to determine if a patient has CFS.
To be diagnosed with CFS, patients must meet both
of the following criteria:
• Unexplained continuing or recurring chronic fatigue
for at least six months that is of new or definite onset,
is not the result of ongoing exertion, and is not mainly
relieved by rest, and causes occupational, educational,
social, or personal activities to be greatly reduced.
• Four or more of the following symptoms: loss of short-
term memory or ability to concentrate: sore throat; tender
lymph nodes; muscle pain; multi-joint pain without
swelling or redness; headaches of a new type, pattern, or
severity; nonrefreshing sleep; and post-exertional malaise
(a vague feeling of discomfort or tiredness following ex-
ercise or other physical or mental activity) lasting more
than 24 hours. These symptoms must have continued or
recurred during six or more consecutive months of illness
and must not have started before the fatigue began.
Treatment
There is no specific cure for CFS, but many treat-
ments are available to help relieve the symptoms. Treat-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
merits usually are individualized to each person’s partic-
ular symptoms and needs. The first treatment recom-
mended is a combination of rest, exercise, and a bal-
anced diet. Prioritizing activities, avoiding overexertion,
and resting when needed are key to maintaining existing
energy reserves. Treatment of airborne allergies is an im-
portant facet in the treatment of CFS.
Diet
Drinking eight to 12 glasses of water daily helps
fight fatigue. Food allergies can worsen CFS symptoms.
Common food allergies include milk, wheat, eggs, citrus,
alcohol, chocolate, and coffee. An extract from shiitake
mushrooms (LEM) has been shown in Japanese studies
to benefit CFS patients.
Ayurvedic medicine stresses that energy is derived
from food. Energy-producing foods include: fresh fruits
and vegetables, whole milk, wheat and wheat products,
rice, barley, honey, olive oil, mung bean soup, raisins,
dates, figs, almonds, clarified butter, and yogurt. Foods
that deplete energy include: red meat, aged or fermented
foods, onions, garlic, mushrooms, potatoes, sugar, alco-
hol, and coffee.
Ayurvedic medicine dictates that complete digestion
of food is necessary to obtain the maximum amount of
energy. The following measures can be taken to optimize
digestion:
• eating in a quiet place
• following established mealtimes
• sitting while eating
• not eating while upset
• eating only until satiety (fullness)
• avoiding ice cold foods and drinks
• not talking while chewing
• eating at a moderate pace
Supplements
The following supplements have been used in treat-
ing CFS.
•Vitamin B 12 deficiency causes fatigue, muscle aches,
confusion, poor memory, and arm and leg numbness.
• Magnesium helps muscles to relax. Persons with kid-
ney or heart disease should not take magnesium.
• Iron treats anemia, which can cause tiredness, and im-
prove mental clarity. This should only be taken if a
physician has diagnosed an iron deficiency.
• Manganese works with the supplements above to re-
lieve CFS symptoms.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• Copper deficiency can cause inflammation. Maximum
recommended daily dose for adults is 2-3 mg. Pregnant
women should consult a physician before taking copper
supplements.
• Zinc may boost the immune system.
• Coenzyme Q 10 can increase immune health.
• NADH led to improvement in energy, cognitive ability,
sleep patterns, headaches, and depression in a small
study of CFS patients.
• Carnitine helps to better utilize fats for energy produc-
tion. The recommended daily dose is 500-3,000 mg.
• Alpha lipoic acid enhances energy.
• 5-HTP helps to regulate sleep patterns.
• DHEA deficiency causes fatigue in females and low
sex drive in males. It should only be taken under the di-
rection of a physician.
Fluoride is a potentially toxic substance and should
be avoided.
Other treatment options
Chinese medicine, including acupuncture and cup-
ping, works to bring the body back into balance. Herbals
which may help relieve symptoms of CFS include:
• astragalus (huang chi) to increase energy
• licorice (gan t’sao) for stomach and liver problems,
adrenal exhaustion, and blood pressure warming
• ginger root for digestion
• turmeric for inflammation
• linden flowers for the heart
• echinacea stimulates the immune system, but should
only be taken daily for 10-14 consecutive days
• Siberian ginseng ( Eleutherococcus senticosus ) to in-
crease resistance to stress and boost the immune sys-
tem
• ginkgo to increase blood flow through the brain, but
also thin the blood
• evening primrose (Oenothera biennis ) oil to increase
energy levels
• borage seed (Borago officinales ) oil
• quercetin
• flaxseed oil
Some CFS patients use fasting only under the direc-
tion of a healthcare practitioner. Probiotics using Lacto-
bacillus acidophilus can restore a normal balance to the
intestinal bacterial.
481
Chronic fatigue syndrome
Chronic fatigue syndrome
Chiropractic adjustments can help relieve symp-
toms of CFS. Osteopathy helps some CFS patients. Os-
teopaths developed the craniosacral method which in-
volves manipulation of the bones and membrane attach-
ments of the head. Naturopathic physicians routinely
treat CFS patients. Components of Ayurvedic treatment
of CFS include stress reduction, daily oil massage, im-
proving sleep, improving bowel function, and light to
moderate exercise.
Mental health, psychological, and spiritual counsel-
ing are important facets of CFS treatment. Cognitive be-
havior therapy helps patients manage activity levels to re-
duce fatigue. The type of psychotherapy employed is less
important than having good rapport with the therapist.
For patients who are employed, modifications to the
workplace are essential to maintaining good health. Vo-
cational rehabilitation counseling allows the patient to
maximize his or her work potential.
Exercise and physical therapy can have a dramatic
impact on the health of CFS patients. Stretching exercises
and moderate aerobic activity are beneficial. Too much
exercise can worsen fatigue and other CFS symptoms.
Exercise programs such as physical therapy, t’ai chi,
yoga, chi kung, the Alexander technique, and muscle
balance and function development (MBF) are all options.
There is a lengthy list of therapies used by CFS pa-
tients to find relief. None are cures and most have not
been tested in clinical studies. CFS patients may find re-
lief, if only temporarily, in the following:
• healing sessions with a spiritual healer
•yoga
• reflexology
• hydrotherapy
• sound therapy
• chocolate therapy
• magnet therapy
• meditation
• visualization
• spiritual cleansing rituals
• biofeedback
A 2002 report noted a study that showed some re-
sults from homeopathy for CFS patients. For the study,
patients underwent six months of treatment chosen by
one of four homeopaths and changed as needed. Sixty-
five percent of patients reported some improvement,
feeling fitter, more rested, and less tired.
482
Allopathic treatment
Drugs
Nonsteroidal anti-inflammatory drugs (NSAIDs), such
as ibuprofen and naproxen, may be used to relieve pain and
reduce fever. Another medication that is prescribed to re-
lieve pain and muscle spasms is cyclobenzaprine (Flexeril).
Many doctors prescribe low dosages of antidepres-
sants for their sedative effects and to relieve symptoms
of depression. Antianxiety drugs, such as benzodi-
azepines or buspirone may be prescribed for excessive
anxiety that has lasted for at least six months.
Other medications that have been tested or are being
tested for treatment of CFS are:
• Fludrocortisone (Florinef), a synthetic steroid, has
helped some CFS patients who have neurally mediated
hypotension.
• Beta-adrenergic blocking drugs, including atenolol
(Tenoretic, Tenormin) and propranolol (Inderal), are
sometimes prescribed for neurally mediated hypotension.
• Gamma globulin, which contains human antibodies has
been used experimentally to boost immune function in
CFS patients.
• Ampligen, a drug which stimulates the immune system
and has antiviral activity, improved mental function in
CFS patients.
Expected results
The course of CFS varies widely for different peo-
ple. Some get progressively worse over time, while oth-
ers gradually improve. Some persons have periods of ill-
ness that alternate with periods of good health. While
some people with CFS do fully regain their health, those
that do not find relief from symptoms and adapt to the
demands of the disorder by carefully following a treat-
ment plan combining adequate rest, nutrition, exercise,
and other therapies.
Prevention
Because the cause of CFS is not known, there are no
recommendations for preventing the disorder.
Resources
BOOKS
Chopra, Deepak. Boundless Energy: The Complete MindIBody
Program for Overcoming Chronic Fatigue. New York:
Harmony Books, 1995.
Demitrack, Mark A., and Susan E. Abbey. Chronic Fatigue
Syndrome: An Integrative Approach to Evaluation and
Treatment. New York: The Guilford Press, 1996.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Alexander technique — A movement therapy that
identifies and changes poor physical habits that
may cause fatigue. The body is put into a state of
relaxation and balance through the use of simple
movements.
Arthralgia — Joi nt pain.
Depression — A psychological condition, with
feelings of sadness, sleep disturbance, fatigue, and
inability to concentrate.
Epstein-Barr virus (EBV) — A virus in the herpes
family that causes mononucleosis.
Fibromyalgia — A disorder closely related to CFS.
Symptoms include pain, tenderness, and muscle
stiffness.
Lymphocytes — White blood cells that are respon-
sible for the actions of the immune system.
Mononucleosis — A flu-like illness caused by the
Epstein-Barr virus.
Muscle balance and function development
(MBF) — A movement therapy that strives to re-
align body posture through a series of exercises.
Myalgia — Muscle pain.
Natural killer (NK) cell — A lymphocyte that acts
as a primary immune defense against infection.
Neurally mediated hypotension — A rapid fall in
blood pressure that causes dizziness, blurred vi-
sion, and fainting, and is often followed by pro-
longed fatigue.
Neurasthenia — Nervous exhaustion. A disorder
with symptoms of irritability and weakness, com-
monly diagnosed in the late 1800s.
Fisher, Gregg Charles. Chronic Fatigue Syndrome: A Compre-
hensive Guide to Symptoms, Treatments, and Solving the
Practical Problems of CFS. New York: Warner Books,
1997.
Skelly, Mari, and Andrea Helm. Alternative Treatments for Fi-
bromyalgia & Chronic Fatigue Syndrome: Insights from
Practitioners and Patients. Alameda, CA: Hunter House,
Inc., 1999.
PERIODICALS
Gibson, Sheila L. M., and Robin G. Gibson. “A Multidimen-
sional Treatment Plan for Chronic Fatigue Syndrome.”
Journal of Nutritional & Environmental Medicine 9
(March 1999): 47+.
“Immune System Dysfunction May Play a Key Role.” Medical
Letter on the CDC & FDA (January 20, 2002): 5.
Johnson, Susan K., John DeLuca, and Benjamin H. Natelson.
“Chronic Fatigue Syndrome: Reviewing the Research Find-
ings.” Annals of Behavioral Medicine 21 (1999): 258-271.
“New Treatment for Chronic Fatigue Syndrome.” Tufts Univer-
sity Diet & Nutrition Letter 13 (February 1996): 1-2.
Walsh. Nancy. “Homeopathy May Help Patients with Chronic
Fatigue Syndrome.” Clinical Psychiatry News (March
2002): 27.
Weiss, Rick. "A Cure for Chronic Fatigue? If New Research
Proves Right. Some Sufferers Have Nothing More than an
Easy-to-Fix Blood Pressure Problem.” The Nurse Practi-
tioner 22 (July 1997): 30-40.
ORGANIZATIONS
American Association for Chronic Fatigue Syndrome. 7 Van
Buren Street, Albany, NY 12206. (518) 435-1765. Chttp://
weber. u. Washington. edu/~dedra/ aacfs 1 .html> .
The CFIDS Association. Community Health Services, P.O.
Box 220398, Charlotte, NC 28222-0398. (704) 362-2343.
The National CFIDS Foundation. 103 Aletha Road, Needham, MA
02192. (781)449-3535. <http://www.cfidsfoundation.org>.
The National CFS Association. 919 Scott Avenue, Kansas City,
KS 66105. (913) 321-2278.
OTHER
Centers for Disease Control and Prevention “The Facts about
Chronic Fatigue Syndrome.” CFS Research group. Mail-
stop A15, Centers for Disease Control and Prevention, At-
lanta, GA 30333. (404) 639-1338. <http://www.cdc.gov/
ncidod/diseases/cfs/facts 1 .htm>.
National Institutes of Health, Public Service Resources
“Chronic Fatigue Syndrome.” <http://www.niaid.hih.gov/
publications/cfs/complete.htm>.
Belinda Rowland
Teresa G. Odle
Chronic pain see Pain
Chrysanthemum flower
Description
The chrysanthemum, of which there are many vari-
eties, has been known by a host of common names
throughout history. Some of the chrysanthemum’s com-
mon names include pellitory, feverfew, ox-eye daisy, and
sunflower among others. It is a flower that has grown in
gardens all around the world as far back as any records
can tell, and seems to have been employed everywhere at
some time or another as a cure for a host of complaints.
Chinese chrysanthemum flower
The Latin name for Chinese chrysanthemum flower
is Chrysanthemum indicum, and it is known in China as Ju
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
483
Chrysanthemum flower
Chrysanthemum flower
Chrysanthemum blooms. (Photograph by Patrick Johns.
CORBIS/Patrick Johns. Reproduced by permission.)
Jua. The plant grows profusely throughout China and is
both an emblem to the Chinese and greatly prized for its
medicinal properties, particularly as an anti-inflammatory.
The best flowers for medicinal purposes are consid-
ered to be the yellow fragrant ones. They are classified
as being acrid, bitter, and slightly cold in the Chinese
pharmacopoeia. Traditionally, they are harvested in the
fall, when they are in full bloom.
The herb is taken internally for headaches, dizzi-
ness, and hearing disorders. It is also useful as a treat-
ment for high blood pressure (hypertension). It is used
as a compress or eye wash for inflammation of the eyes
and for other eye problems such as dry-eye, blurred vi-
sion, and spots before the eyes. The herb can also be
taken internally as an infusion and is combined with
honeysuckle for the treatment of colds, the flu, and in-
fected sores. It has a calming effect and can also be good
for stress. Chrysanthemum is known to be a powerful
antiseptic and antibiotic. However, people suffering from
diarrhea should take it with caution.
Dalmatian pellitory
There are many plants that go by the name of pelli-
tory, but this one is also a member of the chrysanthemum
family. Its botanical name is Chrysanthemum cinerari-
afolium, and it originated in Dalmatia. It is cultivated in
both Dalmatia and California. Previously, Persian pelli-
tory was the most widely used, but it has been superced-
ed by Dalmatian pellitory in practical use due to ease of
cultivation.
Feverfew
The variety of chrysanthemum that is perhaps the
most useful as far as herbal medicine is concerned, is
feverfew, or Chrysanthemum parthenium. Most species
of chrysanthemum are tall daisy-like flowers and fever-
few is no exception. It is commonly found in England
and the United States, and is similar to chamomile in ap-
pearance. Feverfew differs from chamomile in that it is
larger and the white petals are arranged around a flat yel-
low center, as opposed to conical, which is the case with
chamomile. The hairy stems of feverfew grow to about 2
ft (61 cm) tall, and the leaves are serrated and downy.
Feverfew is also known by other common names, includ-
ing featherfew, featherfoil, flirtwort, bachelor’s buttons,
and wild chamomile.
Ox-eye daisy
The botanical name for the ox-eye daisy is Chrysan-
themum leucanthemum. It is a common sight in Britain,
where it is known as dun daisy or maudlinwort. It is
common throughout Europe, Russia, and Asia. Again, it
is a yellow-centered flower with white petals. It grows to
a height of 1-2 ft (30-61 cm) and has small leaves with
serrated edges.
Sunflower
The sunflower is a native of Mexico and Peru, and is
commonly grown in the United States and many other
areas of the world. This is the largest of the chrysanthe-
mum family, and there are several subspecies, varying
slightly in size. Generally it grows to a height of 3-12 ft
(91-366 cm), with flower heads that may measure more
than 6 in (15 cm)across. The leaves are serrated and rough.
General use
The Flower Essence Society (FES) of California has
a chrysanthemum essence that they recommend for those
seeking spiritual growth.
According to many herbalists, species of chrysan-
themum have many medicinal uses.
Dalmatian pellitory
This is commonly known as insect powder due to its
insecticide properties. An advantage is that the powder is
completely harmless to humans, and so does not have
side effects (as is the case with all chemical insecticides),
and can be used as a lotion and applied to the skin as an
insect repellant. If the flowers are burned, the smoke that
is given off can be valuable in exterminating insects.
Feverfew
Feverfew is chiefly regarded for its ability to treat
fevers, reduce swelling, and for its analgesic properties;
it is an excellent cure for a headache or any other pain.
It is also used to promote menstrual flow, as an antidote
484
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
to depression and nervous disorders, and as a general
tonic. In addition, feverfew can be used to help in cases
of difficult breathing, particularly associated with asth-
ma, and chest infections. It has been used as a treatment
for insect bites and even rat bites. In the past, feverfew
was recommended for planting around dwellings be-
cause of its antiseptic properties. It wards off disease and
prevents pests and diseases from attacking other plants.
Similar to Dalmatian pellitory, it also has a repellant ef-
fect on insects. It can be used externally for flatulence
and colic.
Ox-eye daisy
The herb has a soothing effect and is recommended
for night sweats, especially those associated with tuber-
culosis. It is recommended for use in cases of whooping
cough, asthma, and nervous tension. Generally its action
can be compared to that of chamomile. It is useful for re-
lieving chronic coughs and bronchial catarrh. Externally,
it can be used as a lotion for wounds, bruises, and some
skin conditions. In this regard, some herbalists recom-
mend it as an ointment for treating swellings and it is
also known for treating gout. Others recommend it for
treating jaundice and also as a diuretic and tonic.
Sunflower
The sunflower is chiefly grown for its seeds which
produce an oil, similar to olive oil, that is both cheap to
produce and a valuable source of fatty acids. In many
parts of the world, the sunflower provides much needed
nutrition in poorer areas. The seeds can be used medici-
nally for treatment of bronchial complaints. A tincture of
the seed has been used successfully in areas such as Rus-
sia, Turkey, and Persia for fevers (even malaria), where
it has been found to be free of the complications some-
times associated with the use of quinine.
Preparations
Dalmatian pellitory
PARTS USED: FLOWERS. The chief use for Dalmatian
pellitory is as an insecticide, or as an ointment to ward
off insects. It is mainly dried and ground to a powder to
this end.
Feverfew
PARTS USED: BARK, FLOWERS, AND LEAVES. For
coughs it is generally made up into a syrup (decoction)
with sugar or honey. The herb, when bruised and added
to a little oil, can be used as an external application for
flatulence and colic. For swellings and bites, it can be
made up into a tincture, two teaspoonfuls of which
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
should be mixed with half a pint of cold water and ap-
plied. As an infusion, made with boiling water and al-
lowed to cool, feverfew will soothe pain of any kind,
(muscular, nerve -related, rheumatic or intestinal). Chew-
ing the leaves (one to four per day) can be effective in
the case of migraine. It has also been used in this way to
treat cases of worms.
Ox-eye daisy
PARTS USED: FLOWERS, ROOTS, AND LEAVES. This
plant is mainly employed as an infusion. But in the case
of tuberculosis, 15-60 drops of the fluid-extract should
be taken in water. The flowers boiled with the leaves and
stalks and sweetened with a little honey are a treatment
for chest complaints.
Sunflower
PARTS USED: SEEDS AND LEAVES. Chest complaints:
boil two ounces of the seeds in one quart of water until
the water is reduced to 12 oz. Strain and add six ounces
of Holland gin and six ounces of sugar. The dose is one
to two teaspoonfuls of the mixture three times a day.
Roasting the seeds and making an infusion is recom-
mended for whooping cough.
Precautions
As with any herbal preparations, all of the above
should be used with care and preferably under the super-
vision of an herbal practitioner.
Side effects
Feverfew should not be used for migraine that is a re-
sult of some kind of deficiency in the body (whether nu-
tritional or otherwise). It is possible that feverfew may
cause dermatitis, allergic reactions, or sores in the mouth
in susceptible individuals. It should not be taken by preg-
nant women due to its ability to stimulate the uterus.
Interactions
Feverfew has been known to interfere with blood-
clotting ability, and so a doctor should be consulted be-
fore it is used in conjunction with anticoagulants.
Resources
BOOKS
Buchman, Dian Dincin. Herbal Medicine. London: Tiger
Books International, 1993.
Culpeper, Nicholas. Culpeper’ s Complete Herbal. London:
Bloomsbury Books. 1992.
Grieve, Mrs. M. A Modern Herbal. London: Tiger Books Inter-
national, 1992.
485
Chrysanthemum flower
Chymotrypsin
KEY TERMS
Decoction — These are made to be taken immedi-
ately (not for storage): simmer herbs for half an
hour and strain, in the same way as for syrup, but
sweetened to taste only.
Fluid extract — Made by simmering a plant and re-
ducing the water until the mixture is thickened.
This resulting liquid has a concentrated form of
the active constituents of a plant. Alcohol, glyc-
erin, or tincture of Benzoin may be added as a
preservative.
Infusion — This is made in the same way that one
would make tea, i.e., adding boiling water to the
dried herb and allowing it to stand for a while.
Syrup — An herbal preparation that is made gener-
ally by boiling the herb with water, adding sugar
as a preservative, and boiling until it thickens. The
syrup may be stored.
Tincture — Herbs that are not soluble in water are
bruised and steeped in alcohol. This liquid is
placed in a bottle and may be filtered with coffee
filters. The same procedure may be followed using
vinegar instead of alcohol.
ORGANIZATIONS
Flower Essence Society. P.O. Box 459, Nevada City, CA
95959. (800) 736-9222. mail@flowersociety.org. http://
www.flowersociety.org.
Patricia Skinner
Chymotrypsin
Description
Chymotrypsin is a digestive enzyme that breaks
down proteins (i.e., it is a proteolytic enzyme; it can also
be referred to as a protease). It is naturally produced by
the pancreas in the human body. However, it can also be
taken as an enzyme supplement to improve health and
digestion and aid in the treatment of various diseases.
The pancreas, which produces chymotrypsin and
other digestive enzymes, is a digestive organ in the ab-
domen that is located just below the stomach. Its primary
job is to produce enzymes required for the digestion and
absorption of food. Each day the pancreas secrets about
486
1.5 qt (1.4 L) of pancreatic juice, consisting of enzymes,
water, and electrolytes (primarily bicarbonate) into the
small intestine. The enzymes are secreted in an inactive
form (as proenzymes) so that they will not digest the
pancreas. The pancreas secretes an inhibitor to ensure
that the enzymes are not activated too early. When the
pancreatic juice reaches the small intestine, the enzymes
become activated. The small intestine is not digested be-
cause it contains a protective mucous lining. However,
self-digestion can occur if the pancreatic duct becomes
blocked or if the pancreas is damaged. The proenzymes
can overwhelm the inhibitor, causing the enzymes to be-
come active while in the pancreas. This condition, called
acute pancreatitis, can result in a lifetime of pancreatic
insufficiency.
The enzymes secreted by the pancreas break down
food by breaking the chemical bonds that hold food mol-
ecules together. Enzymes secreted include lipase, which,
along with bile, digests fat; amylases, which break down
starch molecules into smaller sugars; and protease,
which breaks protein molecules into dipeptides and
some single amino acids. In addition to chymotrypsin,
other protease enzymes secreted by the pancreas include
trypsin and carboxypeptidase.
Chymotrypsin, as a hydrolase type of enzyme
(which means it adds a water molecule during the break-
down process) acts by catalyzing the hydrolysis of pep-
tide bonds of proteins in the small intestine. It is selec-
tive for peptide bonds with aromatic or large hydropho-
bic side chains on the carboxyl side of this bond. Chy-
motrypsin also catalyzes the hydrolysis of ester bonds.
Chymotrypsin does not digest blood proteins because of
protective factors in the blood that block the enzyme.
General use
Generally, the primary uses of chymotrypsin are as a
digestive aid and as an anti-inflammatory agent. The pres-
ence and amount of chymotrypsin in a person’s stool is
sometimes measured for diagnostic purposes as a test of
pancreatic function. Testing for fecal chymotrypsin is non-
invasive, unlike some other tests of pancreatic function.
Chymotrypsin, along with the other pancreatic en-
zymes, is most often used in the treatment of pancreatic
insufficiency. Pancreatic insufficiency is characterized
by impaired digestion, malabsorption and passing of
undigested food into the stool, nutrient deficiencies, gas,
and abdominal bloating and discomfort. Pancreatic defi-
ciency also occurs in persons with cystic fibrosis, a rare
inherited disorder. It may also occur in those with chron-
ic pancreatitis, as well as in the elderly. Other conditions
that could result in chymotrypsin deficiency include
physical injuries, chemotherapy, and chronic stress.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Starch and fat digestion can be accomplished with-
out the help of pancreatic enzymes; however, the pro-
tease enzymes (i.e., chymotrypsin, trypsin, and car-
boxypeptidase) are required for proper protein digestion.
Incomplete digestion of proteins may result in the devel-
opment of allergies and the formation of toxic sub-
stances produced by putrefaction, the breakdown of pro-
tein materials by bacteria. Protease enzymes and other
intestinal secretions are also required to keep the small
intestine free from parasites such as bacteria, yeast, pro-
tozoa, and intestinal worms. A laboratory analysis of a
stool sample along with physical symptoms are used to
assess pancreatic function.
As an anti-inflammatory agent, the chymotrypsin
and the other protease enzymes prevent tissue damage
during inflammation and the formation of fibrin clots.
Protease enzymes participate in the breakdown of fibrin
in a process called fibrinolysis. Fibrin causes a wall to
form around an area of inflammation, resulting in the
blockage of blood and lymph vessels, which leads to
swelling. Fibrin can also cause the development of blood
clots. In autoimmune diseases, the protease enzymes aid
in the breakdown of immune complexes, which are anti-
bodies produced by the immune system associated with
the compounds they bind to (antigens). High levels of
immune complexes in the blood are associated with au-
toimmune diseases.
Specifically, chymotrypsin is used to:
• Aid in digestion.
• Treat inflammation and reduce swelling (i.e., soft tissue
injuries, acute traumatic injuries, sprains, contusions,
hematomas, ecchymoses, infections, edema of the eye-
lids and genitalia, muscle cramps, and sports injuries).
• Treat arthritis and such other autoimmune diseases as
lupus, scleroderma, and multiple sclerosis.
• Treat ulcerations and abscesses.
• Liquefy mucus secretions.
• Treat enterozoic worms and other parasites in the di-
gestive tract.
• Treat cancer (a controversial use that requires much
more scientific study, though chymotrypsin may be
helpful in alleviating effects of radiation treatment or
chemotherapy).
• Treat shingles and acne.
• Decrease effects of sun damage and age spots.
Preparations
Chymotrypsin is produced from fresh hog, beef, or
oxen pancreas. It can be taken orally, topically, or by in-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
jection (by injection only by a physician in severe life-
threatening situations), but is commonly taken orally in
tablet form. As a tablet, it may be uncoated, microencap-
sulated, or enterically coated (to prevent digestion in the
stomach so that the enzyme will be released in the small
intestine). Other forms include coated granules, powder,
capsules, and liquids. Creams and ointments are used to
break down proteins and debride dead tissue resulting
from burns, wounds, and abscesses. The enzyme prepa-
ration should be stored in a tight container with a mois-
ture-proof liner in a dry, cool place. An opened container
stored properly should maintain enzyme activity for
about two to three months.
Usually chymotrypsin is included in a combination
with other enzymes. A typical formulation may include:
chymotrypsin (0.5-1 mg), bromelain (a plant protease)
(25-45 mg), pancreatin (a mixture of many pancreatic
enzymes) (100 mg), papain (a plant protease similar in
action to chymotrypsin) (25-60 mg), and trypsin (a pan-
creatic protease) (24 mg). Formulations may also include
vitamins, herbs, phytochemicals, and other nutrients to
enhance the activity of the enzyme supplement.
Enzyme activity should be considered when a sup-
plement is selected. Activity is usually indicated in units;
however there is no one standard for enzyme activity
level. Recognized guidelines for measuring enzyme ac-
tivity include Food Chemicals Codex (FCC), United
States Pharmacopoeia (USP), Federation Internationale
du Pharmaceutiques (FIP), British Pharmacopoeia (BP),
and Japanese Pharmacopoeia (JP). For example, the
United States Pharmacopoeia has set a strict definition
for level of activity that must be reported in a enzyme
supplement. A IX chymotrypsin product must contain
not less than 25 USP units for chymotrypsin activity. A
preparation of higher potency is given a whole number
multiple indicating its strength. For example, a full-
strength undiluted extract that is 10 times stronger than
the USP standard would be referred to as 10X USP. A
consumer can compare enzyme activity levels among en-
zyme products within a single guideline system, but un-
fortunately the information is not interchangeable among
guideline systems.
The dose required will vary on the quantity (amount
in mg) and the quality (activity level) of the enzyme in
the preparation, which is usually tablet form. The dose
will also depend on the condition being treated. In most
cases, for oral ingestion and for topical application, the
directions on the bottle or tube label can be followed.
Enterically coated tables should be swallowed and not
chewed or ground up. Tablets should also be taken with
at least 8 oz of water to help activate the enzyme. Chy-
motrypsin taken to enhance digestion is usually taken
just before, during, or just after meals, or before going to
487
Chymotrypsin
Chymotrypsin
bed at night. With proper dosages, improvements in di-
gestion should be noted within a few hours.
For inflammatory or chronic conditions, chy-
motrypsin should be taken on an empty stomach, either
one hour before meals or at least two hours after meals.
When chymotrypsin is taken for an inflammatory condi-
tion, some improvement may be noted within three to
seven days. Those with chronic conditions such as arthri-
tis may require one to three months or more to notice a
change in conditions.
Precautions
Chymotrypsin is generally well tolerated and not as-
sociated with any significant side effects. However, since
a safe dose has not been established, it should only be
used when there is apparent need.
People who should not use enzyme therapy include
those with hereditary clotting disorders such as hemo-
philia, those suffering from coagulation disturbances,
those who are just about to or have undergone surgery,
those on anticoagulant therapy, anyone suffering from
protein allergies, and pregnant women or those breast-
feeding. Since there is not much known about the effects
of enzyme therapy on children, it would be prudent to
avoid giving enzyme supplements to children.
When protective mechanisms against self-digestion
in the body break down, chymotrypsin should not be
used. For example, if a patient has stomach ulcers, chy-
motrypsin therapy should be discontinued.
Side effects
There do not appear to be any long-term side effects
from chymotrypsin therapy if precautions for its use are fol-
lowed. Studies have shown that at recommended doses, en-
zymes cannot be detected in blood analysis after 24-48
hours. Temporary side effects that may occur (but that
should disappear when therapy is discontinued or dosage is
reduced) include changes in the color, consistency, and odor
of the stool. Some individuals may experience gastrointesti-
nal disturbances, such as flatulence, a feeling of fullness, di-
arrhea, constipation, or nausea. With high doses, minor
allergic reactions such as reddening of the skin may occur.
Interactions
Chymotrypsin is most often used in combination
with other enzymes to enhance its treatment potential. In
addition, a well-balanced diet or the use of vitamin and
mineral supplements are recommended to stimulate chy-
motrypsin activity.
Some types of seeds, including jojoba and wild soja
seeds, have been found to contain proteins that inhibit
488
KEY TERMS
Ecchymosis (plural, ecchymoses) — The medical
term for a bruise, or skin discoloration caused by
blood seeping from broken capillaries under the
skin.
Enzyme — Any of a group of complex proteins that
originate in living cells and help to break down
organic compounds into simpler molecules.
Enzyme therapy — An alternative approach to the
treatment of digestive disorders and other illnesses
related to nutritional problems. Enzyme therapy
emphasizes the use of animal- or plant-derived di-
gestive enzymes as dietary supplements.
Pancreas — A tongue-shaped gland located in the
upper abdomen behind the stomach. It secretes
digestive enzymes into the small intestine, and
glucagon and insulin into the bloodstream.
Scleroderma — A chronic autoimmune disorder in
which connective tissue anywhere in the body be-
comes hard and rigid.
the activity of chymotrypsin. These proteins can be inac-
tivated by boiling the seeds.
Chymotrypsin should not be used together with
acetylcysteine, a drug used to thin mucus in the lungs. It
should also not be used together with anticoagulant (blood
thinning) drugs, as it increases their effects. Chlorampheni-
col, a medication used to treat eye infections, may counter-
act the effectiveness of chymotrypsin ophthalmic solutions.
Resources
BOOKS
Bland, Jeffrey. Digestive Enzymes. New Canaan, CT: Keats
Publishing, Inc., 1993.
Cichoke, Anthony J. The Complete Book of Enzyme Therapy.
Garden City Park, NY: Avery Publishing Group, 1999.
PERIODICALS
Deshimaru, M., R. Hanamoto, C. Kusano, et al. “Purification
and Characterization of Proteinase Inhibitors from Wild
Soja (Glycine Soja) Seeds.” Bioscience. Biotechnology,
and Biochemistry 66 (September 2002): 1897-1903.
Fujino, H., T. Aoki, and H. Watabe. “A Highly Sensitive Assay
for Proteases Using Staphylococcal Protein Fused with
Enhanced Green Fluorescent Protein.” Bioscience,
Biotechnology, and Biochemistry 66 (July 2002): 1601-
1604.
Shrestha, M. K., I. Peri, P. Smirnoff, et al. “Jojoba Seed Meal
Proteins Associated with Proteolytic and Protease In-
hibitory Activities.” Journal of Agricultural and Food
Chemistry 50 (September 25, 2002): 5670-5675.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Zintl, A., C. Westbrook, H. E. Skerrett, et al. “Chymotrypsin
and Neuraminidase Treatment Inhibits Host Cell Invasion
by Babesia divergens (Phylum Apicomplexa).” Parasitol-
ogy 125 (July 2002): 45-50.
ORGANIZATIONS
American Dietetic Association (ADA). 216 West Jackson
Blvd., Suite 800, Chicago, IL 60606. (312) 899-0040.
<www.eatright.org>.
Digestive Disease National Coalition (DDNC). 711 Second
Street NE, Suite 200, Washington, DC 20002. (202) 544-
7497. <www.ddnc.org>.
National Digestive Diseases Information Clearinghouse, Na-
tional Institute of Diabetes and Digestive and Kidney Dis-
ease, and National Institutes of Health. 2 Information
Way, Bethesda, MD 20892-3570. (310) 654-3810.
Judith Sims
Rebecca J. Frey, PhD
Cicada
Description
Cicada is an animal-derived substance used in tra-
ditional Chinese medicine (TCM). It is extracted from
or prepared by grinding the empty shell shed every seven
years by the cicada, (Cryptotympana atrata or Crypto-
tympana pustulata ), which is a winged insect that makes
a distinctive chirping sound, and belongs to the Cicadi-
dae family.
Cicadas are commonly found in mainland China,
Taiwan, and Japan. They had religious significance in
ancient China, and symbolized reincarnation or immor-
tality, as the Chinese compared the cicada’s periodic
molting of its shell with a person’s leaving the physical
body behind at the time of death. Bronze vessels as old
as 1500 B.c. ornamented with cicadas have been found in
Chinese tombs, along with white pottery and jewelry
featuring cicada designs. During the Han dynasty (202
B.c. to a.d.) 220, the Chinese carved small cicadas out of
precious jade and placed them in the mouths of the dead.
The pharmaceutical name of the substance made
from this insect is Periostracum cicadae, or chan tui in
Chinese. It is prepared from the exuvium, or cast-off
shell of the nymph form of the insect. The empty shell is
shiny, translucent, and yellow-brown in color. As it
would appear in a living cicada, the shell has three por-
tions: head (with two eyes), chest (with wings and a
crossed gap), and abdomen (with three pairs of feet).
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
A cicada emerging from its skin. (Photograph by Alvin E.
Staffan. Photo Researchers, Inc. Reproduced by permission.)
General use
The medicinal uses of cicada include treatment of
fever and associated seizures; skin rashes; and such eye
disorders as conjunctivitis, cataracts, and blurred vision.
Due to its antipyretic effect, cicada-containing
preparations are often used to treat high fevers, such as
those associated with the common cold or influenza.
Western news media reported in April 2003 that the Chi-
nese were using combinations of cicada and silkworm
droppings to treat the fever associated with SARS. In ad-
dition to reducing fever, cicada is also used in TCM to
treat other symptoms of colds and flu, including laryngi-
tis, headache, restless sleep, or nightmares.
Cicada is said to be effective in relieving itchy rash-
es and eczema. Its special use is for the treatment of
rashes or skin eruptions that occur in the early stages of
measles or chicken pox. According to traditional Chi-
nese medicine, the sooner the rashes appear, the shorter
and less severe these diseases will be. Therefore, a Chi-
489
Cicada
Cicada
nese herbalist may suggest cicada preparations to hasten
the eruption of the rash.
Cicada is said to prevent or reduce muscle spasms
by reducing the tension of the striated muscles. It may
also delay transmission of nerve signals at the neuromus-
cular junction, thereby reducing muscle spasms. Its ac-
tions may be similar to those of Western barbiturates,
sedatives, and anticonvulsants (antiseizure medications).
Cicada has also been used in TCM to treat eye dis-
eases associated with wind and heat, including blurred
vision and conjunctivitis (inflammation of the membrane
that lines the eyelids). It is usually mixed with chrysan-
themum flowers (Chrysanthemum morifolium, or ju hua
in Chinese) when used to treat cataracts.
Preparations
The usual dosage of cicada when taken alone is 3-9
grams per day. As of 2004, whole cicadas cost about 10
cents per gram when purchased in bulk from suppliers of
Chinese medicinal herbs. Cicada may be prepared as a
decoction, which means that the insect shells are boiled
down to a concentrated broth or tea to be taken internal-
ly. Other forms of cicada preparations include ground
powder and water and alcohol extracts.
Precautions
A general precaution when using herbs or other alter-
native medicines is to purchase them only from reputable
sources. In the case of traditional Chinese remedies, this
precaution is particularly important because many of them
are imported from countries without strict production or
labeling standards. In the case of cicada, the United States
Food and Drug Administration (FDA) reported in June
2003 that a shipment described as “Cicada Molting Herbal
Food Supplement” from Taiwan was refused entry into the
United States and considered dangerous. In this instance,
the FDA defined “dangerous” in these terms: “The article
appears to be dangerous to health when used in the dosage
or manner, or with the frequency or duration, prescribed,
recommended, or suggested in the labeling thereof.”
Practitioners of TCM state that pregnant women
should not use cicada because of the risk of miscarriage.
Side effects
No side effects from cicada preparations have been
reported in the United States as of early 2004.
Interactions
As of 2004, cicada decoctions have not been report-
ed to interact with any Western prescription medications.
490
KEY TERMS
Anticonvulsant — A medication given to prevent
or treat seizures.
Antipyretic — A medication or preparation given
to bring down fever. Cicada is thought to have an-
tipyretic properties.
Decoction — A medicine or herbal preparation
prepared by boiling. Cicada is usually taken in the
form of a decoction.
Exuvium — A cast-off shell of an insect or crus-
tacean. Cicada in traditional Chinese medicine is
made from the molted shell of a cicada.
Febrile — Characteristic of fever.
Qi — The Chinese term for life force or vital ener-
gy. It is sometimes spelled chi or ki.
Resources
BOOKS
Bensky, Dan, and Andrew Gamble. Chinese Herbal Medicine:
Materia Medica. rev. ed. Seattle: Eastland Press, 1993.
Kang-Ying, Wong, and Martha Dahlen. “Cicada.” In Streetwise
Guide to Chinese Herbal Medicine. San Francisco: China
Bks. & Periodicals, Inc., 1996.
Molony, David. The American Association of Oriental Medi-
cine’s Complete Guide to Chinese Herbal Medicine. New
York: The Philip Lief Group, 1998.
Reid, Daniel P. Chinese Herbal Medicine. Boston: Shambhala,
1993.
Williams, Tom. The Complete Illustrated Guide to Chinese
Medicine: A Comprehensive System for Health and Fit-
ness. Boston: Element Books, Inc., 1996.
PERIODICALS
Hsieh, M.T., W.H. Peng, F.T. Yeh, et al. “Studies of the Anti-
convulsive, Sedative and Hypothermic effects of Perios-
tracum Cicadae Extracts.” J Ethnopharmacology 35 (Jan-
uary 1991): 83-90.
Riegel, Garland. “Cicada in Chinese Folklore.” Cultural Ento-
mology Digest 3 (November 1994). <http://www.insects.
org/ced3/cicada_chfolk.html>.
ORGANIZATIONS
American Foundation of Traditional Chinese Medicine. 505
Beach Street, San Francisco, CA 94133. (415) 776-0502.
American Herbal Products Association. 8484 Georgia Ave.,
Suite 370, Silver Spring, MD 20910. (301) 588-1174.
<http ://w w w. ahpa. org> .
Food and Drug Administration (FDA). 5600 Fishers Lane,
Rockville, MD 20857. (888) 463-6332. <http://www.
fda.gov>.
National Center for Complementary and Alternative Medicine.
NCCAM Clearinghouse, National Institute of Health, P.O.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Box 8218, Silver Spring, MD 20907-8218. ( 888 ) 644-
6226. Fax: (301) 495-4957. <http://nccam.nih.gov>.
National Oriental Medicine Accreditation Agency (NOMAA).
3445 Pacific Coast Highway, Suite 300, Torrance, CA
90505. (213) 820-2045. <http://www.nomaaa.org>.
OTHER
Food and Drug Administration (FDA). “Refusal Actions by
FDA as Recorded in OASIS (Organization for the Ad-
vancement of Structured Information Standards), Taiwan,
Republic of China.” Rockville, MD: FDA, June 2003.
<http://www.fda.g 0 v/ 0 ra/ 0 asis/ 6 / 0 ra_ 0 asis_c_tw.html>.
Rebecca J. Frey, PhD
Cimicifuga racemosa see Black cohosh
Cinnamon bark
Description
Cinnamon bark ( Cinnamomum verum, C. zeylan-
icum, C. cassica) is harvested from a variety of ever-
green tree that is native to Sri Lanka and India. The tree
has thick, reddish brown bark, small yellow flowers, and
its leathery leaves have a spicy smell. It grows to a height
of approximately 20-60 ft (8-18 m) and is found primari-
ly in tropical forests. Cinnamon bark belongs to the Lau-
raceae family. Related species are Cinnamomum cassia
and Cinnamomum saigonicum (Saigon Cinnamon).
Cinnamon bark is cultivated in such tropical regions as
the Philippines and the West Indies. It is not grown in the
United States. Every two years the trees are cut to just
above ground level. The bark is harvested from the new
shoots, then dried. The outer bark is stripped away, leaving
the inner bark, which is the main medicinal part of the herb.
The use of cinnamon dates back thousands of years
to at least 2700 B.c. Chinese herbals from that time men-
tioned it as a treatment for fever, diarrhea, and menstru-
al problems. Indian Ayurvedic healers used it in a similar
manner. Cinnamon was introduced around 500 B.c. to the
Egyptians, who then added it to their embalming mix-
tures. Hebrews, Greeks, and Romans used it as a spice,
perfume, and for indigestion. Moses included cinnamon
in an anointing oil that he used. By the seventeenth centu-
ry, cinnamon was considered a culinary spice by Euro-
peans. American nineteenth century physicians pre-
scribed cinnamon as a treatment for stomach cramps,
nausea, vomiting, diarrhea, colic, and uterine problems.
General use
Cinnamon bark is a common ingredient in many
products such as toothpaste, mouthwash, perfume, soap,
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
lipstick, chewing gum, cough syrup, nasal sprays, and
cola drinks. A popular food flavoring, it is valued as one
of the world’s most important spices. It is also valuable
in the treatment of various ailments. Modern herbalists
prescribe cinnamon bark as a remedy for nausea, vomit-
ing, diarrhea, and indigestion. Chinese herbalists recom-
mend it for asthma brought on by cold, some digestive
problems, backache, and menstrual problems.
The medicinal value of the herb is attributed to the
oil extracted from the inner bark and leaves. The cinna-
mon bark harvested from the young branches is primari-
ly used for culinary purposes. In fact, the cinnamon
sticks commonly used in cooking are actually pieces of
rolled outer bark.
The active ingredients of the bark contain antibacte-
rial, antiseptic, antiviral, antispasmodic, and antifungal
properties. A study published in 2002 indicates that oil
from cinnamon bark inhibits the production of listeri-
olysin, a protein released by Listeria bacteria that de-
stroys healthy cells. Japanese research has shown cin-
namaldehyde, one of the constituents of cinnamon bark,
to be sedative and analgesic. Eugenol, another compo-
nent, contains pain-relieving qualities.
Cinnamon bark is helpful in strengthening and sup-
porting a weak digestive system. Research reports that
cinnamon bark breaks down fats in the digestive system,
making it a valuable digestive aid. It is used to treat nau-
sea, vomiting, diarrhea, stomach ulcers, acid indigestion,
heartburn, lack of appetite, and abdominal disorders.
A traditional stimulant in Chinese medicine, cinna-
mon bark has a warming effect on the body and is used for
conditions caused by coldness. The twigs of cinnamon en-
hance circulation, especially to the fingers and toes.
Cinnamon bark contains antiseptic properties that
help to prevent infection by killing decay-causing bacte-
ria, fungi, and viruses. One German study showed that
the use of cinnamon bark suppressed the cause of most
urinary tract infections and the fungus responsible for
vaginal yeast infections. It is also helpful in relieving
athlete’s foot.
Cinnamon bark is a frequent ingredient in tooth-
paste, mouthwash, and other oral hygiene products be-
cause it helps kill the bacteria that causes tooth decay
and gum disease. Inflammations of the throat and phar-
ynx may be relieved through its use.
Cinnamon bark is also known to control blood sugar
levels in diabetics. United States Department of Agricul-
ture (USDA) researchers have found that cinnamon bark
may reduce the amount of insulin required for glucose
metabolism. A dose of 1/8 to 1/4 tsp of ground cinnamon
491
Cinnamon bark
Cinnamon bark
Cinnamon bark drying by a road in Sumatra. (Photo Researchers, Inc. Reproduced by permission.)
per meal for diabetic patients may help to regulate their
blood sugar levels.
The spice has also garnered quite a reputation as an
aphrodisiac. A study at the Smell and Taste Research
Foundation in Chicago tested medical students’ reactions
to various aromas by attaching measurement devices to
the students’ penises. The smell of hot cinnamon buns
generated the most blood flow of all the scents.
Cinnamon bark promotes menstruation. It has been
used to treat menstrual pain and infertility. Women in
India take it as a contraceptive after childbirth.
Other conditions in which cinnamon bark may be
helpful include fevers and colds, coughs and bronchitis,
infection and wound healing, some forms of asthma, and
blood pressure reduction.
More recently, cinnamon bark has been shown to be
an effective natural snake repellent that is safer to use
than synthetic pest management chemicals.
Preparations
Cinnamon bark is available in several forms from
Chinese pharmacists, Asian grocery stores, and health
492
food stores: fresh or dried bulk, pill, tincture, and as an
essential oil.
Dosage
In Chinese medicine, cinnamon is usually taken in
combination with other herbs. Below are some typical
dosages for cinnamon alone.
• Tincture: Take up to 4 ml with water three times daily.
• Tea: Take 1 cup 2-3 times daily at mealtimes.
• Crushed: Take 1/2 tsp (2-4 g) daily.
Precautions
• Cinnamon bark may cause an allergic reaction in some
individuals.
• Cinnamon bark is not recommended for pregnant or
nursing women.
• Do not take essential oil of cinnamon bark internally un-
less under professional supervision. Internal ingestion
may cause nausea, vomiting, and possible kidney damage.
• Essential oil of cinnamon bark is one of the most haz-
ardous essential oils and should not be used on the
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
skin. External application of the oil may cause redness
and burning of skin.
• Cinnamon bark should not be given to children under
two years of age.
• Cinnamon bark is considered toxic if taken in excess.
• Cinnamon bark should not be given to persons with in-
flammatory liver disease; in large quantities, it can irri-
tate the liver.
Side effects
Mild side effects include stomach upset, sweating,
and diarrhea. Large doses can cause changes in breath-
ing, dilation of blood vessels, sleepiness, depression, or
convulsions. Excessive use of cinnamon bark may cause
red, tender gums; mouth ulcers; inflamed taste buds; and
a severe burning sensation in the mouth.
Interactions
Some interactions with other medications have been
reported. Cinnamon oil may cause skin irritation if ap-
plied to the skin together with acne medications that
contain retinoic acid. Cinnamon bark has also been re-
ported to intensify the effects of medications given to
lower blood pressure. Persons taking cinnamon bark
should discontinue its use two weeks before any surgery
requiring general anesthesia because of the herb’s ten-
dency to lower blood pressure.
Resources
BOOKS
Chevalier, Andrew The Encyclopedia of Medicinal Plants. New
York: DK Publishing Inc., 1996.
Duke, James A., Ph.D. The Green Pharmacy Emmaus, PA: Ro-
dale Press, 1997.
Pelletier, Kenneth R., MD. The Best Alternative Medicine. New
York: Simon & Schuster, 2002.
Reid, Daniel. Chinese Herbal Medicine. Boston: Shambhala,
1996.
PERIODICALS
Clark, L., and J. Shivik. “Aerosolized Essential Oils and Indi-
vidual Natural Product Compounds as Brown Treesnake
Repellents.” Pest Management Science 58 ( August 2002):
775-783.
Lee, K. G., and T. Shibamoto. “Determination of Antioxidant
Potential of Volatile Extracts Isolated from Various Herbs
and Spices.” Journal of Agricultural and Food Chemistry
50 (August 14, 2002): 4947-4952.
Smith-Palmer, A.. J. Stewartt, and L. Fyfe. “Inhibition of Liste-
riolysin O and Phosphatidylcholine-Specific Production in
Listeria monocytogenes by Subinhibitory Concentrations
of Plant Essential Oils.” Journal of Medical Microbiology
51 (July 2002): 567-574.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Analgesic — A pain-relieving substance.
Antispasmodic — A substance that relieves muscle
spasms or cramping.
Aphrodisiac — A drug or other substance that
arouses or is thought to arouse sexual desire.
Essential oil — A concentrated oil that has been
distilled from a plant.
Sedative — A drug or herb that has a calming and
relaxing effect. Sedatives are used to aid sleep and
ease pain, and are often given as mild tranquilizers.
ORGANIZATIONS
American Association of Oriental Medicine. 5530 Wisconsin
Avenue, Suite 1210, Chevy Chase, MD 20815. (301) 941-
1064. <www.aaom.org>.
Rocky Mountain Herbal Institute. P. O. Box 579, Hot Springs,
MT 59845. (406) 741-3811. <www.rmhiherbal.org>.
Jennifer Wurges
Rebecca J. Frey, PhD
Cirrhosis
Definition
Cirrhosis is a chronic degenerative disease of the
liver in which normal liver cells are damaged and then
replaced by scar tissue. There are different types of cir-
rhosis that could afflict a person.
Description
Cirrhosis changes the structure of the liver and the
blood vessels that nourish it. The disease reduces the
liver’s ability to manufacture proteins, complex carbohy-
drates, fats, cholesterol, and to process hormones, nutri-
ents, medications, and poisons. Cirrhosis worsens over
time and can become potentially life threatening.
Cirrhosis is the seventh leading cause of disease-re-
lated death in the United States. It is the third most com-
mon cause of death in adults between the ages of 45 and
65. It is twice as common in men as in women. The dis-
ease occurs in more than half of all malnourished chron-
ic alcoholics, and kills about 25,000 people a year. In
Asia and Africa, however, most deaths from cirrhosis are
due to chronic hepatitis B.
493
Cirrhosis
Cirrhosis
A close-up image indicating biliary cirrhosis of the liver.
(Custom Medical Stock Photo. Reproduced by permission.)
Types of cirrhosis
• Portal, or nutritional cirrhosis. The most common form
of the disease in the United States. About 30-50% of
all cases of cirrhosis are this type. Nine out of every 10
people who have nutritional cirrhosis have a history of
alcoholism. Portal cirrhosis is also called Laennec’s
cirrhosis.
• Biliary cirrhosis. Caused by liver bile-duct diseases that
impede bile flow. Bile is formed in the liver and carried
via the ducts to the intestines. Bile then helps digest
fats in the intestines. Biliary cirrhosis can scar or block
these ducts. It represents 15-20% of all cirrhosis.
• Postnecrotic cirrhosis. Caused by chronic infections.
This form of the disease affects up to 40% of all pa-
tients who have cirrhosis.
• Pigment cirrhosis (hemochromatosis). Disorders like
the inability to metabolize iron and similar disorders
may cause pigment cirrhosis, which accounts for
5-10% of all instances of the disease.
Causes & symptoms
Causes and risk factors
Long-term alcoholism is the primary cause of cir-
rhosis in the United States. Men and women respond dif-
ferently to alcohol. Although most men can safely con-
sume two to five drinks a day, one to two drinks a day
can cause liver damage in women. Individual tolerance
to alcohol varies, but people who drink more and drink
more often have a higher risk of developing cirrhosis. In
some people, one drink a day can cause liver scarring.
Chronic liver infections, such as hepatitis B and par-
ticularly hepatitis C, are commonly linked to cirrhosis.
People at high risk of contracting hepatitis B include
those exposed to the virus through contact with blood
and body fluids. This includes healthcare workers and
intravenous (IV) drug users. In the past, people have
contracted hepatitis C through blood transfusions. As of
2003, cirrhosis resulting from chronic hepatitis has
emerged as a leading cause of death among HIV-positive
patients; in Europe, about 30% of HIV-positive patients
are coinfected with a hepatitis virus.
Liver injury, reactions to prescription medications,
certain autoimmune disorders, exposure to toxic sub-
stances, and repeated episodes of heart failure with liver
congestion can cause cirrhosis. A family history of dis-
eases can genetically predispose a person to develop cir-
rhosis. These are:
• a lack of a specific liver enzyme (alpha r antitrypsin de-
ficiency)
• the absence of a milk-digesting enzyme (galactosemia)
• an inability to convert sugars to energy (glycogen stor-
age disease)
• an absorption deficit in which excess iron is deposited
in the liver, pancreas, heart, and other organs
• a disorder characterized by accumulations of copper in
the liver, brain, kidneys, and corneas (Wilson's disease)
Obesity has recently been recognized as a risk fac-
tor in nonalcoholic hepatitis and cirrhosis. Some sur-
geons are recommending as of 2003 that patients sched-
uled for weight-reduction surgery have a liver biopsy to
evaluate the possibility of liver damage.
Symptoms
Symptoms of cirrhosis are usually caused by the
loss of functioning liver cells or organ swelling due to
scarring. The liver enlarges during the early stages of ill-
ness. Patients may experience:
• anemia
• bleeding gums
• constipation
• decreased interest in sex
• diarrhea
• dull abdominal pain
• extremely dry skin and intense itching
• fatigue
• fever
• fluid in the lungs
• hallucinations
• indigestion
• lethargy
• lightheadedness
494
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• loss of appetite
• muscle weakness
• musty breath
• nausea
• painful nerve inflammation (neuritis)
• portal hypertension (this type of hypertension can be
life threatening; it can cause veins to enlarge in the
stomach and esophagus; the enlarged veins, called
varices, can rupture and bleed massively)
• redness of the palms of the hands
• slurred speech
• tremors
• dark yellow or brown urine and black or bloody stools
• vomiting
• weakness
• weight loss
• yellowish whites of the eyes and skin, indicating the
development of jaundice
As the disease progresses, other symptoms usually
appear:
• spleen enlarges and fluid collects in the abdomen (as-
cites) and legs (edema)
• spider-like blood vessels appear on the chest and shoul-
ders, and bruising becomes common
• men sometimes lose chest hair; their breasts may grow
and their testicles may shrink
• women may have menstrual irregularities
If the liver loses its ability to remove toxins from the
brain, the patient may have additional symptoms. The
patient may become forgetful and unresponsive, neglect
personal care, have trouble concentrating, and acquire
new sleeping habits. These symptoms are related to am-
monia intoxication and the failure of the liver to convert
ammonia to urea. High protein intake in these patients
can also lead to these symptoms.
Cirrhosis worsens over time and can become poten-
tially life-threatening. This disease can cause:
• excessive bleeding (hemorrhage)
• impotence
• liver cancer
• coma due to accumulated ammonia and body wastes
(liver failure)
• sepsis (blood poisoning)
• death
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Diagnosis
A patient’s medical history can reveal illnesses or
lifestyles likely to lead to cirrhosis. Liver changes can be
seen during a physical examination. A doctor who sus-
pects cirrhosis may order blood and urine tests to measure
liver function. Because only a small number of healthy
cells are needed to carry out essential liver functions, test
results may be normal even when cirrhosis is present.
In about 10 out of every 100 patients, the cause of cir-
rhosis cannot be determined. Many people who have cir-
rhosis do not have any symptoms (often called compensat-
ed cirrhosis). Their disease is detected during a routine
physical or when tests for an unrelated medical problem
are performed. This type of cirrhosis can also be detected
when complications occur (decompensated cirrhosis).
Computed tomography scans (CT), ultrasound, and
other imaging techniques can be used during diagnosis.
They can help determine the size of the liver, indicate
healthy and scarred areas of the organ, and detect gall-
stones. Cirrhosis is sometimes diagnosed during surgery
or by examining the liver with a laparoscope. This view-
ing device is inserted into the patient’s body through a
tiny incision in the abdomen.
Liver biopsy is usually needed to confirm a diagno-
sis of cirrhosis. In this procedure, a tissue sample is re-
moved from the liver and examined under a microscope
in order to learn more about the organ's condition and to
properly diagnose it.
A newer and less invasive test involves the measure-
ment of hyaluronic acid in the patient's blood serum. As
of 2003, however, the serum hyaluronic acid test is most
useful in monitoring the progress of liver disease; it is
unlikely to completely replace liver biopsy in the diagno-
sis of cirrhosis.
Treatment
Before starting on any alternative treatment pro-
gram, patients should consult their doctor for monitoring
of side effects and effectiveness of treatment. Any nutri-
tional changes should be discussed with the primary care
provider. Alternative treatments that may be of help to
cirrhotic patients include nutritional and juice therapy.
Western herbal therapy, traditional Chinese medicine,
and homeopathy.
Nutritional therapy
To support liver function and slow down disease pro-
gression, a naturopath may recommend the following:
• Avoid liver toxins. Cirrhotic patients must completely
avoid alcohol. Alcohol accelerates liver failure and has-
495
Cirrhosis
Cirrhosis
tens death in cirrhotic patients. In addition, even over-the-
counter drugs, such as acetaminophen (Tylenol), should
be avoided because they can be toxic in cirrhotic patients.
• Juice therapy helps the liver detoxify toxins from the
body. Patients should mix one part of pure juice with
one part of water before drinking.
• Eat smaller meals. To avoid overworking the liver, five
or six smaller, lighter meals per day are recommended.
• Avoid fatty foods, especially those prepared with animal
fats or hydrogenated oils and processed foods. These
types of foods put additional demands on the liver.
• Eat only lean proteins (containing no fats) and in limit-
ed amounts. Vegetable proteins, such as those found in
legumes or tofu, and whole grains are preferred. High
protein intake causes increases in ammonia levels in
the blood, possibly resulting in mental confusion, and
in severe cases, coma. However, do not severely limit
protein intake, as this may cause protein deficiency and
impair healing process.
• Increase consumption of fruits and steamed vegetables.
Fruits and vegetables are easy to digest, thus less work
for the liver. In addition, they are good sources of vita-
mins, minerals, and antioxidants that help the liver
detoxify and heal.
• Practice intermittent fasting.
• Take supplements that can improve digestion and help
the liver heal and prevent further injury to the liver.
They include pancreatic enzymes, milk thistle (Sily-
bum marianum), lipotropic agents such as vitamin B 6 ,
vitamin B 12 , folic acid, choline, alpha lipoic acid, be-
taine, and methionine.
In 2001, several studies were compared to determine
the effectiveness of milk thistle in treating cirrhosis and
other liver diseases. The active component in milk this-
tle, silymarin, promotes liver protein synthesis. Studies
appear to show improved survival among cirrhosis pa-
tients who use milk thistle (study subjects received 140
mg of silymarin three times a day).
Other therapies
Other types of therapies the patient may want to
consider are naturopathic hydrotherapy, and ones that
may improve immune function, including stress reduc-
tion, guided imagery, and massage.
Traditional Chinese medicine
Depending on a patient’s specific condition, an ex-
pert Chinese herbalist may prescribe herbal remedies
that may help improve liver function. Animal studies
have shown that the following Chinese herbs may have
protective effects on the liver:
496
• Propolis
• Bupleurum chinense is the most frequently used herb
for a variety of liver diseases
• Phellodendron wilsonii
• Clementis chinensis
• Solanum incanum
• Ixeris chinensis
• Gardenia jasminoides
Western herbal therapy
Patients should consult an experienced herbalist for
specific herbal treatments. There has also been moderate
evidence regarding the use of milk thistle in helping to
alter the effects of cirrhosis; however, there is no conclu-
sive data as of 2002.
Homeopathy
For homeopathic therapy, patients should consult a
homeopathic physician who will prescribe specific reme-
dies based on knowledge of the underlying cause.
Allopathic treatment
The goal of treatment is to cure or reduce the condi-
tion causing cirrhosis, prevent or delay disease progres-
sion, and prevent or treat complications.
Salt and fluid intake is often limited, and activity is
encouraged. A diet high in calories and moderately high in
protein can benefit some patients. Tube feedings or vita-
min supplements may be prescribed if the liver continues
to deteriorate. Patients are asked not to consume alcohol.
Medication
Iron supplements, diuretics, and antibiotics may be
used for anemia, fluid retention, and ammonia accumu-
lation associated with cirrhosis. Vasoconstrictors are
sometimes needed to stop internal bleeding and
antiemetics may be prescribed to control nausea.
Laxatives help the body absorb toxins and acceler-
ate their removal from the digestive tract. Beta-blockers
may be prescribed to control cirrhosis-induced portal hy-
pertension. Interferon medicines may be used by patients
with chronic hepatitis B and hepatitis C to prevent post-
hepatic cirrhosis.
Surgery
Medication that causes scarring can be injected di-
rectly into veins to control bleeding from varices in the
stomach or esophagus. Varices may require a special sur-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
gical procedure called balloon tamponade ligation to
stop the bleeding. Surgery may be required to repair dis-
ease-related throat damage. It is sometimes necessary to
remove diseased portions of the spleen and other organs.
The incidence of liver cancer related to cirrhosis in
the United States has increased 75% since the early 1990s.
Partial surgical removal of the liver in patients with early-
stage cancer of the liver appears to be as successful as
transplantation, in terms of the 5-year survival rate.
Liver transplants can benefit patients with advanced
cirrhosis. However, the new liver will eventually become
diseased unless the underlying cause of cirrhosis (such
as alcoholism) is removed.
Supportive measures
A balanced diet promotes regeneration of healthy
liver cells. Eating five or six small meals throughout the
day should prevent the sick or bloated feeling patients
with cirrhosis often have after eating. Alcohol and caf-
feine, which destroy liver cells, should be avoided, as
should any other foods that upset the stomach. Patients
with brain disease associated with cirrhosis should avoid
excessive amounts of protein in the diet.
A patient can keep a food diary that describes what
was eaten, when it was eaten, and how the patient felt af-
terwards. This diary can be useful in identifying foods
that are hard to digest and in scheduling meals to coin-
cide with the times the patient is most hungry.
Patients who have cirrhosis should weigh them-
selves every day and notify their doctor of a sudden gain
of 5 lb (2.3 kg) or more within a one to two week period.
A doctor should also be notified if symptoms of cirrhosis
appear in anyone who has not been diagnosed with the
disease. A doctor should also be notified if a patient di-
agnosed with cirrhosis:
• vomits blood
• passes black stools
• seems confused or unresponsive
• shows signs of infection (redness, swelling, tenderness,
pain)
Expected results
Cirrhosis-related liver damage cannot be reversed,
but further damage can be prevented by patients who:
• eat properly
• get enough rest
• do not consume alcohol
• remain free of infection
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
If the underlying cause of cirrhosis cannot be cor-
rected or removed, scarring will continue. As scarring
continues, the liver will fail, and the patient will proba-
bly die within five years. Patients who stop drinking
after being diagnosed with cirrhosis can increase their
likelihood of living more than a few years from 40% to
60-70%.
Prevention
Eliminating alcohol abuse could prevent 75-80% of
all cases of cirrhosis.
Other preventive measures include:
• maintaining a healthy diet that includes whole foods
and grains, vegetable, and fruits
• obtaining counseling or other treatment for alcoholism
• taking precautions (practicing safe sex, avoiding dirty
needles) to prevent hepatitis
• getting immunizations against hepatitis if a person is in
a high-risk group
• receiving appropriate medical treatment quickly when
diagnosed with hepatitis B or hepatitis C
• having blood drawn at regular intervals to rid the body
of excess iron from hemochromatosis
• using medicines (chelating agents) to rid the body of
excess copper from Wilson’s disease
• wearing protective clothing and following product di-
rections when using toxic chemicals at work, at home,
or in the garden
In 2001, research scientists identified the protein
segment and method in which excess tissue grows in dis-
eases like cirrhosis. With further study, the discovery
might one day result in an oral or inhalable peptide for
those with cirrhosis.
Resources
BOOKS
Andrews, Marcia, and Robert B. Cooper. Everything You Need
to Know About Diseases. Springhouse, PA: Springhouse
Corporation, 1997.
The Burton Goldberg Group. “Cirrhosis.” In Alternative Medi-
cine: The Definitive Guide. 2nd ed. Tiburon, CA: Future
Medicine Publishing, Inc., 2002.
“Cirrhosis.” Section 4, Chapter 41 in The Merck Manual of Di-
agnosis and Therapy, edited by Mark H. Beers, MD, and
Robert Berkow, MD. Whitehouse Station, NJ: Merck Re-
search Laboratories, 2002.
Editors of Time-Life Books. The Medical Advisor: The Com-
plete Guide to Alternative & Conventional Treatments.
Alexandria, VA: Time Life Inc., 1996.
“Liver Problems.” In The Hamlyn Encyclopedia of Comple-
mentary Health. London: Reed Inti. Books Ltd.
497
Cirrhosis
Cnidium seeds
Murray, Michael T., and Joseph E. Pizzorno. “Detoxification."
In Encyclopedia of Natural Medicine. Rocklin, CA: Prima
Publishing, 1998.
Pelletier, Kenneth R., MD. The Best Alternative Medicine, Part
II, “CAM Therapies for Specific Conditions: Alcoholism.”
New York: Simon & Schuster, 2002.
PERIODICALS
Cha, C. H., L. Ruo, Y. Fong, et al. “Resection of Hepatocellular
Carcinoma in Patients Otherwise Eligible for Transplanta-
tion.” Annals of Surgery 238 (September 2003): 315-321.
Foreman, M. G., D. M. Mannino, and M. Moss. “Cirrhosis as a
Risk Factor for Sepsis and Death: Analysis of the National
Hospital Discharge Survey.” Chest 124 (September 2003):
1016-1020.
Higuchi, H., and G. J. Gores. “Mechanisms of Liver Injury: An
Overview.” Current Molecular Medicine 3 (September
2003): 483-490.
Kamath. B. M., and D. A. Piccoli. “Heritable Disorders of the
Bile Ducts.” Gastroenterology Clinics of North America
32 (September 2003): 857-875.
Lin, Song-Chow, Yun-Ho Lin. Chin-Fa Chen, Chia-Yu Chung,
and Shih-Hsien Hsu. “The Hepatoprotective and Thera-
peutic Effects of Propolis Ethanol Extract on Chronic Al-
cohol-induced Liver Injuries.” American Journal of Chi-
nese Medicine 25, no. 3^1 (1997): 325-332.
“Management of Alcoholic Hepatitis." Drug Therapy Bulletin
41 (July 2003): 49-52.
Moretto, M., C. Kupski, C. C. Mottin, et al. “Hepatic Steatosis
in Patients Undergoing Bariatric Surgery and Its Relation-
ship to Body Mass Index and Co-Morbidities.” Obesity
Surgery 13 (August 2003): 622-624.
“Peptides: Peptide Critical to Cirrhosis Development.” Drug
Discovery and Technology News 4, no. 1 1 (November
2001).
Phillips, M. G., V. R. Preedy, and R. D. Hughes. “Assessment
of Prognosis in Alcoholic Liver Disease: Can Serum
Hyaluronate Replace Liver Biopsy?” european Journal of
Gastroenterology and Hepatology 15 (September 2003):
941-944.
Ristig, M., H. Drechsler, J. Crippin, et al. “Management of
Chronic Hepatitis B in an HIV-Positive Patient with 3TC-
Resistant Hepatitis B Virus.” AIDS Patient Care and STDs
17 (September 2003): 439^142.
Walsh, Nancy. “Milk Thistle for Liver Disease (Alternative
Medicine: An Evidence-Based Approach.” Internal Medi-
cine News (January 1, 2002): 10.
ORGANIZATIONS
American Liver Foundation. 1425 Pompton Ave., Cedar Grove,
NJ 07009. (800) 465-4837. <http://www.liverfoundation.
org>.
United Network for Organ Sharing. 1100 Boulders Parkway,
Suite 500, PO. Box 13770, Richmond, VA 23225-8770.
(804) 330-8500. <http://www.unos.org>.
OTHER
National Institute of Diabetes and Digestive and Kidney Dis-
eases (NIDDK). Cirrhosis of the Liver. April 200 [cited
498
October 2002]. <http://www.niddk.nih.gov/health/digest/
pubs/cirrhosi/cirrhosi.htm>.
Teresa G. Odle
Rebecca J. Frey, PhD
Clap see Gonorrhea
Clinical ecology see Environmental therapy
Cnidium seeds
Description
A variety of carrot unknown to most Americans,
Cnidium monnieri is a leafy annual with flowers that
grow in clusters. The herb has been a popular remedy in
Asian folk medicine for millennia, being first described
about 2,000 years ago in the Chinese herbal classic Shen
Nong Ben Cao Jing. Cnidium’s reputation for treating
itchy skin conditions persists to this day. Only the seeds
and essential oil of Cnidium monnieri, which belongs to
the Apiaceae family, are used as a drug.
The seeds, which are also referred as she chuang zi
or she chuang dze, are somewhat yellow in color and
have a sweet smell. They are believed to have several im-
portant therapeutic properties, including antibacterial, an-
tifungal, and astringent effects. Some of these claims
have been supported by animal and laboratory studies, in
one test tube investigation, published in the Chinese jour-
nal Chung Kuo Chung Yao Tsa Chih in 1991, researchers
demonstrated that Cnidium monnieri was effective
against several strains of bacteria and fungi. Cnidium
monnieri also appears to have anti-pruritic activity, mean-
ing that the herb may help to alleviate itching. In a study
of mice, published in the Japanese journal Biological &
Pharmaceutical Bulletin in 2000, cnidium was shown to
significantly reduce the itch-scratch response in rodents.
In the somewhat ethereal parlance of Chinese folk
medicine — in which diseases are often believed to occur
due to disruptions in the flow of bodily energy — cnidium
seeds are considered warm, bitter, and acrid. The essen-
tial oils derived from the seeds include camphene, bor-
neol, pinene, and terpineol.
General use
While not approved by the FDA, cnidium seeds
have been reported to have several beneficial effects. Be-
cause the seeds have not been extensively studied in peo-
ple, their effectiveness is based mainly on animal studies
and their ancient reputation as a folk remedy in China. In
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
modem times, the herb is primarily used to treat skin
conditions such as scabies, eczema, ringworm, and
itchy, oozing skin lesions, it is also thought to be helpful
in the treatment of vaginitis and vaginal discharge. Cni-
dium is used externally for all the purposes mentioned
above. The seeds may also be taken internally to treat
impotence as well as infertility in both sexes.
Cnidium has shown some intriguing activity against
asthma and osteoporosis in animal studies, though the
clinical implications of these findings are not yet known.
In one investigation, published in the Chinese journal
Chung-kuo Chung Ya Yao Tsa Chih in 1990, chemicals in
Cnidium monnieri called coumarins appeared to protect
guinea pigs from the effects of bronchial asthma, which
the animals experienced after inhaling histamine. The re-
searchers also demonstrated that the coumarins can relax
the tracheal muscles of guinea pigs in test tube experi-
ments. A possible link between cnidium and osteoporo-
sis was examined in two rodent studies published in the
Chinese journal Chung-kuo Yao Li Hsueh Pao in 1994
and 1997. Both studies suggest that cnidium can help to
prevent osteoporosis induced by glucocorticoid drugs.
Preparations
The optimum dosage of cnidium seeds has not been
established with any certainty. Dosage may range from
3-12 g. Because cnidium seeds have been recommended
for a variety of purposes, and can be used internally and
externally, consumers are advised to consult a doctor ex-
perienced in the use of alternative remedies or Chinese
medicine to determine proper dosage.
To treat skin conditions, the herb is usually applied
to the skin in the form of a solution or ointment. Vagini-
tis and vaginal discharge are treated with a douche pre-
pared from the seeds.
In Chinese folk medicine, cnidium seeds are often
combined with other herbs or minerals. When used ex-
ternally, the seeds may be mixed with stemona and
sophora for itchy, oozing skin lesions or with calomel for
scabies and eczema (including genital eczema). Taken
internally, cnidium seeds are often combined with
schisandra or cuscuta to treat impotence or infertility.
Cnidium seeds are generally available in bulk or in
combination products (such as powders or pills) that
contain several different herbs.
Precautions
Cnidium seeds are not known to be harmful when
taken in recommended dosages, though it is important to
remember that the long-term effects of taking the seeds
(in any amount) have not been investigated. Due to lack
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
of sufficient medical study, cnidium seeds should be used
with caution in children, women who are pregnant or
breast-feeding, and people with liver or kidney disease.
Cnidium seeds should not be applied to skin that is
hot, dry, and sore.
Do not confuse cnidium seeds with the essential oil
derived from them. While the seeds may be taken inter-
nally, the essential oil should not be ingested except
under the supervision of a doctor.
While cnidium has shown some activity against
bronchial asthma and osteoporosis in animal studies, it is
not yet recommended for either of these conditions. Both
diseases are potentially serious and require a doctor’s care.
Side effects
When taken in recommended dosages, cnidium
seeds are not associated with any bothersome or signifi-
cant side effects.
Interactions
Cnidium seeds should not be used at the same time
as croton seeds, fritillaria, or peony root, according to
practitioners of Chinese folk medicine. When used exter-
nally, cnidium seeds have been combined with stemona,
sophora, and calomel without apparent harm. When used
internally, the seeds have been safely mixed with schis-
andra and cuscuta.
Resources
BOOKS
Editors of Time-Life Books. The Drug and Natural Medicine
Advisor. Alexandria, VA: Time-Life Books, 1997.
PERIODICALS
Cai, J., B. Yu, G. Xu, et al. “Studies on the quality of fructus
Cnidii-comparison of antibacterial action.” Chung Kuo
ChungYao Tsa Chih 16, no. 8 (1991): 451-453, 510.
Chen, Z. and X. Duan. “Mechanism of the antiasthmatic effect
of total coumarins in the fruit of Cnidium monnieri (L.)
Cuss.” Chung Kuo Chung Yao Tsa Chih 15, no. 5 (1990):
304-305, 320.
Liao, J. M., Q. A. Zhu, H. J. Lu, et al. “Effects of total
coumarins of Cnidium monnieri on bone density and bio-
mechanics of glucocorticoids-induced osteoporosis in
rats.” Chung Kuo Yao Li Hsueh Pao 18, no. 6 (1997): 519-
521.
Tohda, C., Y. Kakihara, K. Komatsu, et al. “Inhibitory effects
of methanol extracts of herbal medicines on substance P-
induced itch-scratch response.” Biol Pharm Bull 23, no. 5
(2000): 599-601.
Xie, H., Q. N. Li, L. F. Huang, et al. “Effect of total coumarins
from dried fruits of Cnidium monnieri on glucocorticoid-
induced osteoporosis in rats.” Chung Kuo Yao Li Hsueh
Pao 15, no. 4 (1994): 341-344.
499
Cnidium seeds
Codonopsis root
KEY TERMS
Astringent — An agent that helps to contract tissue
and prevent the secretion of internal body fluids
such as blood or mucus. Astringents are typically
used to treat external wounds or to prevent bleed-
ing from the nose or throat.
Eczema — A condition characterized by inflamed,
itchy skin. Eczema may also involve oozing, crust-
ing, and scaling.
Essential oil — A term describing a wide variety of
concentrated plant-derived oils. They are often
used to make soaps and perfumes, as well as being
used extensively in natural medical remedies.
Osteoporosis — An age-related disease in which
bones become fragile and prone to debilitating
fractures.
Ringworm — A fungal skin infection that predomi-
nantly affects children. The condition is character-
ized by reddish, scaly rings on the skin.
Scabies — A contagious rash caused by the Sar-
coptes scabiei mite, which burrows into the upper
layer of the skin in order to lay eggs. Scabies is
characterized by intense itching.
Vaginitis — An inflammation of the mucous mem-
brane that lines the interior of the vagina. It often re-
sults from a Candida or other fungal infection, and
is accompanied by pain, itching, and discharge.
ORGANIZATIONS
American Botanical Council. P.O. Box 144345, Austin, TX
78714-4345.
OTHER
OnHealth. http://www.onhealth.com.
MEDLINE, http://igm.nlm.nih.gov.
Greg Annussek
Cobalain see Vitamin B 12
Cocklebur see Burdock root
Codonopsis root
Description
Codonopsis is the fresh or dried root of the plant
Codonopsis pilosula. Codonopsis is a small perennial
500
native to Asia. It is especially abundant in the Shanxi and
Szechuan provinces of China. Codonopsis grows to a
height of about 5 ft (1.5 m) in dense brushy thickets and
at the edges of woods where the soil remains moist.
Codonopsis is well known in Chinese herbalism. Its Chi-
nese name is tang shen. The plant is also cultivated in
many other parts of the world, including the United
States, because of its distinctive bell-shaped greenish-
purple flowers. Other names for codonopsis include bas-
tard ginseng and bonnet bellflower.
General use
Codonopsis, or tang shen , has been used in China
for more than 2,000 years. It is one of the best-known
and most widely used herbs in Chinese medicine. In the
Chinese system of health, the yin aspects of nature,
which have to do with cold, moisture, dark, and passivi-
ty, must be kept in balance with the yang aspects, which
have to do with heat, dryness, light, and activity. Ill
health occurs when the energies and elements of the
body are out of balance with nature or in interior dishar-
mony. Health is restored by taking herbs and treatments
that restore this balance. In traditional Chinese medi-
cine, codonopsis is said to have a neutral nature and a
sweet taste. It is used as a tonic for the lungs and spleen
and to strengthen and nourish the blood and balance
metabolic function.
Like ginseng, codonopsis is an adaptogen. Adapto-
gens are substances that non-specifically enhance and reg-
ulate the body’s ability to withstand stress. They increase
the body’s general performance in ways that help the
whole body resist disease. Codonopsis is thought to bene-
fit the entire body by boosting strength, increasing stami-
na and alertness, rejuvenating the body, strengthening the
immune system, aiding recovery from chronic illness, re-
ducing stress, and stimulating the appetite. It belongs to a
class of herbs called stomachics, which means that they
tonify the stomach to improve digestive functions.
Codonopsis is sometimes called the “poor man’s gin-
seng.” It is often substituted in Chinese herbal formulas
for ginseng, although it has a milder action that lasts for a
shorter time. Scientists have shown that the actions of
ginseng and codonopsis, although similar, are caused by
very different chemical compounds. This type of substitu-
tion based on function rather than chemical structure,
however, is considered acceptable in Chinese medicine.
In addition to the whole-body effects of codonopsis,
the herb is used for a number of other specific conditions.
It can be taken internally, in various combinations with
other herbs, for anemia; asthma; cancer; diarrhea;
headaches, especially tension headaches; hemorrhoids;
high blood pressure; mucus in the lungs and shortness of
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
breath; nausea and vomiting; neck tension; and a pro-
lapsed (collapsed) uterus. Codonopsis can also be taken
internally as a galactogogue, which means that it increas-
es the supply of breast milk in nursing mothers.
University and medical researchers became interest-
ed in codonopsis only in the 1980s. Most of the research
work has been done in China. Overall research findings
suggest that codonopsis is relatively effective and safe.
Most of this work has been done in test tubes and on
small laboratory animals. Large-scale controlled human
studies have yet to be done.
In many studies, scientists have found that extract of
codonopsis root helps mice withstand stress, whether
that stress comes from swimming, high temperatures, or
oxygen deprivation. Other studies show that codonopsis
boosts the immune system. In research done in China in
1997, codonopsis was shown to protect laboratory ani-
mals against gastric ulcers.
Other research has shown that codonopsis can in-
crease the number of red blood cells and hemoglobin in
animals. It also improves the production of antibodies.
Studies are being done to determine if codonopsis would
be useful in treating HIV infection; such autoimmune
diseases as systemic lupus erythematosus (SLE), or
immune systems that have been weakened by
chemotherapy. Although the results are promising, defin-
itive answers cannot be obtained until controlled studies
on humans are performed.
Preparations
Codonopsis root comes in different grades. Roots at
least three years old are harvested in the autumn after the
leaves of the plant have died back. The best quality roots
are large, clean, and dry on the surface, but moist inside
when chewed. Codonopsis has a pleasant taste when
eaten raw. Poor quality codonopsis is almost tasteless
and may be dry and dirty.
Although codonopsis is sometimes eaten raw, the
dried root is usually made into a decoction, which is an
extract of the plant made by boiling. Tinctures, which are
solutions of alcohol and water-containing plant matter,
are used in the West but not in traditional Chinese medi-
cine. Commercially produced tablets, capsules, and tinc-
tures of codonopsis are available. Dosage varies with the
condition being treated. Codonopsis is often used in Chi-
nese preparations, and may replace ginseng in almost
any formula.
Precautions
Years of use in China suggest that codonopsis is not
toxic and can be used by almost everyone. In China, ba-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Adaptogen — A substance that regulates a body
system, either stimulating or suppressing it to
bring it back within its normal range.
Decoction — An extract of a plant made by boiling
it, then straining the solid material out. The result-
ing liquid is the decoction.
Galactogogue — A substance or medication that in-
creases the flow of breast milk in nursing mothers.
Stomachic — A substance or medication that toni-
fies the stomach to improve digestive functions.
Tincture — A plant extract prepared in a solution
of alcohol and water.
Yang aspects — In traditional Chinese medicine,
yang aspects are qualities of nature such as
warmth, activity, light, and dryness.
Yin aspects — Yin aspects are the opposite of yang
aspects and are represented by qualities such as
cold, moisture, darkness, and passivity.
bies are sometimes given pieces of codonopsis root to
teethe on. It is given to children to help them grow
strong, and breast-feeding women use it as a tonic to in-
crease the quantity of milk they produce.
Side effects
No unwanted side effects are reported with the use
of codonopsis.
Interactions
There are few, if any, studies of how codonopsis in-
teracts with traditional Western medicines. It has been
used for many years in combination with other Chinese
herbs without incident.
Resources
BOOKS
Chevallier, Andrew. Encyclopedia of Medicinal Plants. New
York: DK Publishing, Inc., 1996.
Molony. David. Complete Guide to Chinese Herbal Medicine.
New York: Berkeley Books, 1998.
Teegaurden, Ron. The Ancient Wisdom of the Chinese Tonic
Herbs. New York: Warner Books, 1998.
ORGANIZATIONS
American Association of Oriental Medicine (AAOM). 433
Front Street, Catasauqua, PA 18032. (610) 266-2433.
Tish Davidson
501
Codonopsis root
Coenzyme Q
Coenzyme Q 10
Description
Coenzyme Q 10 is a fat-soluble nutrient also known
as CoQ 10 , vitamin Q 10 , ubidecarenone, or ubiquinone. It
is a natural product of the human body that is primarily
found in the mitochondria, which are the cellular or-
ganelles that produce energy. It occurs in most tissues of
the human body; however, the highest concentrations are
found in the heart, liver, kidneys, and pancreas.
Ubiquinone takes its name from a combination of the
word ubiquitous, meaning something that is found
everywhere, and quinone 10. Quinones are substances
found in all plants and animals. The variety found in hu-
mans has a 10-unit side chain in its molecular structure.
Apart from the important process that provides energy,
CoQ 10 also stabilizes cell membranes and acts as an an-
tioxidant. In this capacity, it destroys free radicals, which
are unstable molecules that can damage normal cells.
General use
CoQ 10 is used extensively in Canada, Western Eu-
rope, Japan, and Russia to treat congestive heart failure.
It is available as a prescription medication almost every-
where it is sold, although it is sold over-the-counter as a
nutritional supplement in the United States. Some stud-
ies have shown it to be effective for as many as 70% of
patients with congestive heart failure. It appears to im-
prove patient health and wellbeing, and to increase car-
diac efficiency. The dosage generally recommended for
this condition is 100-300 mg a day, preferably in divided
doses. According to Dr. Karl Folkers in Prevention’ s
Healing with Vitamins, it takes one to three months to
achieve desired results from supplementation, and as
long as six months to attain maximum benefit.
CoQ 10 may also help people with some forms of car-
diomyopathy. Patients should consult their physician about
the possible benefits of supplementation for this condition.
The usefulness of CoQ 10 in lowering blood pressure
is not well documented. One study suggests that the sup-
plement is helpful for hypertension, but the results are in
question as it was not a double-blind, controlled research
project. The dose recommended is 200-250 mg a day,
with results taking several months to appear. It is possible
that some patients with essential hypertension who are ini-
tially low in CoQ 10 may eventually be able to decrease the
amount of their other blood pressure medications. This
must be done under the care of a health care provider.
Oral supplementation of CoQ 10 has been shown to
improve periodontal disease, as it decreases the size of
abnormally deep pockets in the gums, and also reduces
502
the extent of bacterial contamination. Other possible
benefits of CoQ 10 are to decrease angina symptoms, im-
prove immune function in patients with AIDS and other
immune deficiencies, improve control of blood sugar,
lower cholesterol, improve physical stamina, and help
people with muscular dystrophy and Huntington’s dis-
ease. A group of researchers at the University of Califor-
nia at San Diego reported in 2002 that coenzyme Q 10 ap-
pears to slow the progress of Parkinson’s disease,
Friedreich’s ataxia, and other conditions marked by de-
generation of the central nervous system. The supple-
ment can also reduce the toxicity of some types of
chemotherapy. Doxorubicin, a chemotherapeutic agent,
is known to sometimes damage the heart. Concomitant
supplementation seems to reduce this toxic effect. The
possible benefits of CoQ 10 should be discussed with a
nutritionally-oriented health care provider.
Since 1961, when it was first noticed that cancer pa-
tients in Sweden and the United States had low levels of
the enzyme, coenzyme Q 10 has been studied as a possible
cancer treatment. Researchers believe that coenzyme Q 10
may protect against cancer by stimulating the immune
system, and functioning as an antioxidant. Although ani-
mal studies have been conducted, as of early 2004 no re-
port of a randomized clinical trial involving human sub-
jects whose survival times were lengthened by using coen-
zyme Q 10 in addition to a traditional cancer treatment has
been reported in a peer-reviewed medical journal.
Deficiency
Patients with certain conditions tend to have lower
levels of CoQ 10 , and may benefit from supplements.
Some diseases that are associated with decreased
amounts of this nutrient are AIDS, chronic fatigue, con-
gestive heart failure, cardiomyopathy, and inflammatory
gum disease. Fevels of CoQ 10 tend to decrease with age;
tests for its presence in the body are not widely available.
Adverse effects from this supplement are rare and mild,
so anyone suffering from one of the listed conditions
should consider discussing supplementation with a
health care provider.
Preparations
Natural sources
Food products are a good source of CoQ 10 , and pro-
vide approximately half of the body’s requirement. Cold-
water fish such as mackerel, salmon, sardines, and tuna
are particularly high in CoQ 10 . Vegetable oils and meats
also provide good sources. The liver manufactures ade-
quate amounts to fulfill the need not met in the diet. Peo-
ple who are deficient in B vitamins, selenium, vitamin
C, and vitamin E may not be able to make as much
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
CoQ 10 as they need because these nutrients are required
for production. Consumption of foods rich in CoQ 10 and
production of the nutrient in the liver will not provide the
amounts needed to treat heart failure and other condi-
tions that may contribute to a deficiency of this nutrient.
In those cases, supplements are required.
Supplemental sources
Supplements of CoQ 10 are widely available; howev-
er, its cost varies considerably. As of 2004, it is available
in the United States, ranging in price from $7.79 for a
bottle of 40 30-mg capsules to $38.95 for a bottle of 60
100-mg capsules. It is found in various forms including
capsules, gelcaps, liquids, and tablets. The latter may be
the best choice, as this form generally includes a source
of fat that improves absorption. Vitamin E is a helpful sta-
bilizing additive as well. Most of the CoQ 10 products cur-
rently available on the market are manufactured in Japan.
Like other supplements, Co 10 is best kept in a cool, dry
place, out of direct light, and out of the reach of children.
Precautions
As of 2004, the safety of CoQ 10 for pregnant or
breast-feeding women has not been established, and its
use is not recommended under these conditions. It is also
not recommended for young children. People diagnosed
with heart failure, diabetes, kidney problems, or liver
disease should use particular care with this supplement,
as the dosage of other medications may require adjust-
ment. These individuals should consult a physician be-
fore taking coenzyme Q 10 .
Side effects
Reported adverse effects related to supplemental
CoQ 10 use include diarrhea, irritation of the stomach,
poor appetite, and nausea. These effects are rarely report-
ed and are mild. CoQ 10 is considered extremely safe for
most people. If doses over 300 mg per day are taken, liver
enzyme levels may be affected, and may need monitoring.
Interactions
It is possible that CoQ 10 decreases the action of sodi-
um warfarin (known by the brand name, Coumadin),
which is prescribed to prevent the formation of blood
clots in patients at risk of heart attack or stroke. Some
oral diabetes medications may also interfere with the ac-
tion of CoQ 10 . Cholesterol-lowering drugs in the statin
group may have this effect as well.
Resources
BOOKS
Bratman, Steven, and David Kroll. Natural Health Bible. Ro-
seville, CA: Prima Publishing, 2000.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Angina — Symptoms of pressure or burning in the
chest that result from inadequate oxygen in the
heart, generally due to coronary artery spasm or
blockage.
Antioxidant — An enzyme or other substance that
is capable of countering the damaging effects of
oxidation in the body's tissues. Coenzyme Q 10
performs antioxidant activity.
Cardiomyopathy — A condition of damaged, dis-
eased, thickened, or stretched heart muscle, re-
sulting in weakness of the heart. Cardiomyopathy
often occurs following heart attacks due to scar-
ring, but may also have an infectious or nutritional
origin.
Friedreich's ataxia — An inherited disease that usu-
ally manifests in childhood or adolescence, char-
acterized by loss of muscular coordination (atax-
ia), curvature of the spine, impaired speech, and
cardiomyopathy.
Huntington's disease — A fatal inherited disorder
characterized by progressive neurologic symptoms
including loss of motor and cognitive function.
Griffith, H. Winter. Vitamins, Herbs, Minerals & Supplements:
The Complete Guide. Tucson, AZ: Fisher Books, 2000.
Pressman, Alan H., and Sheila Buff. The Complete Idiot’s
Guide to Vitamins and Minerals., 2nd ed. Indianapolis:
Macmillan General Reference, 2000.
Therapeutic Research Faculty Staff. Natural Medicines Com-
prehensive Database. Stockton, CA: Therapeutic Re-
search Faculty, 1999.
PERIODICALS
Baker, S. K., and M. A. Tamopolsky. “Targeting Cellular Ener-
gy Production in Neurological Disorders.” Expert Opinion
on Investigational Drugs 12 (October 2003): 1655-79.
Naini, A., V., J. Lewis, M. Hirano, and S. DiMauro. “Primary
Coenzyme Q 10 and the Brain.” Biofactors 18 (2003):
145-52.
Shults, C. W. “Coenzyme Q 10 in Neurodegenerative Diseases.”
Current Medical Chemistry 10 (October 2003): 1917-21.
Shults, C. W., D. Oakes, K. Kieburtz, et al. “Effects of Coen-
zyme Q 10 in Early Parkinson’s Disease: Evidence of
Slowing of the Functional Decline.” Archives of Neurolo-
gy 59 (October 2002): 1541-50.
Vedanarayanan, V. V. "Mitochondrial Disorders and Ataxia.”
Seminars in Pediatric Neurology 10 (September 2003):
200-9.
503
Coenzyme Q
Coix
ORGANIZATIONS
Food and Drug Administration (FDA). 5600 Fishers Lane,
Rockville, MD 20857. (888) 463-6332. <http://www.fda.
gov>.
National Cancer Institute (NCI), <http://www.nci.nih.gov>.
National Center for Complementary and Alternative Medicine
(NCCAM) Clearinghouse. P. O. Box 7923, Gaithersburg,
MD 20898-7923. (888) 644-6226. Fax: (866) 464-3615.
<http://nccam.nih.gov>.
OTHER
National Cancer Institute (NCI). Complementary and Alternative
Medicine (CAM) Information Summary: Coenzyme Q I0 ■
Bethesda, MD: NCI, 2003. [cited June 3, 2004]. <http:/
www.nci.nih.gov/cancerinfo/pdq/cam/coenzymeQ10>.
National Institute of Neurological Disorders and Stroke
(NINDS). “Study Suggests Coenzyme Q 10 Slows Func-
tional Decline in Parkinson's Disease.” NINDS press re-
lease, 14 October 2002. [cited June 3, 2004], <http://
www.ninds.nih.gov/news_and_events/pressrelease_parkin
sons_coenzymeq 1 0_1 0 140>.
Rebecca J. Frey, PhD
Coix
Description
Coix is a plant whose botanical name is Coix lacry-
ma-jobi. It belongs to the Gramineae (or Poaceae) family.
Coix is used in traditional Chinese medicine, where it is
called yi yi ren. In English it is also known as Job’s tears.
Coix is an annual plant that grows wild to a height
of about 3 ft (1 m) in sunny but moist grasslands. It is
also cultivated in many parts of the Orient. Coix may
have originated in East Asia, but it is now found through-
out East India, China, Japan, the Philippines, northern
Africa, the Caribbean, Central America, northern South
America, and the United States. The plant has narrow,
ribbon-like leaves. The seed with the husk removed is
used medicinally. In some areas coix is cultivated as a
food grain. The seeds contain about 52% starch, 18%
protein, and 7% fat, giving them a higher protein-to-car-
bohydrate ratio than other cereal grains.
General use
Coix is used as both a healing herb and a food. The
seeds, with the husks removed, are important in tradi-
tional Chinese medicine. These are said to have a cool
nature and a sweet, bland taste. In traditional Chinese
medicine, coix seed is used to treat internal dampness
and damp-heat conditions, especially disorders of the
spleen, stomach, lungs, and large intestine.
504
Chinese herbalists used coix to improve water flow
through the body. It is used to promote urination and as a
diuretic to treat edema. It can be used to reduce pain and
spasms in the legs when there is also swelling of the
legs. Coix is also used to treat such conditions of the gas-
trointestinal system as diarrhea, poor digestion, and ab-
dominal bloating.
Other claims are also made for coix seed. It is said that
a tea made from the boiled seeds will help to cure warts,
and that in general coix is good for the skin, helping to
nourish and soften it so that it looks smooth and healthy.
Coix is often used in formulas that treat arthritis and
rheumatism, conditions believed to be caused by excess
dampness according to traditional Chinese medicine.
Chinese herbalists also use it to treat appendicitis, lung
disease, lung abscesses, beriberi, and cancer.
The seeds of coix are said to have anti-inflammato-
ry, antiseptic, and fever-reducing properties. It is claimed
that they can prevent spasms, lower blood sugar, and act
as a sedative. The coix root has been used to treat men-
strual disorders.
There is no doubt that coix also has value as a food
grain, although the seedcoat is hard to remove, making it
difficult to produce flour. Coix can be cooked like barley
or rice, however, and the flour can be used to make
bread. Parched coix seeds are used to make tea, and a
coffee substitute can be made from the roasted seeds of
some Chinese subspecies.
With so many claims made for coix, scientific inter-
est in the plant is quite high. Agricultural scientists are
investigating the genetics of coix with an eye toward
growing it as a food crop, and medical researchers are
looking at its healing properties. In 1994, Chinese re-
searchers isolated a compound from coix that had anti-
tumor properties. This compound has not been tested
outside the laboratory, however. Many other researchers
have investigated the effects of coix on the immune sys-
tem cells in test tubes and in laboratory animals. Still
other researchers have seen test-tube evidence of anti-
viral activity. It is too early to tell whether these labora-
tory results will carry over into humans, but given the
high interest in coix, more studies are being done that
will soon make the findings clearer.
Preparations
Coix seeds are harvested when the plant ripens in
the autumn. The husks are removed and the seed is used
either fresh, boiled, roasted, or fermented. In traditional
Chinese medicine, a liquor fermented from coix seeds
may be given for rheumatism. Coix is also used in com-
bination with other herbs in rheumatism and arthritis for-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Beriberi — A serious disease caused by a deficien-
cy in vitamin B, and characterized by a slow de-
generation of the nerves of the digestive system
and heart.
Diuretic — Any substance that increases the pro-
duction of urine.
Edema — Water retention in the body that often
causes swelling of the hands and feet.
mulas such as ginseng and atractylodes formula. When
coix is used for medicinal purposes, the usual daily dose
is 10-30 g. Coix can be eaten as nourishment, and in this
way is different from other herbs, which are given in
limited doses. Puffed coix, similar to puffed wheat or
puffed rice cereals, is sold in health food stores.
Precautions
Traditional Chinese herbalists suggest that pregnant
women not use coix.
Side effects
In traditional Chinese medicine, coix has been used
without any undesirable side effects. There are indica-
tions, however, that people who eat large amounts of
coix as food can become dehydrated.
Interactions
Coix is has been used for thousands of years in con-
junction with other herbs with no reported interactions.
Since coix is used almost exclusively in Chinese medi-
cine, there are no studies of its interactions with Western
pharmaceuticals.
Resources
BOOKS
Molony. David. Complete Guide to Chinese Herbal Medicine.
New York: Berkley Books, 1998.
Teegaurden, Ron. The Ancient Wisdom of the Chinese Tonic
Herbs. New York: Warner Books, 1998.
ORGANIZATIONS
American Association of Oriental Medicine (AAOM). 433
Front Street. Catasauqua, PA 18032. (610) 266-2433.
OTHER
Plants for a Future. “Coix lacryma-jobi.” http://www.pfaf.org.
Tish Davidson
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Cola nut see Kola nut
Cold, common see Common cold
Cold sore
Definition
A cold sore is a fluid-filled blister that usually ap-
pears at the edge of the lips. Cold sores are caused by a
herpes simplex virus infection.
Description
A cold sore is a fluid-filled, painful blister that is
usually on or around the lips. Other names for cold sores
are fever blisters, oral herpes, labial herpes, herpes labi-
alis, and herpes febrilis. Cold sores most often occur on
the lips, distinguishing them from the common canker
sore that is usually located inside the mouth. Cold sores
do not usually occur inside the mouth except during the
initial episode. Canker sores usually form either on the
tongue or inside the cheeks.
Cold sores are caused by a herpes virus. There are
eight different kinds of human herpes viruses. Only two
of these, herpes simplex, types 1 and 2, can cause cold
sores. It is commonly believed that herpes simplex virus
type 1 infects above the waist and herpes simplex virus
type 2 infects below the waist. This is not completely
true. Both herpes virus type 1 and type 2 can cause her-
pes lesions on the lips or genitals but recurrent cold sores
are almost always type 1 .
Oral herpes is very common. More than 60% of
Americans have had a cold sore and almost 25% of those
infected experience recurrent outbreaks. Most of these
persons became infected before age 10. Anyone can be-
come infected by herpes virus and once infected, the virus
remains latent for life. Herpes viruses are spread from per-
son to person by direct skin-to-skin contact. The highest
risk for spreading the virus is the time period beginning
with the appearance of blisters and ending with scab for-
mation. However, infected persons need not have visible
blisters to spread the infection to others since the virus
may be present in the saliva without obvious oral lesions.
Viruses are different from bacteria. While bacteria
are independent and can reproduce on their own, viruses
enter human cells and force them to make more virus.
The infected human cell is usually killed and releases
thousands of new viruses. The cell death and resulting tis-
sue damage causes the actual cold sores. In addition, her-
pes virus can infect a cell and instead of making the cell
505
Cold sore
Cold sore
A close-up view of a patient’s mouth with stomatitis cold
sores. (Custom Medical Stock Photo. Reproduced by permis-
sion.)
produce new viruses, it hides inside the cell and waits.
Herpes virus hides in the nervous system. This is called
“latency.” A latent virus can wait inside the nervous sys-
tem for days, months, or even years. At some future time,
the virus “awakens” and causes the cell to produce thou-
sands of new viruses which causes an active infection.
This process of latency and active infection is best
understood by considering the cold sore cycle. An active
infection is obvious because cold sores are present. The
first infection is called the “primary” infection. This ac-
tive infection is then controlled by the body’s immune
system and the sores heal. In between active infections
the virus is latent. At some point in the future, latent
viruses become activated and once again cause sores.
These are called “recurrent” infections. Although it is
unknown what triggers a latent virus to activate, several
conditions seem to bring on infections. These include
stress, illness, fatigue, exposure to sunlight, menstrua-
tion, fever, and diet.
Causes & symptoms
While anyone can be infected by herpes virus, not
everyone will show symptoms. The first symptoms of
herpes occur within two to 20 days after contact with an
infected person. Symptoms of the primary infection are
usually more severe than those of recurrent infections.
The primary infection can cause symptoms like other
viral infections including fatigue, headache, fever, and
swollen lymph nodes in the neck.
Typically, 50-80% of persons with oral herpes experi-
ence a prodrome (symptoms of oncoming disease) of pain,
burning, itching, or tingling at the site where blisters will
form. This prodrome stage may last anywhere from a few
hours, to one or two days. The herpes infection prodrome
occurs in both the primary infection and recurrent infections.
506
In 95% of patients with cold sores, the blisters occur
at the outer edge of the lips which is called the “vermil-
ion border.” Less often, blisters form on the nose, chin,
or cheek. Following the prodrome, the disease process is
rapid. First, small red bumps appear which quickly form
fluid-filled blisters. The painful blisters may either burst
and form a scab or dry up and form a scab. Within two
days of the first red bumps, all the blisters have formed
scabs. The skin heals completely and without scarring
within six to 10 days.
Some children have a very serious primary (first
episode) herpes infection called gingivostomatitis. This
causes fever, swollen lymph glands, and numerous blisters
inside the mouth and on the lips and tongue, which may
form large, open sores. These painful sores may last up to
three weeks and can make eating and drinking difficult. Be-
cause of this, young children with gingivostomatitis are at
risk for dehydration (excessive loss of water from the body).
Most people experience fewer than two recurrent
outbreaks of cold sores each year. Some people never ex-
perience outbreaks while others have more frequent oc-
currences. In most people, the blisters form in the same
area each time and are triggered by the same factors
(such as stress, sun exposure, etc.).
Diagnosis
Because oral herpes is so common, it is diagnosed
primarily by symptoms. It can be diagnosed and treated
by the family doctor, dermatologists (doctors who spe-
cialize in skin diseases) and infectious disease special-
ists. Laboratory tests may be performed to look for the
virus. Because healing sores do not shed much virus, a
sample from an open sore is taken for viral culture. A
sterile cotton swab is wiped over open sores and the
sample used to infect human cells in culture. Cells which
are killed by herpes virus have a certain appearance
under microscopic examination. The results of this test
are available within two to 10 days.
Oral herpes may resemble a bacterial infection
called impetigo. This skin infection is most commonly
seen in children and causes herpes-like blisters around
the mouth and nose. Also, because oral herpes can occur
inside the mouth, the blisters could be mistaken for com-
mon canker sores. Therefore, doctors need to determine
whether the blisters are oral herpes, canker sores, or im-
petigo. The diagnosis and treatment of herpes infections
should be covered by most insurance providers.
Treatment
There is no cure for cold sores but many alternative
treatments can reduce outbreaks and shorten healing
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
time. During an outbreak of cold sores, salty foods, citrus
foods (oranges etc.), and other foods that irritate the sores
should be avoided. Wash the sores once or twice a day
with a warm, saline solution and pat gently to dry. Appli-
cation of ice or a cold wet teabag for 10 minutes four or
five times a day can relieve the itching and burning.
Supplements
Vitamin and mineral supplements and diet may have
an effect on the recurrence and duration of cold sores. In
general, cold sore sufferers should eat a healthy diet of
unprocessed foods such as vegetables, fruits, and whole
grains. Alcohol, caffeine, chocolate, nuts, and sugar
should be avoided.
An imbalance in the amino acids lysine and argi-
nine is thought to be a contributing factor in herpes virus
outbreaks. A diet that is rich in the amino acid lysine
may help prevent recurrences of cold sores. Foods that
contain high levels of lysine include most vegetables,
legumes, fish, turkey, and chicken. In one study, patients
taking lysine supplements had milder symptoms during
an outbreak, a shorter healing time, and had fewer out-
breaks than patients who did not take lysine. Patients
should take 1 ,000 mg of lysine three times a day during a
cold sore outbreak and 500 mg daily on an ongoing basis
to prevent recurrences. The effectiveness of lysine sup-
plementation in treating herpes infections is controver-
sial. Intake of the amino acid arginine should be reduced.
Foods rich in arginine that should be avoided are choco-
late, peanuts, almonds, and other nuts and seeds.
Vitamin C and bioflavonoids (a substance in fruits
that helps the body to absorb and use vitamin C) have
been shown to reduce the duration of a cold sore out-
break and reduce the number of sores. The vitamin B
complex includes important vitamins that support the
nervous system where herpes viruses are dormant. B
complex vitamins also can help manage stress, an impor-
tant contributing factor to the outbreak of herpes viruses.
Some studies have shown that correcting iron, folate, vi-
tamin C, or vitamin B 12 deficiencies improves cold
sores. Vitamin E speeds healing and reduces pain.
Squeeze the oil from a vitamin E capsule onto a cotton
ball and apply to the sore for 30 minutes to one hour.
Herbals
Mints are effective antivirals. Lemon balm or
Melissa ( Melissa officinalis ) is comparable to the antivi-
ral acyclovir in the treatment of cold sores. Apply lemon
balm cream to the sore several times a day. Alternatively,
prepare lemon balm tea, drink the tea and apply the
dregs to the sore for one or two hours. The patient may
also drink several strong cups of teas prepared from hys-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
sop, oregano, rosemary, thyme, and sage. Licorice may
be added to the tea.
Licorice (Glycyrrhiza glabra) is an antiviral and im-
mune system stimulant. Licorice is available as a capsule
or an ointment. Gradually take up to 300 mg a day. Apply
ointment that contains glycyrrhetinic or glycyrrhizic acid
directly to the sore as necessary. Ingestion of licorice may
cause loose stools and high blood pressure.
Chinese medicine
Treatment with Qing Dai San (Natural Indigo Pow-
der) mixed with cold boiled water and applied to the sore
is generally all that is needed. For recurrent cold sores,
the following oral preparations can be taken:
• Yin Huang Kou Fu Yi (Honeysuckle and Scutellaria
Fluid): one ampule three times daily
• Yin Qiao Jie Du Pian (Honeysuckle and Forsythia
Tablet to Resolve Toxin): two to four tablets three times
daily
• Huang Lian Shang Qing Wan (Coptis Pill to Clear
Heat of Upper Jiao): 5 g, two to three times daily
Other treatments for cold sores include:
• Pepto-Bismol. Rub liquid into cold sore.
• Laser therapy. Ten daily treatments with low-intensity
laser significantly lowered the incidence of oral herpes
outbreaks as compared to placebo.
• Mild electric current. Preliminary studies of a small de-
vice that delivers a mild electric current to the cold sore
site have shown shorter duration of pain and blisters.
Allopathic treatment
There is no cure for herpes virus infections. There
are antiviral drugs available which have some effect in
lessening the symptoms and decreasing the length of her-
pes outbreaks. There is evidence that some may also pre-
vent future outbreaks. These antiviral drugs are most ef-
fective when taken as early in the infection process as
possible. For the best results, drug treatment should begin
during the prodrome stage before blisters are visible.
Acyclovir (Zovirax) has been the drug of choice for
herpes infection and can be given intravenously or taken
by mouth. It can be applied directly to sores as an oint-
ment but is not very useful in this form. A liquid form for
children is also available. Acyclovir is effective in treat-
ing both the primary infection and recurrent outbreaks.
When taken by mouth to prevent an outbreak, acyclovir
reduces the frequency of herpes outbreaks. In 2001, a re-
port showed that use of high-dose acyclovir during pri-
mary infection will reduce the extent of latent infection.
507
Cold sore
Cold sore
The use of penciclovir (Denavir) cream as soon as the
prodrome symptoms appear speeds healing.
Over-the-counter lip products which contain the
chemical phenol (such as Blistex Medicated Lip Oint-
ment) and numbing ointments (Anbesol) help to relieve
cold sores. Pharmacists also recommend the over-the-
counter medicine Abreva, the only cold sore medicine
approved by the U.S. Food and Drug Administration
(FDA) to shorten healing time. Acetaminophen (Tylenol)
or ibuprofen (Motrin, Advil) may be taken if necessary
to reduce pain and fever.
Expected results
Oral herpes can be painful and embarrassing but it is
not a serious infection. There is no cure for oral herpes
but outbreaks usually occur less frequently after age 35.
Alternative medicines can reduce the pain, prevent out-
breaks, and shorten the course of cold sores. The spread
of herpes virus to the eyes is very serious. Herpes virus
can infect the cells in the cornea and cause scarring that
may impair vision.
Prevention
The only way to prevent oral herpes is to avoid con-
tact with infected persons. This is not an easy solution
because many people are not aware that they are infected
and can easily infect others. As of 2001 there were no
known herpes vaccines available, although vaccines are
being tested.
Several practices can reduce the occurrence of cold
sores and the spread of virus to other body locations or
people. These practices are:
• Avoidance of sun exposure to the face. Before getting
prolonged exposure to the sun, apply sunscreen to the
face and especially to the lips. Wearing a hat with a
large brim is also helpful.
•Avoid touching cold sores. Squeezing, picking, or
pinching blisters can allow the virus to spread to other
parts of the lips or face and infect those sites.
• Wash hands frequently. Persons with oral herpes should
wash their hands carefully before touching others. An
infected person can spread the virus to others even
when he or she has no obvious blisters.
• Avoid contact with others during active infection. In-
fected persons should avoid kissing or sexual contact
with others until after the cold sores have healed.
• Wear gloves when applying ointment to a child’s sore.
• Be especially careful with infants. Never kiss the eyes
or lips of a baby who is under six months old.
508
KEY TERMS
Latent — A nonactive virus in a dormant state within
a cell. Herpes virus is latent in the nervous system.
Prodrome — Symptoms that warn of the beginning
of disease. The herpes prodrome consists of pain,
burning, tingling, or itching at a site before blisters
are visible.
Recurrence — The return of an active infection fol-
lowing a period of latency.
• Be watchful of infected children. Do not allow infected
children to share toys that may be put into the mouth.
Toys that have been mouthed should be disinfected be-
fore other children play with them.
• Maintain good general health. A healthy diet, plenty of
sleep, and exercise help to minimize the chance of get-
ting a cold or the flu, which are known to bring on cold
sores. Also, good general health keeps the immune sys-
tem strong which helps to keep the virus in check and
prevent outbreaks.
• Participate in a stress reduction program. Yoga, mas-
sage, aromatherapy, meditation, hypnosis, or biofeed-
back can relieve stress which may reduce outbreaks.
Resources
BOOKS
Gorbach, Sherman, John Bartlett, and Neil Blacklow, eds. In-
fectious Diseases. Philadelphia: W. B. Saunders Co.,
1998.
Ying, Zhou Zhong, and Jin Hui De. “Herpes Zoster and Herpes
Simplex.” In Clinical Manual of Chinese Herbal Medicine
and Acupuncture . New York: Churchill Livingston, 1997.
PERIODICALS
“Abreva Recommended Most by Pharmacists for Cold Sores.”
Virus Weekly (November 13, 2001): 12.
Khalsa, Karta Purkh Singh. "Simple Solutions for Cold Sores.”
Let’ s Live 61 (May 1999): 66+.
Nash, Karen. “Cold Sore Treatment: Take Whatever Works, In-
cluding Placebos.” Dermatology Times 19 (July 1998):
37+.
Sawtell, N. M. “Early Intervention with High-Dose Acyclovir
Treatment During Primary Herpes Simplex Virus Infec-
tion Reduces Latency and Subsequent Reactivation in the
Nervous System in Vivo.” The Journal of the American
Medical Association 286, no. 23 (December 19, 2001):
2922.
Schindl, Andreas, and Reinhard Neumann. ’’Low-Intensity
Laser Therapy is an Effective Treatment for Recurrent
Herpes Simplex Infection. Results from a Randomized
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Double-Blind Placebo-Controlled Study.” The Journal of
Investigative Dermatology 113 (1999): 221-223.
OTHER
MayoClinic.com. [cited October 2002], <http://www.mayoclinic.
com>.
Belinda Rowland
Teresa G. Odle
Coleus
Description
Coleus for skohlii is a perennial plant, with a strong,
camphor-like odor. It is in the mint family. It grows well
in warm temperate or subtropical areas. The plant is na-
tive to areas of India, Myanmar, Nepal, and Sri Lanka.
Coleus has long been used in traditional Indian
(Ayurvedic) medicine, but gained popularity when a
chemical extract of the root called forskolin demonstrat-
ed properties that make it a potential treatment for asth-
ma, bronchitis, glaucoma, congestive heart failure, and
other conditions. Forskolin was first identified by West-
ern researchers in the 1970s, but the effects of the whole
coleus plant and its extracts have not been as well stud-
ied or understood.
Another species of coleus. Coleus kilimandschari, is
found in parts of Africa and has been used in Rwandan
folk medicine to treat infections and autoimmune dis-
eases. Recent studies of Rwandan coleus indicate that it
is effective against a variety of disorders involving de-
struction of red blood cells. As of 2002, however, Rwan-
dan coleus has not been studied as intensively as Coleus
forskohlii, and its extracts await further analysis.
Chinese research indicates that several diterpenoids
found in the leaves and stems of coleus may be effective
against leukemia cells. These recently discovered com-
pounds, however, require further study and analysis.
General use
Forskolin increases the levels of a cell-regulating
compound called cyclic adenosine monophosphate
(cAMP). This property allows it to stabilize mast cells,
which contain histamine and other inflammatory sub-
stances. Preventing the release of these compounds could
make forskolin valuable in the treatment of diseases with
an allergic component, such as asthma and eczema.
Another benefit of the increase of cAMP is forsko-
lin’s ability to relax smooth muscles. The bronchioles,
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
uterus, arteries, gastrointestinal tract, and bladder all
contain smooth muscle that is responsive to the antispas-
modic effects of forskolin. As an antispasmodic, it has
potential applications for conditions that involve cramp-
ing or smooth muscle contraction. These include asthma,
painful periods, angina, irritable bowel syndrome,
bladder infections, and high blood pressure.
People suffering from asthma may benefit from the
use of forskolin in its capacity as an antispasmodic. Dur-
ing an asthma attack, the smooth muscle within small
passageways of the lungs (bronchioles) constricts and
makes breathing difficult. The action of forskolin is simi-
lar to that of some standard inhalers containing such
medications as albuterol, a beta agonist bronchodilator.
Both substances relax the smooth muscle, and improve
the person’s breathing ability. Studies of forskolin for the
treatment of asthma have shown positive results in both
oral and inhaled preparations, although it is not commer-
cially available in an inhaled formula at this time. Other
allergic conditions, including eczema, may also respond
well to forskolin. Levels of cAMP are reduced in the
bronchioles and skin of people suffering from asthma
and eczema. The lack of cAMP causes histamine release
and subsequent allergic symptoms, including bron-
choconstriction and local reaction. Forskolin may be
able to prevent the onset of symptoms in susceptible
people by increasing cAMP levels. It can theoretically be
helpful for any condition that is caused, wholly or par-
tially, by an allergic reaction. Professional help should
be sought to use forskolin for this indication, particularly
because of potential interactions with other medications
used for asthma.
Psoriasis can be treated by taking forskolin supple-
ments. In this condition, skin cells multiply at a rate
much greater than normal. Itchy, silvery patches are
formed on the skin. This may be due to an imbalance of
cell regulating chemicals, including cAMP, that can be
normalized by forskolin.
Cardiovascular diseases, such as congestive heart
failure, angina, and high blood pressure, have the poten-
tial to be treated by forskolin. The extract appears to in-
crease the contractility of the heart, and relax the smooth
muscles in the walls of the arteries. The relaxation of
the arteries decreases blood pressure, pain due to angina,
and strain on the heart. Maximum benefit may be
achieved in conjunction with other botanicals or medica-
tions, such as dobutamine.
Blood vessels in the brain are dilated by forskolin,
which could have clinical applications for patients who
are at risk of, or recovering from, stroke. Forskolin also
decreases the risk of abnormal clotting. This is another
desirable effect for stroke patients and those with other
509
Coleus
Coleus
cardiovascular conditions that cause, or result from, in-
creased susceptibility to blood clots.
The high pressure inside the eye that occurs with
glaucoma has been reduced in research studies with the
use of forskolin drops. Eye drops made with forskolin
are not yet available to the consumer, but oral prepara-
tions have the potential for beneficial effects.
An infusion of the leaves of Coleus forskohlii has
traditionally been used in Indian medicine for the treat-
ment of gas and bloating. This effect has not been sub-
jected to study.
Other potential applications for forskolin, which are
not yet adequately studied, include treatment for weight
loss, hypothyroidism, malabsorptive conditions, de-
pression, cancer metastasis, and immune dysfunction.
Preparations
Crude preparations of Coleus forskohlii may not
contain enough forskolin to exert a clinical effect.
Forskolin extracts are available. One recommended dose
is 50 mg two or three times daily of a preparation con-
taining 18% forskolin. A health care provider knowl-
edgeable in the clinical use of botanicals should be con-
sulted before undertaking treatment with this extract.
Precautions
Forskolin can be a powerful medication, and has ef-
fects on many systems of the body. It has been described
as a central nervous system depressant. It should not be
taken for an indication without a person being aware of
potential effects on other parts of the body. For this rea-
son, professional supervision is recommended.
People with low blood pressure or gastric ulcers may
wish to avoid forskolin due to potential exacerbation of
these conditions. Children, or women who are pregnant
or breastfeeding, should also avoid this substance due to
the current lack of data about potential risks. Similarly,
those who have chronic liver or kidney disease should use
great caution in taking this medication, particularly if
other herbs or medications are being used.
Side effects
Forskolin does not appear to be toxic based on stud-
ies done on animals; however, it has been reported by
veterinarians to lower the blood pressure of cats and
dogs. As of 2002, the most common side effect reported
for coleus leaves is contact dermatitis (skin rash) in
people who are allergic to the plant. The overall safety
and side effects of forskolin, however, have not yet re-
ceived an in-depth analysis.
510
KEY TERMS
Angina — Symptoms of pressure or burning in the
chest that result from inadequate oxygen in the
heart, generally due to coronary artery spasm or
blockage.
Antispasmodic — Any substance that relieves or
prevents muscle spasm, particularly in smooth
muscle.
Beta agonist — Class of substances that relieve
bronchoconstriction, among other effects.
Bronchioles — Small tubes in the lungs leading to
the alveoli, where gas exchange occurs.
Forskolin — Chemical compound extracted from
coleus root that appears to be effective in treating
asthma, eczema, colic, and other conditions.
Histamine — A substance released from cells that
causes some of the symptoms of an allergic reaction.
Interactions
Forskolin may intensify the effects of other medica-
tions taken concurrently. Caution should be used when
taking any botanical or prescription medication.
Forskolin should not be taken in conjunction with anti-
asthmatic, anticoagulant or antihypertensive medications
without the supervision of a health care provider.
Resources
BOOKS
Bratman, Steven and David Kroll. Natural Health Bible. Ro-
seville, CA: Prima Publishing, 1999.
Chevallier, Andrew. The Encyclopedia of Medicinal Plants.
New York: DK Publishing, Inc., 1996.
Murray, Michael. The Healing Power of Herbs. Roseville, CA:
Prima Publishing, 1995.
PERIODICALS
Cos, P, N. Hermans, P. B. Van, et al. “Complement Modulating
Activity of Rwandan Medicinal Plants’" Phytomedicine 9
(January 2002): 56-61.
Mei, S. X., B. Jiang, X. M. Niu, et al. “Abietane Diterpenoids
from Coleus xanthanthus.” Journal of Natural Products
65 (May 2002): 633-637.
ORGANIZATIONS
The Ayurvedic Institute. 11311 Menaul NE, Albuquerque, NM
87112. (505) 291-9698. <www.ayurveda.com>.
National Institute of Ayurvedic Medicine. 584 Milltown Road,
Brewster, NY 10509. (845) 278-8700. <www.niam.com>.
Judith Turner
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Colic
Definition
Colic is persistent, unexplained crying and discom-
fort in an otherwise healthy baby between the ages of
two weeks and about five months.
Description
Colic affects 10-20% of all infants. It is more com-
mon in boys than in girls and most common in a family’s
first child. Symptoms of colic usually appear when a
baby is 14-21 days old, reach a peak at the age of three
months, and disappear within the next eight weeks.
Causes & symptoms
Some babies who have colic are simply fussy. Oth-
ers cry so hard that their faces turn red, then pale.
Episodes may occur frequently but intermittently, usual-
ly beginning with prolonged periods of crying in the late
afternoon or evening. Crying may intensify, taper off,
and then get even louder. It can last for just a few min-
utes or continue for several hours. During a colicky
episode, babies’ bellies often look swollen, feel hard, and
make a rumbling sound. Many babies grow rigid, clench
their fists, curl their toes, and draw their legs toward their
body. A burp or a bowel movement can end an attack.
Most babies who have colic do not seem to be in pain
between attacks.
One cause of colic may be the swallowing of large
amounts of air, especially during feeding time. Air may
then become trapped in the digestive tract and cause dis-
comfort. Other possible causes include:
• immaturity of the digestive system
• food intolerances
• too little or too much food
• lack of sleep
• loneliness
• overheated formula
• overstimulation resulting from too much noise, light, or
activity
• stress and tension on the part of the mother and other
caregivers
• foods the mother eats, if breast-feeding, which are al-
lergens or irritants for the baby
Diagnosis
Colic is suspected in an infant who:
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
To help soothe a colicky infant, place the baby’s stomach
down across the forearm. Use the opposite hand to pat the
infant’s back while rocking back and forth. (Illustration by
Electronic Illustrators Group. The Gale Group.)
• has cried loudly for at least three hours a day at least
three times a week for three weeks or longer
• is not hungry but cries for several hours between din-
nertime and midnight
• demonstrates the clenched fists, rigidity, and other
physical traits associated with colic
The baby’s medical history and a parent’s descrip-
tion of eating, sleeping, and crying patterns are used to
confirm the diagnosis of colic. Physical examination and
laboratory tests are used to rule out infection, intestinal
blockage, and other conditions that can cause abdominal
pain and other colic symptoms.
Treatment
Parents should consult their healthcare practitioner
before giving any herbal or allopathic medications to
very young children. Teas made with chamomile ( Ma-
tricaria recutita), lemon balm (Melissa officinalis), pep-
permint (Mentha piperita), catnip (Nepeta cataria), or
dill (Anethum graveolens) can lessen bowel inflamma-
tion and reduce gas. Slippery elm powder (Ulmus fulva)
is soothing and healing for the digestive system. Homeo-
pathic remedies that may be effective for colic include
Bryonia 30c every five minutes as needed, and
Chamomilla 6c every five minutes for up to an hour. A
homeopath can be further consulted for remedies to help
strengthen the child’s entire constitution. In addition, it is
511
Colic
Colloidal silver
helpful to give the Bach flower essence called Rescue
Remedy to the infant and to the caregivers. This will
help to calm the situation.
Hands-on treatments are often helpful in treating
colic. Squeezing the acupressure point at the webbing be-
tween the thumb and index finger of either hand can calm
a crying child. Gently massaging the abdomen with a cir-
cular motion can also be used. Applying warm compress-
es over the child’s abdomen can also relieve cramping.
Soothing movements may help to calm the baby.
Colicky babies cry less when they are soothed by the
motion of a swing, a car ride, or being carried in a par-
ent’s arms. Taking the infant for a walk may also help
with soothing and encouraging sleep. Rocking the baby
in a quiet, darkened room can be used to reduce over-
stimulation, as well.
Giving small, frequent feedings rather than a few
large feedings will be easier on digestion for a bottle-fed
baby. For those who breastfeed, food allergens can be
transmitted through the milk of the mother. Therefore,
foods that cause problems in the infant should be re-
moved from the mother’s diet. These are most often like-
ly to be coffee, tea, chocolate, citrus fruit, peanuts,
wheat, and vegetables belonging to the cabbage family,
including broccoli.
Allopathic treatment
Medications do not cure colic. Doctors sometimes
recommend simethicone (Mylicon drops) to relieve gas
pain. Generally, parents are advised to take a practical
approach, using home remedies. However, a doctor
should be notified if a baby with colic:
• develops a rectal fever higher than 101°F (38.3°C)
• cries for more than four hours without relief
• vomits
• has diarrhea or stools that are black or bloody
• continually loses weight
• continually eats less than normal
Expected results
Colic is distressing, but it is not dangerous. Symp-
toms almost always disappear before a child is six
months old.
Prevention
To help prevent air from being swallowed during
feedings, the infant’s back can be gently massaged to re-
lease trapped gas bubbles. Keeping the infant in a sitting
512
position while feeding is also helpful. Bottle-fed babies
can swallow air if the nipple holes in the bottle are either
too large or too small. This can be checked by filling the
bottle with formula, turning it upside down, and counting
the number of drops released as the bottle is being shaken
or squeezed. The hole should allow the release of formula
at the rate of one drop per second. In addition, sometimes
a different style of nipple may improve nursing. A phar-
macy should be consulted for additional guidance.
Cow’s milk can often be disruptive to an infant’s di-
gestion. When cow’s milk is the source of the symptoms,
bottle-fed babies should be switched to a soy protein
formula. (Regular soymilk should not be used, as it is not
formulated for the nutritional needs of a nursing infant.)
Goat’s milk is easier to digest than cow’s milk, and is
also an acceptable substitute. Alternately, a tablespoon of
acidophilus liquid or powder can be added to eight
ounces of the infant’s formula. A tablespoon of yogurt
can also be used for this purpose. If an intolerance to
cow’s milk is suspected in a breastfed infant, the mother
should eliminate dairy products from her diet, gradually
reintroduce after seven days, and monitor the baby’s
symptoms. This should be done with any suspected aller-
gen or irritating foods.
Resources
BOOKS
Editors of Time Life Books. The Medical Advisor: The Com-
plete Guide to Alternative & Conventional Treatments.
Alexandria, VA: Time-Life Books, 1996.
Taylor, Robert, ed. Family Medicine Principles and Practice.
New York: Springer- Verlag, 1994.
Weed, Susun. Wise Woman Herbal for the Childbearing Year.
New York: Ash Tree Publishing, 1986.
ORGANIZATIONS
American Academy of Family Physicians. 880 Ward Parkway,
Kansas City, MO 64114. http://www.aafp.org.
Patience Paradox
Colloidal silver
Description
A colloid is a suspension of submicroscopic parti-
cles in a medium of a different material. Colloidal silver
is metallic silver suspended in water.
Some minerals are required in the diet for optimum
health. These are known as essential minerals. Contrary
to claims by some manufacturers of colloidal products,
silver is not an essential mineral.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
On the other hand, silver undoubtedly has antimi-
crobial properties, along with some other metals such as
copper. Historically, coins or other items made of silver
were used to help keep water from becoming contami-
nated and to keep milk fresh for longer periods when re-
frigeration was not available. This method may still be
used today in some remote areas of the world. Silver is
also impregnated into some water filtration systems used
both for swimming pools and for drinking water.
Despite the proven antibacterial, antiviral, and anti-
fungal properties of silver in vitro, it is unclear whether
it can exert the same effects when taken into the body.
Part of the issue is what concentration of silver reaches
the area where the infection is occurring before being
bound, disseminated, or excreted. Another question is
whether the ingested silver would have an adequate time
of contact with the target organisms to produce the de-
sired effect. It has a greater chance of benefiting a patient
with local and topical infections.
Colloidal silver products are often touted as the an-
swer to the problem of microbial resistance to antibi-
otics. While it is certainly true that antibiotics are
overused, leading to more bacteria becoming resistant,
substantive evidence that colloidal silver is a safe and ef-
fective replacement does not yet exist.
General use
Silver is already used in some compounds that are in
common use against infections. Silvadine is a frequently
used agent to prevent infection in burn patients. Silver
nitrate was used in the eyes of newborns for years to pre-
vent blindness caused by contracting gonorrhea, a sexu-
ally transmitted disease (STD), during the passage
through the birth canal. The medication was not, howev-
er, effective against chlamydia, another STD that causes
neonatal conjunctivitis. Silver nitrate can also be very
irritating to the tissues of the eye. Erythromycin and
tetracycline are now more frequently used in the United
States for neonatal prophylaxis.
The claims made for colloidal silver are innumerable.
Silver has been said to be effective against hundreds of
strains of bacteria, and to be supportive in the treatment of
colds and flu, hepatitis, Epstein-Barr virus, pneumonia,
bronchitis, and yeast infections. It has also been recom-
mended for topical use in the mouth, eyes, ears, nose, si-
nuses, and for a wide variety of skin conditions. It is diffi-
cult to determine which of the claims, if any of them, have
merit because substantive research data are lacking. Most
of the reported effects are based on in vitro or anecdotal
evidence. Extrapolations from such testimonials would be
challenging due to the variability in particle size, concen-
tration, quality of the preparation, and total dose.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Preparations
Silver colloid has been created by grinding, wave
method (such as ultrasonic), liquid, chemical, or electri-
cal modes of manufacture. They vary in how large the
particles of silver are that are produced, and whether
they carry an electrical charge. Particles that are very
small and charged repel each other enough that they tend
to remain in a suspended state for a longer time rather
than settling. Currently, the electrocolloidal process is
the most used, and considered to be the best at creating
very small, charged particles.
Colloidal silver may be purchased ready for use, but
products have been found to be inconsistent in content,
varying from 15-120% of the silver concentration they
are labeled to contain. Commercially produced products
vary greatly in particle size, potency, stability, and con-
tents. Some contain stabilizers or trace elements in addi-
tion to silver, which are considered undesirable. Others
have been found to have bacterial contaminants.
The Food and Drug Administration (FDA) at one
time considered it a medication, exempted from the stan-
dard regulations as a result of being used and marketed
prior to 1938. Since that time, the exemption has been
revoked. In the United States, silver is now considered a
dietary supplement as opposed to an over-the-counter
medication. As such, specific claims to benefit or treat
medical conditions can not be made.
As an alternative to manufactured colloidal silver
products, assorted kits are available for the individual to
make colloidal silver for personal use. These kits gener-
ally use an electrical current to disperse particulate silver
into the carrier. Important factors for producing colloidal
silver at home are the purity of the silver, the purity of
the water, and proper timing to form the desired concen-
tration. Stability of the colloid is variable, and the silver
will tend to gradually settle as the charge on the particles
dissipates.
Precautions
The deposition of silver under the skin can cause a
condition called argyria. This condition is not common,
but the skin of those who are affected is permanently
stained a blue or gray color. The type of silver com-
pound, length of treatment, concentration, and total dose
required to cause argyria is a matter of some debate.
There seems to be a great individual variation in suscep-
tibility. Proponents claim that the true colloidal form of
silver cannot cause the condition, but for safety purpos-
es, all silver consumed should be considered a potential
contributor to argyria. Some colloidal silver products in-
clude this warning on the label.
513
Colloidal silver
Colonic irrigation
KEY TERMS
Antimicrobial — A substance that destroys or in-
hibits the growth of disease causing organisms.
Epstein-Barr — A virus in the herpes family that
causes mononucleosis as well as other diseases.
In vitro — An artificial environment; not in a living
organism.
Extremely large doses of silver, much beyond what
is recommended by proponents for therapeutic use, may
cause neurologic signs or organ damage. Most of the
studies of toxicity have been performed using salts of sil-
ver, such as silver nitrate, which have a higher silver con-
centration and greater toxicity than colloidal forms. The
latter are generally in the range of 5-10 parts per million
(PPM), which is equal to a 0.0005-0.001% solution.
Side effects
There are no reported side effects.
Interactions
Interaction of colloidal silver with foods, medica-
tions, or herbs are not documented.
Resources
BOOKS
Baranowski, Zane. Colloidal Silver: The Natural Antibiotic Al-
ternative. New York: Healing Wisdom Publications, 1995.
OTHER
Barrett, Stephen. Colloidal Silver: Risk Without Benefit.
http://www.quackwatch.com/01QuackeryRelatedTopics/
Phony Ads/silverad.html. 1999.
Hill, John. A Brief History of Silver and Silver Colloids in
Medicine, http://www.clspress.com/history.html. 1998.
Weil, Andrew. Charmed by Colloidal Minerals? http://www.
pathfinder.com/drweil/qa_answer/0,31 89,252, 00.html. 1997.
Weil. Andrew. Colloidal Silver: Better than Antibiotics? http://
www.pathfinder.com/drweil/qa_answer/0, 3 189,1 665 ,00.
html. 1999.
Judith Turner
Colonic irrigation
Definition
Colonic irrigation is also known as hydrotherapy
of the colon, high colonic, entero-lavage, or simply
514
colonic. It is the process of cleansing the colon by pass-
ing several gallons of water through it with the use of
special equipment. It is similar to an enema but treats the
whole colon, not just the lower bowel. This has the effect
of flushing out impacted fecal matter, toxins, mucous,
and even parasites, which often build up over the passage
of time. It is a procedure that should only be undertaken
by a qualified practitioner.
Origins
Cleansing the colon with the use of hydrotherapy is
not a new concept. Forms of colonic irrigation have been
used successfully for decades to relieve chronic toxicity
and even acute cases of toxemia.
Benefits
Anyone suffering from gas, bloating, cramping
pains, acne and other skin complaints, arthritis, and a list
of bowel complaints such as diverticulitis and irritable
bowel etc., may benefit from colonic irrigation. In partic-
ular, cancer patients are often advised to undertake a
course of colonic irrigation sessions as an essential part
of their treatment. When a biological cancer therapy be-
gins to enable the body to breakdown a cancerous mass,
it is essential that speedy and effective elimination of the
resulting toxins is achieved.
Colon and bowel cancer remain among the leading
causes of death in the United States, and alternative practi-
tioners suggest that it can be prevented by efficient hygiene
procedures. Providing that care is taken to replace the nat-
ural organisms that flourish in the bowel, many health ben-
efits can be expected from colonic irrigation. In general, al-
ternative practitioners maintain that an ill-functioning
bowel is the source of all disease, and therefore keeping it
clean will be an effective protection against disease.
Removing large amounts of toxic matter relieves the
patient and can lead to the alleviation of symptoms such
as arthritis, chronic fatigue syndrome, candidiasis, and a
host of other illnesses. Properly executed, colonic irriga-
tion can help restore normal peristaltic action to a slug-
gish bowel, thus reducing the need for more hydrotherapy
treatments over time. In addition, removing the layer of
fecal matter which coats the intestines in many individu-
als allows improved assimilation of the nutrients from
foods and can alleviate symptoms of vitamin and other
nutrient deficiencies. Many alternative health practition-
ers consider some form of hydrotherapy for the bowel to
be essential in the treatment of degenerative diseases.
Description
Over time, many people develop a thick layer of
fecal matter that coats their colon. It hardens and be-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
comes impacted, reducing the efficiency of the bowel,
and in some cases completely obstruct normal elimina-
tion of waste matter from the body. It is quite common
for people to only have one bowel movement per day,
some as few as one or two per week.
Alternative practitioners advise that we probably
should have one bowel movement for every meal that we
eat. If not, then we are not eliminating wastes complete-
ly, and if input exceeds output, then we will surely suffer
the consequences at some point.
Incomplete elimination of body wastes may result in
the following, depending on where the deposits end up:
• sluggish system
•joint pain and arthritis
• irritable bowel syndrome
• diverticulitis
• Crohn’s disease
• leaky gut syndrome
• heart problem
• migraine
• allergies
• bad breath
• acne and other skin problems such as psoriasis
• asthma
• early senility and Alzheimer’s disease
• chronic fatigue syndrome
• cancer, particularly of the bowel
• multiple sclerosis
During colonic irrigation, a small speculum is
passed into the patient’s bowel through the rectum. This
is attached to a tube, which leads to a machine that
pumps temperature-controlled water into the colon at a
controlled rate (to be controlled by either the practitioner
or the patient). The temperature of the water should ide-
ally be kept as close to body temperature as possible.
The patient will temporarily be filled with water up
to the level of the entire colon. Patients say they can feel
the water up under their ribs but that the process, al-
though sometimes uncomfortable, is not painful. The
amount of water will vary but will generally be in the re-
gion of between two and six liters (or quarts) at any one
time. This triggers peristaltic action and the patient will
begin to expel the water along with fecal matter back
through the tube and into the machine.
The fecal matter is flushed out through a viewing
tube, so that what is eliminated may be monitored. Quite
often, unsuspected parasites are expelled, along with
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
very old fecal material, very dark in color, which may
have been in the colon for years. Some therapists com-
ment that it looks like aging rubber.
During the treatment, the therapist will gently mas-
sage the patient’s abdomen to help dislodge impacted
fecal matter. In addition to massage, sometimes acu-
pressure, reflexology, or lymphatic drainage tech-
niques may be used to loosen deposits and stimulate the
bowel. It is important that the right amount of water is
used, as too much will cause discomfort and too little
will be ineffective. If correctly done, colonic irrigation is
not painful at all and some patients claim to sleep
through their treatment.
Sanitation is vital to this process. The tubes and
speculums used are generally disposable, but other parts
of the machine, such as the viewing tube, must be steril-
ized after each patient.
Normally, a series of treatments will be required to
achieve desired results regarding the elimination of im-
pacted, decaying matter, and restoration of bowel regu-
larity. Initially only gas and recent fecal matter may be
expelled. The residue attached to the colon wall is usual-
ly the result of years of neglect, and therapists say that
one cannot expect complete relief in only one session.
Impacted fecal matter can cause an imbalance of the
natural organisms that normally populate the bowel,
causing what is known as dysbiosis. Under ideal condi-
tions, the bowel is populated by a variety of naturally oc-
curring organisms. It seems that the enzymes occurring
in fresh fruit and vegetables encourage these beneficial
organisms. One of the results of eating processed dena-
tured foods is that this natural balance is upset, and food
may begin to rot in the bowel instead of being processed.
Decomposing matter can cause a toxic condition
and may lead to many health problems, as constipation
causes backed up pollution of the body cells. The
process of repair and elimination of wastes enters a
downward spiral which at best will cause fatigue, lack of
energy and premature aging, and at worst can cause de-
generative diseases, among them allergies, and even can-
cer and Alzheimer’s disease.
The cost of colonic irrigation treatments varies, but is
generally between $35-70 per session, which may last
from 45 minutes to one hour. The cost of the machine itself
ranges from $4,000-12,000, but again, it should be noted
that only qualified therapists should conduct sessions.
Preparations
Most practitioners prefer that distilled or purified
water is used for colonic irrigation, but others use steril-
ized tap water.
515
Colonic irrigation
Colorectal cancer
Resources
KEY TERMS
Dysbiosis — The condition that results when the
natural flora of the gut are thrown out of balance,
such as when antibiotics are taken.
Peristalsis — The natural wave-like action of a
healthy bowel that transports matter from one end
of the bowel to the other.
Probiotics — Supplements of beneficial microor-
ganisms that normally colonize the gut.
Toxemia — Poisoning of the blood.
Precautions
It may be advisable to use a probiotic pessary
after colonic irrigation, to ensure replacement of de-
sirable natural flora. There are certain conditions that
either partly or completely preclude the use of
colonic irrigation, such as an active attack of Crohn’s
disease, bleeding ulcers, and hyperacidosis. If in
doubt, a qualified practitioner should be consulted.
Anyone suffering from these conditions should al-
ways notify the practitioner when receiving colonic
irrigation treatments.
Side effects
Some allopathic practitioners claim that colonic irri-
gation flushes out essential electrolytes and friendly bac-
teria from the bowel and that it can be dangerous. Practi-
tioners counter that this can easily be remedied with the
use of probiotics, and that in any case, these possible
disadvantages are easily offset by the benefits of having
large amounts of putrefying matter, harmful organisms,
and parasites removed from the system.
Research & general acceptance
Although many alternative health care practitioners
swear by colonic irrigation, there is a large allopathic
lobby that claims that there are no benefits to be had, and
that there are dangers involved. However, there are many
decades of records and research from the alternative
health care community, which indicate that this therapy
may have a valuable place in the treatment of degenera-
tive diseases and toxic conditions.
Training & certification
Trained technicians usually conduct colonic irriga-
tion sessions.
516
BOOKS
Bonk, Melinda, ed. Alternative Medicine Yellow Pages.
Tiburon, CA: Future Medicine Publishing, Inc., 1994.
ORGANIZATIONS
California Colon Hygienist Society. 333 Miller Ave., Suite 1,
Mill Valley, CA 94941. (415) 383-7224.
Intestinal Health Institute. 4427 East Fifth St., Tucson, AZ
85711. (520) 325-9686. info@sheilas.com. http://www.
sheilas.com.
Patricia Skinner
Teresa G. Odle
Colorectal cancer
Definition
Colorectal cancer is a malignancy of the colon
(bowel) and/or rectum. It is the second most common
cause of cancer-related death in the United States, and is
diagnosed in more than 130,000 new patients annually.
Description
Colorectal cancer occurs in either the last 6 ft (1.8
m) of intestine, known as the large bowel or colon,
and/or in the rectum, where the colon terminates and
waste (feces) leaves the body. The majority of malignan-
cies that occur in colorectal cancers are called adenocar-
cinomas. When an individual develops colorectal adeno-
carcinomas, malignant cancer cells grow inside the colon
and/or the rectum. Large clusters of these cells form
structures known as tumors.
Causes & symptoms
Causes & risk factors
The exact cause of colorectal cancer is unknown.
However, there are a number of known risk factors that
increase the odds for developing the disease. They in-
clude:
• Family history. Individuals who have one or more close
relatives that were diagnosed with colorectal cancer
may be at increased risk for the disease. In 2003, re-
search showed that about 5% of colorectal cancer pa-
tients had inherited syndromes.
• History of bowel disease and/or colon polyps. Certain
types of colon polyps, which are tumor-like, benign
outgrowths of tissue within the colon, may act as an
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
early warning sign of or a precursor to colorectal can-
cer. They may develop into malignancies later in life.
Colon diseases that cause inflammation and irritation
of the bowel, such as Crohn’s disease and inflamma-
tory bowel disease, also can increase an individual’s
risk of developing a colorectal malignancy.
• Obesity. Overweight individuals, especially those with
an apple-shaped body type (where fat is concentrated
around the waist) as opposed to a pear-shaped body
(where fat is stored in the hips and thighs), are at an in-
creased risk for colorectal cancer. A high fat diet also
increases an individual’s chance of developing colorec-
tal cancer.
•Age. Individuals over age 50 are at an increased risk
for colorectal cancer.
• Sedentary lifestyle. A moderate exercise program is
thought to have a preventive effect against cancer.
• Night work. A 2003 study showed that working the
night shift actually may increase risk of colorectal can-
cer in women. Exposure to light at night suppresses the
body’s natural production of melatonin, a hormone that
helps keep certain intestinal cancers from proliferating.
Symptoms
Symptoms of colorectal cancer include:
• blood on the rectum or in the stool
• feelings of fecal urgency (feeling as if one has to have a
bowel movement all the time)
• stomach and/or abdominal pain
• changes in bowel habits, including constipation, diar-
rhea, and/or pencil-thin stools
• extreme fatigue
• decreased appetite
Diagnosis
The simplest screening tests for colorectal cancer in-
clude a digital rectal exam and a fecal occult blood test
(FOBT). In the digital rectal exam, a physician inserts a
gloved finger into the rectum and feels for any irregulari-
ties. In the FOBT, stool samples are tested for traces of
blood. The test can be done at home and sent to a lab for
analysis. FOBT can reduce the death rate by about 33%.
Unfortunately, in the United States, over the past six years
less than 35% of the population had received a FOBT.
A flexible sigmoidoscopy and/or a colonoscopy may
be performed to view the interior of the colon. The for-
mer examines the rectum and lower colon for cancer, and
the latter examines the full length of the colon. During
these procedures, a doctor passes a flexible tube with a
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
An endoscopic view of a colorectal tumor. (Custom Medical
Stock Photo. Reproduced by permission.)
tiny, fiber-optic camera device (an endoscope) through
the rectum and into the colon. The doctor can carefully
examine the lining of the intestine for signs of cancer. A
tissue sample (a biopsy) of the colon also can be taken
through the endoscope to examine under a microscope
for evidence of malignancy. Both tests can cause discom-
fort, and may be done under a local anesthetic if desired.
A lower GI (gastrointestinal) x-ray series can be
helpful in determining how much of the intestine is in-
volved in the disease. A chalky solution called barium,
which acts as a contrast agent to illuminate the gastroin-
testinal tract on x-ray film, is administered in enema
form to the patient. In some cases, air also is pumped
into the rectum to provide a clearer view of the large in-
testine. This is called a double-contrast barium enema.
The pressure in the patient’s abdomen from the air and
barium contrast likely will cause some discomfort.
After colorectal cancer is diagnosed, further testing
is required to determine how far the cancer has spread.
This procedure is known as staging. There are five dif-
ferent stages of colorectal cancer:
• Stage 0 (carcinoma in situ). This is the earliest stage of
colorectal cancer, and indicates that cancerous cells
have not spread beyond the colon lining.
• Stage I. The cancer has spread to the second and third
layers of the inside wall of the colon, but is still con-
tained within the colon.
• Stage II. The cancer has spread beyond the colon, but
has not spread to the lymph nodes.
• Stage III. The cancer has spread to a nearby lymph
node, but has not spread throughout the body.
• Stage IV. The cancer has spread throughout the body.
There is a sixth subtype of cancer, called recurrent,
which is used to classify colorectal cancer that was treat-
517
Colorectal cancer
Colorectal cancer
ed, seemed to resolve, and has now recurred either in the
colon or in another part of the body.
Treatment
The best chance for successful treatment is to detect
colorectal cancer early. Colorectal cancer is a life-threat-
ening disease, and a correct diagnosis and appropriate
treatment with surgery, chemotherapy, and/or radiation is
critical to controlling the illness.
Acupuncture and guided imagery may be useful
tools in treating pain symptoms and improving immune
function associated with colorectal cancer. Acupuncture
involves the placement of a series of thin needles into the
skin at targeted locations on the body, known as acu-
points, in order to harmonize the energy flow within the
human body.
Guided imagery involves creating a visual mental
image of pain as a means of relaxation. Once the pain can
be visualized, the patient can adjust the image to make it
more pleasing, and thus more manageable, to them.
Movement therapies, such as yoga, t’ai chi, and
qigong can aid the recovering patient. They may lessen
pain symptoms, and help the person to relax and reduce
stress.
A number of herbal remedies also are available to
lessen pain symptoms and promote relaxation and heal-
ing. However, cancer patients should consult with their
healthcare professional before taking them. Depending
on the preparation and the type of herb, these remedies
may interact with or enhance the effects of other pre-
scribed medications. Herbs that promote healing of the
digestive tract include slippery elm bark ( Ulmus rubra),
marsh mallow root {Althaea officinalis), and goldenseal
{Hydrastis canadensis).
Allopathic treatment
Treatment options include surgery, chemotherapy,
and radiation. Colorectal cancer is treated in two ways,
locally to eliminate tumor cells from the colon by
surgery and radiation, and to systemically destroy cancer
cells that have traveled to other parts of the body. Sys-
temic therapy includes the use of chemotherapy drugs.
Surgery
The extent of surgery depends on the type of colorec-
tal cancer, whether the disease has spread, and the pa-
tient’s age and health. A surgical procedure known as a
bowel resection is performed for colon cancers, where the
length of colon containing the cancerous cells is removed,
518
along with nearby tissues and lymph nodes. The two ends
of the remaining colon are then sewn back together.
For cancer affecting the rectum, several other surgi-
cal methods may be employed, including local excision
of the cancer (where cancerous cells and nearby tissues
are cut out of the rectum) and transanal resection, where
invasive cancerous tissue is removed along with normal
anal tissue.
Depending on the stage of the cancer and the degree
of surgery required, some patients may need to get a
colostomy. A colostomy involves surgically attaching the
bowel to an opening in the abdominal wall where waste
is eliminated into an attached bag.
The presence of cancer cells in the lymph nodes
may require more extensive surgery. If the cancer has
spread to the nodes, the patient will need either radiation,
chemotherapy, hormone therapy, or a combination of all
three after surgery. This is called “adjuvant therapy.”
Radiation
Once the cancer has been removed, the doctor may
recommend radiation treatment to destroy any remaining
cancer cells. In cases where the cancer is located in hard
to reach areas, radiation may be used to shrink the cancer
growth or tumor. Radiation stops the cancer cells from di-
viding. It works especially well on fast-growing tumors.
Unfortunately, it also stops some types of healthy cells
from dividing. Healthy cells that divide quickly, like those
of the skin and hair, are affected the most. This is why ra-
diation can cause fatigue, skin problems, and hair loss.
Radiation therapy can be internal, where particles of
radioactive materials are implanted into a tumor, or ex-
ternal, where energy rays (radiation) are directed at the
cancer from outside the body. External radiation, the
most common type of treatment for colorectal cancer, is
usually administered five days a week for several weeks.
Recent studies indicate that radiation therapy decreases
the likelihood of local recurrence of colorectal cancer by
a significant margin. Some clinicians argue that the ther-
apy is most effective when given before surgery rather
than after. No definitive clinical trials proved the most
effective timing as of late 200 1 .
Chemotherapy
Colorectal cancer surgery may be followed by
chemotherapy in even the earliest stages. Chemotherapy
is administered either orally or by injection into a blood
vessel. It is usually given in cycles, followed by a period
of time for recovery, followed by another course of
drugs. Treatment time may range between four and nine
months. In the fall of 2001, the Food and Drug Adminis-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
tration (FDA) approved trials for a new vaccine to help
treat colorectal cancer. Investigators planned to give the
vaccine in conjunction with chemotherapy to help pre-
vent recurrentce of the disease. In 2003, the FDA ap-
proved a new chemotherapy drug called Avastin to help
fight metastatic spread of colorectal cancer.
Some types of chemotherapy produce significant side
effects, including nausea and vomiting, temporary hair
loss, mouth sores, skin rashes, fatigue, a weakened im-
mune system, and infertility. However, most side effects
are temporary and disappear once treatment has ended.
Expected results
According to the American Cancer Society, colorec-
tal cancers cause more than 56,000 deaths each year in
the United States. However, the death rate for the disease
has declined steadily over the past several decades, and
since 1985, annual deaths due to colorectal cancer have
declined at an average rate of 1 .6% per year. Early detec-
tion is key to improved survival; patients with colorectal
cancers detected early (at stage I) have a 96% survival
rate. In comparison, patients who are diagnosed with
stage IV colorectal cancer only have a 5% survival rate.
Prevention
Proper diet and exercise have been shown to help pre-
vent many types of cancers, including colorectal cancer.
Research published in 2003 confirmed the benefits of
physical activity in reducing risk of colon and rectal can-
cers. A well-balanced diet consisting of a minimum of five
servings of fruits and vegetables and six servings of food
from other plant sources (i.e., cereals, grains, pastas) is
recommended by the American Cancer Society. Addition-
ally, patients may opt for a diet of whole foods. A number
of fruits and vegetables have been shown to have antioxi-
dant properties, and may be useful in preventing cancer.
These include carotenoids, which are found in fruit pig-
ments; flavenoids found in vegetable pigments; and partic-
ularly, lycopene, which is found in tomato juice.
Recent clinical studies also have indicated that regu-
lar use of green tea (produced from the Camellia sinen-
sis plant) may reduce the risk of certain types of cancer,
including colorectal cancers. Green tea contains
polyphenols, an antioxidant substance that also may in-
hibit the growth of existing cancer cells. In some animal
studies, injections of tea extracts reduced the size of can-
cerous tumors. The antioxidant effects of green tea need
to be studied further to more clearly define the role of
the herb in cancer treatment and prevention.
Because early detection is so critical to recovery
from colorectal cancer, patients considered “at risk” for
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Adjuvant therapy — Treatment involving radiation,
chemotherapy (drug treatment), hormone therapy,
or a combination of all three.
Antioxidants — Enzymes that bind with free radi-
cals to neutralize their harmful effects.
Free radicals — Reactive molecules created during
cell metabolism that can cause tissue and cell
damage like that which occurs in aging and with
disease processes such as cancer.
Lymph nodes — Small, bean-shaped masses of tis-
sue scattered along the lymphatic system that act
as filters, removing fluids, bacteria, or cancer cells
that travel through the lymph system. Cancer cells
in the lymph nodes are a sign that the cancer has
spread.
Malignant — Cancerous.
Polyp — A benign, tumor-like outgrowth.
the disease due to genetic, lifestyle, or environmental
factors should undergo regular screening after age 50
(and possibly before, depending on the individual’s per-
sonal and medical history). The American Cancer Soci-
ety recommends the following screening tests:
• an annual FOBT plus a flexible sigmoidoscopy every
five years
• a colonoscopy every 10 years
• a double contrast barium enema every five to 10 years
A digital rectal exam also is recommended during
each screening session.
Resources
BOOKS
Fauci, Anthony S., et al., eds. Harrison's Principles of Internal
Medicine. 14th ed. New York: McGraw-Hill, 1998.
Holmes, Nancy H., ed. Illustrated Guide to Diagnostic Tests.
2nd ed. Springhouse, PA: Springhouse Corporation, 1997.
PERIODICALS
"Approximately 5% of Colorectal Cancer Patients Have Inher-
ited Syndromes.” Cancer Weekly (July 8, 2003): 83.
"Avastin Receives FDA Fast-track Designation for Metastatic
Colorectal Cancer.” Cancer Weekly (July 22, 2003): 50.
"Colorectal Cancer Patients Participate in Clinical Trial.” Gene
Therapy Weekly (November 14, 2001): 14.
"Fecal Occult Blood Testing for Colorectal Cancer Screening:
Use the Finger.” Internal Medicine Alert 23, no. 24 (Dec
29,2001): 187.
519
Colorectal cancer
Color therapy
Minsky Bruce D. “Adjuvant Radiation Therapy for Rectal Can-
cer: Is There Finally an Answer?” The Lancet 358, no.
9290 (October 20, 2001): 1285.
Mukhtar, H., and N. Ahmad. “Green Tea in Chemoprevention
of Cancer.” Toxicological Sciences 52, no. 2 (December
1999): 111-7.
“Night-shift Work May Increase Risk of Colorectal Cancer in
Women." Women's Health Weekly (August 14, 2003): 24.
“Physical Activity Lowers Risk of Colorectal Cancer.” Obesity,
Fitness & Wellness Week (September 27, 2003): 3.
ORGANIZATIONS
National Cancer Institute. Cancer Information Service. 31 Cen-
ter Drive, MSC 2580, Bethesda, MD 20892-2582. (800)
4-CANCER. TTY: (800) 332-8615. <http://cancernet.nci.
nih.gov>.
American Cancer Society. (800) ACS-2345. <http://www.
cancer.org>.
Paula Ford-Martin
Teresa G. Odle
Color therapy
Definition
Color therapy, also known as chromatherapy, is based
on the premise that certain colors are infused with healing
energies. The therapy uses the seven colors of the rainbow
to promote balance and healing in the mind and body.
Origins
Color therapy is rooted in Ayurveda, an ancient form
of medicine practiced in India for thousands of years.
Ayurveda is based on the idea that every individual con-
tains the five basic elements of the universe: earth, water,
air, fire, and ether (space). These elements are present in
specific proportions unique to an individual’s personality
and constitution. When these elements are thrown out of
balance through unhealthy living habits or outside forces,
illness results. Ayurvedic medicine uses the energies in-
herent in the colors of the spectrum to restore this balance.
Color therapy was also used in ancient Egypt and
China. In traditional Chinese medicine (TCM), each
organ is associated with a color. In qigong, healing
sounds are also associated with a color, which in turn
corresponds to a specific organ and emotion.
Benefits
Each of the seven colors of the spectrum are associ-
ated with specific healing properties.
520
Violet
Violet promotes enlightenment, revelation, and spiri-
tual awakening. Holistic healthcare providers use violet to
soothe organs, relax muscles, and calm the nervous system.
Indigo
Indigo is also sedative and calming. It is said to pro-
mote intuition. Indigo may be useful in controlling
bleeding and abscesses.
Blue
Blue promotes communication and knowledge. It elimi-
nates toxins, and is used to treat liver disorders and jaundice.
Green
Because it is located in the middle of the color spec-
trum, green is associated with balance. Green is calming,
and is used by Ayurvedic practitioners to promote heal-
ing of ulcers. It is said to have antiseptic, germicide, and
antibacterial properties and is sometimes used by holistic
color therapists to treat bacterial infections.
Yellow
Yellow is a sensory stimulant associated with wis-
dom and clarity. Yellow is thought to have decongestant
and antibacterial properties, and is useful in stimulating
both the digestive system and the lymphatic system.
Orange
Orange promotes pleasure, enthusiasm, and sexual
stimulation. Ayurvedic practitioners believe it has an-
tibacterial properties and may be useful in easing diges-
tive system discomforts (e.g., flatulence, cramps).
Red
Red promotes energy, empowerment, and stimula-
tion. Physically, it is thought to improve circulation and
stimulate red blood cell production.
Description
The color spectrum is composed of different fre-
quencies and wavelengths of light energy. Ayurvedic
medicine uses the energy of colors to promote harmony
and healing. The colors are said to be imbued with cer-
tain healing properties (i.e., red is energizing, blue is
calming) and the vibrations generated by each color bal-
ance the individual.
Holistic healthcare providers who practice color
therapy often relate the seven colors of the color spec-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
tram to specific areas of the body known as the chakras.
In yoga, the chakras are specific spiritual energy centers
of the body. The therapeutic action of colors is related to
the chakra they represent:
• first (root; or base of spine): red
• second (sacral; or pelvis/groin area): orange
• third (solar plexus) chakra: yellow
• fourth (heart) chakra: green
• fifth (throat) chakra: blue
• sixth (brow) chakra: indigo
• seventh (crown) chakra: violet
Therapeutic color can be administered in number of
ways. Practitioners of Ayurvedic medicine wrap their pa-
tients in colored cloth chosen for its therapeutic hue. Pa-
tients suffering from depression may be wrapped in reds
and oranges chosen for their uplifting and energizing
properties. Patients may also be bathed in light from a
color-filtered light source to enhance the healing effects
of the treatment.
Another method of color therapy treatment recom-
mended in Ayurvedic medicine is to treat water with
color and then drink the water for its purported healing
properties. This is achieved by placing translucent col-
ored paper or colored plastic wrap over and around a
glass of water and placing the glass in direct sunlight so
the water can soak up the healing properties and vibra-
tions of the color.
Color may also be used environmentally to achieve
certain calming or healing effects. Paint, wall and win-
dow treatments, furniture, and decorative accessories may
all be selected in specific color families. Clothing may be
chosen in specific colors for its healing properties.
Color therapy can be used in conjunction with both
hydrotherapy and aromatherapy to heighten the thera-
peutic effect. Spas and holistic healthcare providers may
recommend color baths or soaks, which combine the
benefits of a warm or hot water soak with healing essen-
tial oils and the bright hues used in color therapy.
Because color is composed of different light fre-
quencies, certain types of music and sound therapy are
sometimes used as a companion to the treatment by
holistic healthcare providers. One such method, known
as the 49th Vibrational Technique, uses a mathematical
formula to translate the inaudible vibrations produced in
the color spectrum to their audible counterparts. Red is
associated with the musical note G, orange is A, yellow
is A#, green is C, blue is D, indigo is D#, and violet is E.
By combining both visual colors and their audible fre-
quency counterparts, the therapeutic value of the color
frequency is thought to be enhanced.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Preparations
Before administering any treatment, practitioners of
Ayurvedic medicine will perform a thorough examina-
tion of and interview with the patient to determine his
prakriti, or constitution. In Ayurveda, an individual’s
prakriti is determined at conception and remains un-
changed during his lifetime. Treatment colors will be
chosen based on the prakriti and the individual’s specific
imbalance of doshas, or energies. There are three
doshas — vata, pitta, and kapha — that correspond to a
person’s temperament and body type. Most are a combi-
nation of the three (tridosha) with one predominating.
In some cases, holistic providers may take a photo-
graphic image of the patient’s aura, or individual energy
field, using a special camera that reads electrical impulses
from the patient’s hands. The camera produces an image
of the patient with bands of color(s) around the body. The
colors are then analyzed to determine the patient’s unique
aura energy pattern, and to decide what type of color
therapy would be complementary to that aura.
Precautions
While color therapy may be an effective treatment
for promoting relaxation and overall well-being, and as
an adjunct, or complementary therapy in treating some
disorders and illnesses, individuals with serious chronic
or acute health problems should not rely solely on the
therapy for treatment. Anyone with a chronic or acute
health concern should seek the advice of a qualified med-
ical practitioner.
Side effects
There are no known side effects to common prac-
tices of color therapy.
Research & general acceptance
Ayurvedic medicine has been a firmly entrenched
practice of medicine in India for thousands of years.
However, it is largely regarded as a complementary prac-
tice in the United States, although its popularity has
grown in recent years as Ayurvedic spas and medical
practices have grown in number. The benefits of color
therapy have not been researched extensively and it is
still considered a fringe therapy by the allopathic med-
ical community.
Training & certification
Individuals practicing as color therapists and/or
practitioners of Ayurvedic medicine do not require spe-
cial certification or licensing.
521
Color therapy
Colostrum
KEY TERMS
Aromatherapy — The therapeutic use of plant-de-
rived, aromatic essential oils to promote physical
and psychological well-being.
Hydrotherapy — Water therapy; the use of water
(hot, cold, steam, or ice) to relieve discomfort and
promote physical well-being.
Yoga — An Indian philosophical and health move-
ment that strives to achieve balance through relax-
ation, meditation, breathing exercises, and body
movements.
Resources
BOOKS
Klotsche, Charles. Color Medicine: The secrets of colorlvihra-
tionai healing. Sedona, AZ: Light Technology Publishing.
Lad, Vasant. The Complete Book of Ayurvedic Home Remedies.
New York: Three Rivers Press, 1998.
PERIODICALS
Sandroff, Ronni. “Color Me Healthy.” Vegetarian Times (June
1999): 46-48.
Paula Ford-Martin
Colostrum
Description
Colostrum is a thick yellow fluid, rich in protein,
growth factors, and immune factors. It is secreted by the
mammary glands of all female mammals during the first
few days of lactation. It also contains essential nutrients
and protease inhibitors that keep it from being destroyed
by the processes of digestion. Humans produce relatively
small amounts of colostrum in the first two days after
giving birth, but cows produce about 9 gallons (36 L) of
colostrum. Bovine colostrum can be transferred to all
other mammals, and is four times richer in immune fac-
tors than human colostrum.
Although colostrum has received widespread atten-
tion as a dietary supplement only since the late 1990s, it
has a lengthy history of medicinal use. Ayurvedic physi-
cians in India have used colostrum as a treatment for
thousands of years. In the United States, mainstream
medical practitioners recommended colostrum as a nat-
ural antibiotic before the discovery of penilcillin and
522
sulfa drugs. In the 1950s, colostrum was used to treat
rheumatoid arthritis (RA). Dr. Albert Sabin, the re-
searcher who developed the first oral vaccine for po-
liomyelitis, found that colostrum contains antibodies
against polio. He recommended colostrum as a dietary
supplement for children who were vulnerable to polio.
The major components of colostrum include the fol-
lowing substances:
• Immunoglobulins. Immunoglobulins are globulin pro-
teins that function as antibodies. They are the most plen-
tiful immune factors found in colostrum. Immunoglobu-
lin G (IgG) counteracts bacteria and toxins in the blood
and lymphatic system; immunoglobulin M (IgM) seeks
out and attaches itself to viruses in the circulatory sys-
tem; immunoglobulins D and E (IgD and IdE) remove
foreign substances from the bloodstream and activate al-
lergic reactions. High-quality colostrum is certified to
contain a minmum of 16% immunoglobulins.
• Lactoferrin. Lactoferrin is a protein that transports iron
to red blood cells and helps to deprive viruses and
harmful bacteria of iron.
• Proline -rich polypeptide (PRP). PRP is a hormone that
regulates the thymus gland, helping to calm a hyperac-
tive immune system or stimulate an underactive im-
mune system.
• Growth factors. The growth factors in bovine colostrum
include insulin-like growth factors (IgF-1 and IgF-2),
an epithelial growth factor (EgF), transforming growth
factors (TgF-A and TgF-B), and a platelet-derived
growth factor (PDGF). Growth factors stimulate nor-
mal growth as well as the healing and repair of aged or
injured skin, muscle, and other tissues. In addition,
growth factors help the body to burn fat instead of mus-
cle for fuel when a person is dieting or fasting.
• Growth hormone. Growth hormone slows some of the
signs of aging.
• Leukocytes. Leukocytes are white cells that stimulate
production of interferon, a protein that inhibits viruses
from reproducing.
• Enzymes. Colostrum contains three enzymes that oxi-
dize bacteria.
• Cytokines and lymphokines. These are substances that
regulate the body’s immune response, stimulate the
production of immunoglobulins, and affect cell growth
and repair.
•Vitamins. Colostrum contains small amounts of vita-
mins A, B 12 , and E.
• Glycoproteins. Glycoproteins, or protease inhibitors,
are complex proteins that protect immune factors and
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
growth factors from being broken down by the acids in
the digestive tract.
• Sulfur. Sulfur is a mineral that is an important building
block of proteins.
General use
Colostrum is presently used to treat a variety of dis-
eases and disorders. Applications that have been investi-
gated in clinical trials include the following:
Bacterial and viral infections
A number of recent clinical studies have shown that
colostrum is effective in reversing the inflammation of
the digestive tract in HIV/AIDS patients caused by op-
portunistic infections. The antiviral, antifungal, and an-
tibacterial properties of colostrum enable it to kill such
pathogens as E. coli , Candida albicans, rotaviruses, and
Cryptosporidium.
In 1980, a British researcher showed that a large
proportion of the antibodies and immunoglobulins in
colostrum are not absorbed by the body but remain in the
digestive tract. There they attack food- and water-borne
organisms that cause disease. More recent clinical stud-
ies have demonstrated that colostrum is effective in pre-
venting intestinal infections by first keeping the bacteria
from attaching themselves to the intestinal wall, and sec-
ondly by killing the bacteria themselves. Colostrum has
proved to be capable of killing Campylobacter, Heli-
cobacter pylori, Listeria, Salmonella, Shigellosis, and
five types of streptococci.
Allergies and autoimmune diseases
The PRP in colostrum has been demonstrated to re-
duce or eliminate the pain, swelling, and inflammation
associated with allergies and autoimmune diseases
(multiple sclerosis, rheumatoid arthritis, lupus, myas-
thenia gravis). These effects are related to PRP’s ability
to inhibit the overproduction of lymphocytes (white
blood cells) and T-cells.
Heart disease
Recent research suggests that cardiovascular disease
may be caused in part by alterations in the patient’s im-
mune system. One study indicated that 79% of patients
with heart diseases had a certain type of Chlamydia (an
intracellular parasite closely related to certain bacteria)
associated with the formation of plaque in their arteries.
The PRP in colostrum may be able to reverse heart dis-
ease in the same way it counteracts allergies and autoim-
mune diseases. In addition, the growth factors and
growth hormone in colostrum appear to lower the blood
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
levels of “bad” cholesterol while raising the blood levels
of “good” cholesterol. These growth factors also repair
damage to heart muscle and support the growth of new
blood vessels in the part of the circulatory system that
surrounds the heart.
Cancer
Since 1985, the cytokines contained in colostrum
have been a major area of research in seeking a cure for
cancer. Researchers have found that the lactoferrin in
colostrum has some anti-cancer activity. In addition, the
combination of immune factors and growth factors in
colostrum appears to inhibit the growth of cancers.
Weight loss
The growth factor called IgF-1 that is contained in
colostrum is needed by the body in order to metabolize
fat. As humans grow older, their bodies produce less IgF-
1 . These lower levels of growth factor are associated with
a higher rate of type 2 diabetes in older adults and with
increased difficulty losing weight in spite of exercise and
careful attention to diet. While colostrum by itself will
not cause weight loss, it appears to be a useful part of a
weight reduction program because of its IgF-1 content.
Sports medicine
The immune factors in colostrum appear to be help-
ful in protecting athletes from infections caused by the
physical and emotional stress of competition. Using
colostrum as a dietary supplement also increases the effi-
ciency of the digestive tract for athletes in training. The
intestines are able to make more nutrients available to
the muscle cells and the body’s vital organs. A 2002 re-
port stated that cyclists taking 20 to 60 grams of bovine
colostrums supplements per day showed significant per-
formance improvements following a two-hour ride.
Open wounds
The growth factors in colostrum have been found to
stimulate the growth of new skin and to repair tissues
damaged by ulcers, injuries, burns, surgery, or inflam-
mation. They are able to do this through their direct ac-
tion on the cells’ DNA and RNA. Powdered colostrum
has been used in topical preparations for gum disease,
sensitive teeth, mouth ulcers, cuts, and burns.
Other
Colostrum has been used outside clinical research to
treat a variety of other conditions. Satisfied individuals
have reported that colostrum has successfully treated skin
disorders, emphysema, baldness in males, anger outbursts,
523
Coloslrum
Coltsfoot
fever blisters, shingles, tendinitis, thyroid disorders,
gout, insect bites, vaginal yeast infections, and anemia.
Preparations
Colostrum is presently available in a variety of
forms, including tablets, liquids, powders, and encapsu-
lated powders. In general, the powdered forms are rec-
ommended as preferable to liquids or tablets, on the
grounds that liquid colostrum has a short shelf life and
the processing necessary to produce tablets destroys
much of colostrum’s biological activity. The recom-
mended dose for adults with disease symptoms is
1,000-2,000 mg of powdered colostrum in capsules,
taken twice daily with 8-12 oz of water. Preventive
doses are left to the patient’s choice. Children can be
given colostrum but require less than adults.
In the United States, colostrum is taken from dairy
cows within 24 hours after the birth of a calf. Only dairy
cows that meet USDA health standards and have been
raised on a feed supplemented with nutrients are used to
supply colostrum. The calf needs four gallons of the nine
that the cow produces. The remaining five gallons are
collected by a USDA-certified dairy. The colostrum is
frozen and kept at a temperature of 17°F (-8.3°C). After
the frozen colostrum is taken to a processing plant, it is
carefully thawed and evaluated for quality and im-
munoglobulin content. About 30% is rejected at this
stage. The fat is then removed from the remaining
colostrum, after which the colostrum is spray-dried at
low heat. The colostrum is repeatedly tested during pro-
cessing for freedom from bacterial contamination.
Precautions
Persons who are using colostrum as a dietary sup-
plement in the United States should obtain it from a
source licensed by the USDA.
Side effects
With the exception of allergic reactions in persons
who are known to be allergic to cow’s milk, colostrum
does not produce any major side effects at any level of con-
sumption. Mild flu-like symptoms that disappear with con-
tinued use of colostrum have been reported in children.
Interactions
No significant drug interactions between colostrum
and standard pharmaceuticals have been reported.
Resources
PERIODICALS
Coombes, Jeff S., et al. “Dose Effects of Oral Bovine Colostrum
on Physical Work Capacity in Cyclists.” Medicine and Sci-
ence in Sports and Exercise (July 2002): 1184.
524
KEY TERMS
Cytokines — Substances of low molecular weight
that affect cell growth and repair, tissue inflamma-
tion, and immunity to diseases.
Glycoproteins — Complex proteins that protect im-
mune factors and growth factors from being bro-
ken down by stomach acids. Glycoproteins are
also called protease inhibitors.
Immunoglobulins — A group of globulin proteins
that function as antibodies.
Lactoferrin — A protein found in colostrum that
carries iron to red blood cells and appears to have
anti-cancer activity.
Lymphocyte — A type of white blood cell that is
important in the production of antibodies.
Opportunistic infection — A type of infection
caused only under certain circumstances, as when
a person's immune system is impaired.
Proline-rich polypeptide (PRP) — A hormone
found in colostrum that regulates the thymus
gland and the immune system. It helps to make
colostrum an effective treatment for autoimmune
disorders and possibly heart disease. Proline is an
amino acid.
T cell — A type of lymphocyte that develops in the
thymus gland, circulates in the blood and lymph,
and regulates the body's immune response to in-
fected or malignant cells.
ORGANIZATIONS
National Association of Alternative Medicines (NAAM). P. O.
Box 35189, Chicago, IL 60707-0189. (708) 453-0080.
Fax: (708) 453-0083.
OTHER
Health/Link: Alternative Health Directory. http://www.selene.
com/healthlink/bovine.html.
Rebecca Frey, Ph.D.
Teresa G. Odle
Coltsfoot
Description
Coltsfoot is the plant Tussilago farfara, a member of
the daisy family (Asteraceae). Coltsfoot is a perennial
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
herb that grows to a height of 4-10 inches (10-25 cm).
The stem is covered with white, downy fibers. Its leaves
are hoof-shaped, and the flowers are yellow. The leaves,
flowers, and occasionally the root are used medicinally.
Coltsfoot is a tough, invasive plant that lives in mar-
ginal soil, wasteland, roadsides, and sand dunes. In some
areas coltsfoot is considered an undesirable weed. Al-
though native to Europe, coltsfoot grows wild in North
America and the temperate parts of China. Other names for
coltsfoot are cough wort, horsefoot, horsehoof, bull’s foot,
ass’s foot, foal's foot, British tobacco, butterbur, field hove,
and flower velure. In Chinese it is called kuan dong hua.
General use
Coltsfoot has been used as a cough remedy in both
Western herbalism and traditional Chinese medicine
for at least 2,500 years. Coltsfoot was such a well-known
and well-respected herb in eighteenth century France
that apothecary shops advertised their presence by paint-
ing a picture of the herb on their signs. Chinese herbal-
ists prefer to use the flower and flower buds, while West-
ern herbalists most often choose to use the leaves.
Coltsfoot is recommended to treat:
• asthma
• bronchitis
• dry, hacking cough
• laryngitis and hoarseness
• lung cancer symptoms
• mouth and throat irritations
• sore throat
• wheezing
A decoction (boiling the herb down to a concentrat-
ed broth or tea to be taken internally) of coltsfoot root is
sometimes used to induce sweating. Externally, a poul-
tice of flowers is sometimes applied to the skin to treat
eczema, stings, bites, and skin inflammations. Some-
times coltsfoot leaves are smoked to relieve cough.
Modern scientific investigation shows that coltsfoot
contains a substance called mucilage (about 8%) that
coats and soothes the throat. It is the presence of this
substance that appears to make coltsfoot so effective in
treating coughs and respiratory problems. Coltsfoot tea
also appears to help clear the airways of mucus in some
animal studies. Smoking coltsfoot will probably do
more to irritate the throat than to soothe it.
Inhaling steam from a pot of boiling coltsfoot leaves
is likely to produce little effect because so little of the
medicinal material will reach the throat. The German
Federal Health Agency’s Commission E, established in
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
1978 to independently review and evaluate scientific lit-
erature and case studies pertaining to herb and plant
medications, has approved the use of fresh or dried colts-
foot leaf in products to treat dry cough, hoarseness, and
mild throat or mouth inflammations.
Despite evidence that coltsfoot does generally work,
it is not without its problems. The leaves, and to a greater
degree the buds and flowers, contain compounds called
pyrrolizidine alkaloids. These compounds are known to
damage the liver. They can cause liver cancer with ex-
tended exposure and may also cause the blood vessels of
the liver to narrow dangerously. In one laboratory study,
rats fed a diet of coltsfoot flower developed a high rate
of cancerous liver tumors.
In the United States, the Food and Drug Administra-
tion (FDA) has labeled coltsfoot an herb of “undefined
safety.” Coltsfoot leaf also falls under some legal restric-
tions in Austria. German authorities, however, simply rec-
ommend that preparations containing coltsfoot leaf should
not be taken for more than four to six weeks each year.
There is, however, fairly unanimous agreement that the
level of pyrrolizidine alkaloids in coltsfoot flowers is much
higher than the level found in the leaves, and that medici-
nal preparations that use the flower or flower bud should be
avoided. Some American herbalists are recommending that
the internal use of coltsfoot be discontinued as a precaution
until further research clarifies the risks involved.
Preparations
Coltsfoot leaves are harvested in early summer and
can be used fresh or dried. In China, the flower heads are
dug up in winter, before they emerge from the ground.
When the root is used, it is harvested in the autumn.
Coltsfoot is most commonly prepared as a tea. It can
also be made into a cough syrup when combined with
licorice, thyme, or black cherry. Commercial prepara-
tions are also available.
Precautions
The safest course is to avoid the internal use of colts-
foot. Pregnant and nursing women and children under the
age of six should not be given coltsfoot. People who
choose to use coltsfoot should avoid ingesting more than 1
gram of pyrrolizidine alkaloids daily. However, accurate
measurement of pyrrolizidine alkaloids is difficult and this
information is not easily available to many consumers.
Side effects
Coltsfoot is believed to increase the incidence of
liver damage and cancerous liver tumors in both labora-
tory animals and humans.
525
Coltsfoot
Comfrey
Interactions
There are no studies of the interactions of coltsfoot with
conventional pharmaceuticals or other herbal remedies.
Resources
BOOKS
Chevallier, Andrew. Encyclopedia of Medicinal Plants. New
York: DK Publishing, Inc., 1996.
PDR for Herbal Medicines. Montvale, NJ: Medical Economics
Company, 1999.
Peirce, Andrea. The American Pharmaceutical Association
Practical Guide to Natural Medicines. New York: William
Morrow and Company, 1999.
Weiner, Michael and Janet Weiner. Herbs that Heat. Mill Val-
ley, CA: Quantum Books, 1999.
OTHER
Plants for a Future “Tussilago farfara." http://www.pfaf.org.
Tish Davidson
Comfrey
Description
Comfrey ( Symphytum officinale ), or common com-
frey, has been known by many names, including
boneset, knitbone, bruisewort, black wort, salsify, ass
ear, wall wort, slippery root, gum plant, healing herb,
consound, or knit back. This distinctive herb, considered
by the English herbalist Culpeper to be “under the do-
minion of the moon,” is a member of the Boraginaceae
family. The genus name Symphytum is from the Greek
word sympho meaning to unite. The common name com-
frey is from the Latin confirmare meaning to join togeth-
er. The herb is named after its traditional folk use in
compress and poultice preparations to speed the healing
of fractures, broken bones, bruises, and burns. Com-
frey is a perennial native of Europe and Asia and has
been naturalized throughout North America. There are
about 25 species of the herb, including prickly comfrey
(S. asperum) and Russian comfrey (S. X uplandicum,
known as okopnik). In Russian medicine, the herb is
considered poisonous when used excessively.
Comfrey grows well in rich, moist, low meadows, or
along ponds and river banks, where it may reach a height
of 4 ft (1.2 m). Comfrey root is large, branching, and
black on the outside with a creamy white interior contain-
ing a slimy mucilage. Hollow, erect stems, also contain-
ing mucilage, are covered with bristly hairs that cause
itching when in contact with the skin. The thick, some-
526
what succulent, veined leaves are covered with rough
hairs. They are alternate and lance shaped, with lower
leaves as large as 10 in (25 cm) in length, and dark green
on top and light green on the underside. Small, bell-
shaped flowers grow from the axils of the smaller, upper
leaves on red stalks. Flowers are mauve to violet and
form in dense, hanging clusters, blooming in summer.
The cup-like fruits each contain four small, black seeds.
General use
Comfrey root and other parts of the herb have been
valued medicinally for more than 2,000 years. The specific
name officinale designates its inclusion in early lists of of-
ficial medicinal herbs. Comfrey has been prepared as a
poultice or compress with healing properties for blunt in-
juries, fractures, swollen bruises, boils, carbuncles, vari-
cose ulcers, and burns. The external application of comfrey
preparations may minimize the formation of scar tissue.
Poultices were also applied to ease breast pain in breast-
feeding women. Comfrey, taken internally as a tea or ex-
pressed juice, has been used to soothe ulcers, hernias, coli-
tis, and to stop internal bleeding. As a gargle it has been
used to treat mouth sores and bleeding gums. The herbal
tea has also been used to treat nasal congestion and inflam-
mation, diarrhea, and to quiet coughing. The hot, pulped
root, applied externally, was used to treat bronchitis,
pleurisy, and to reduce pain and inflammation of sprains.
The herb is thought to loosen congestion, soothe irri-
tated membranes and skin, reduce bleeding, tighten tissues,
and heal wounds. The allantoin in comfrey, found most
abundantly in the flowering tops, has been identified as the
source of much of the herb’s healing actions. Comfrey, ap-
plied externally to superficial wounds, promotes the heal-
ing of connective tissue, bones, and cartilage. Other con-
stituents found in comfrey include tannins, resin, essential
oil, gum, carotene, rosmarinic acid, choline, glycosides,
sugars, betea-sitosterol, and steroidal saponins.
Comfrey contains vitamins A and B 12 , and is high in
calcium, potassium, and phosphorus. The herb has long
been used as a cooked green vegetable in early spring, and
the fresh, young leaves have been added to salads. The
widespread suffering caused by the Irish potato famine of
the 1840s motivated Henry Doubleday, an Englishman, to
fund research into comfrey ’s potential as a nutritional food
crop. Farmers have valued comfrey as a nutritious fodder
for cattle. When the leaves are soaked in rainwater for a
few weeks, they will produce a valuable fertilizer for the
garden, especially beneficial to tomatoes and potatoes.
Modern herbalists, however, disagree strongly about
comfrey ’s safety, particularly when herbal preparations
are taken internally. A Japanese study in 1968 implicated
comfrey constituents (known as pyrrolizidine alkaloids)
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
as being toxic to the liver even when taken in small
amounts. The study involved large amounts of comfrey
extract rather than the whole herb. The most toxic of
these pyrrolizidine alkaloids, according to Varro Tyler of
the Purdue University School of Pharmacy, is echimidine.
This alkaloid is found primarily in Russian comfrey and
prickly comfrey rather than the common comfrey. How-
ever, Tyler cautions that other alkaloids toxic to the liver
are present in common comfrey, and commercial prepara-
tions may not distinguish between the types of comfrey
contained in the products offered for sale. Herbal prod-
ucts containing echimidine are prohibited for sale in
Canada as medicines. In fact, all comfrey products made
from the root, which contains a higher concentration of
pyrrolizidine alkaloids, are restricted in Canada.
A 1978 Australian study reported that rats fed a large
diet of comfrey leaf developed liver cancer. The research
literature has reported some cases of liver toxicity attrib-
uted to long-term, internal use of comfrey. However, some
Japanese doctors still continue to recommend a vinegar ex-
tract of comfrey to treat cases of cirrhosis of the liver, de-
spite these previous research findings of the hazards asso-
ciated with internal use. The research on the safety and ef-
fectiveness of comfrey as a medicine continues with some
conflicting research results. In Germany, where standard-
ized comfrey remedies are commercially available, the al-
lowed dosage and duration of treatment is regulated. In the
United States, however, commercial preparations may not
be standardized to meet these dosage restrictions.
Preparations
Ointments, salves, and oil extracts of comfrey are
available for external treatment. The crushed or pow-
dered root and extracted juice of the herb are used to
make poultices for external applications. Comfrey ex-
tract is an ingredient in commercially prepared medi-
cines for chest congestion, coughs, and pain relief.
Precautions
Comfrey should not be used, either externally or in-
ternally, by pregnant or breast-feeding women. Many
herbalists caution against internal use of comfrey. This
caution is due to the dangers of the pyrrolizidine alka-
loids that are toxic to the liver and may have cancer-
causing effects, even in small amounts. Consumers
should avoid external use of comfrey on deep wounds
because the herb may promote premature healing of sur-
face tissue before the deeper damage has been healed.
Wounds must be thoroughly cleaned before application
of comfrey remedies to avoid tissue forming over dirt
particles. Comfrey preparations should not be used for
more than four weeks. Gathering comfrey in the wild
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
may be dangerous for the novice herbalist because the
early spring leaves somewhat resemble the deadly ones
of nightshade and, in some reported cases, ingesting
comfrey in preparations contaminated with deadly night-
shade has led to poisoning.
Side effects
No side effects are known with proper preparation
and administration of Symphytum officinale in external,
therapeutic applications. Internal use of herbal prepara-
tions should be avoided pending further research.
Interactions
None reported.
Resources
BOOKS
Hutchens, Alma R. A Handbook of Native American Herbs.
Boston: Shambhala Publications, Inc., 1992.
527
Comfrey
Common cold
KEY TERMS
Carbuncle — A skin infection creating deep, pus-
filled boils.
Pleurisy — Inflammation of the pleura, the mem-
branes enclosing the lungs and lining the chest
cavity.
McIntyre, Anne. The Medicinal Garden. New York: Henry Holt
and Company, 1997.
Ody, Penelope. The Complete Medicinal Herbal. New York:
Dorling Kindersley, 1993.
PDR for Herbal Medicines. Montvale, NJ: Medical Economics
Company, 1998.
Polunin, Miriam, and Christopher Robbins. The Natural Phar-
macy. New York: Macmillan Publishing Company, 1992.
Tyler, Varro E., Ph.D. The Honest Herbal. New York: Pharma-
ceutical Products Press, 1993.
Clare Hanrahan
Common cold
Definition
The common cold is a viral infection of the upper
respiratory system, which includes the nose, throat, si-
nuses, eustachian tubes, trachea, larynx, and bronchial
tubes. Although more than 200 different viruses can
cause a cold, 30-50% are caused by a group known as
rhinoviruses. Almost all colds clear up in less than two
weeks without complications.
Description
Colds, sometimes called rhinovirus or coronavirus
infections, are the most common illness to strike any
part of the body. It is estimated that the average person
has more than 50 colds during a lifetime. Anyone can get
a cold, although preschool and grade school children
catch them more frequently than adolescents and adults.
Repeated exposure to viruses causing colds creates par-
tial immunity.
Although most colds resolve on their own without
complications, they are a leading cause of visits to the doc-
tor and of time lost from work and school. Treating symp-
toms of the common cold has given rise to a multimillion
dollar industry in over-the-counter medications, yet none of
these medications are actually anti-viral to the rhinovirus.
528
Cold season in the United States begins in early au-
tumn and extends through early spring. Although it is not
true that getting wet or being in a draft causes a cold (a
person has to come in contact with the virus to catch a
cold), certain conditions may lead to increased suscepti-
bility. These include:
• fatigue and overwork
• emotional stress
• poor nutrition
• smoking
• inadequate rest or sleep
• living or working in crowded conditions
Colds make the upper respiratory system less resis-
tant to secondary bacterial infection. Secondary bacterial
infection may lead to a number of other complications,
including middle ear infection, bronchitis, pneumonia,
sinus infection, or strep throat. People with chronic
lung disease, asthma, diabetes, or a weakened immune
system are more likely to develop these complications.
Causes & symptoms
Colds are caused by more than 200 different viruses.
The most common groups include rhinoviruses and coro-
naviruses. Different groups of viruses are more infectious
at different seasons of the year, but knowing the exact
virus causing the cold is not important in treatment.
People with colds are contagious during the first two
to four days of the onset of symptoms. Colds pass from
person to person in several ways. When an infected per-
son coughs, sneezes, or speaks, tiny fluid droplets con-
taining the virus are expelled. If these are breathed in by
other people, the virus may establish itself in their noses
and airways.
Colds may also be passed through direct contact.
For example, if a person with a cold touches his runny
nose or watery eyes, then shakes hands with another per-
son, some of the virus is transferred to the uninfected
person. If that person then touches his mouth, nose, or
eyes, the virus is transferred to an environment where it
can reproduce and cause a cold.
Finally, cold viruses can be spread through inani-
mate objects (door knobs, telephones, toys) that become
contaminated with the virus. This is a common method
of transmission in child care centers. Another vector of
transmission is air travel, due to closed air circulation in
buildings.
Once acquired, the cold virus attaches itself to the
lining of the nasal passages and sinuses. This causes the
infected cells to release a chemical called histamine.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Histamine increases the blood flow to the infected cells,
causing swelling, congestion, and increased mucus pro-
duction. Within one to three days, the infected person be-
gins to show cold symptoms.
The first cold symptoms are usually a tickle in the
throat, runny nose, and sneezing. The initial discharge
from the nose is clear and thin. Later, it may change to a
thick yellow or greenish discharge. Most adults do not
develop a fever when they catch a cold. Young children
may develop a low fever of up to 102°F (38.9°C).
Other symptoms of a cold include coughing, sneez-
ing, nasal congestion, headache, muscle ache, chills,
sore throat, hoarseness, watery eyes, fatigue, dull hear-
ing and blocked eustachian tube (a danger when flying),
and lack of appetite. The cough that accompanies a cold
is usually intermittent and dry.
Most people begin to feel better four to five days
after their cold symptoms become noticeable. All symp-
toms are generally gone within 10 days, except for a dry
cough that may linger for up to three weeks.
Colds make people more susceptible to secondary
bacterial infections such as strep throat, middle ear in-
fections, and sinus infections. A person should seek a
doctor’s consultation if the cold does not begin to im-
prove within a week. If an individual experiences chest
pain, fever for more than a few days, difficulty breath-
ing, bluish lips or fingernails, a cough that brings up
greenish-yellow or grayish sputum, skin rash, swollen
glands, or whitish spots on the tonsils or throat, then that
person should also consult a doctor to see if they have
acquired a secondary bacterial infection that needs to be
treated with an antibiotic.
People who have emphysema, chronic lung disease,
diabetes, or a weakened immune system — either from
diseases such as AIDS or leukemia, or as the result of
medications, (corticosteroids, chemotherapy drugs) —
should consult their doctor if they get a cold. People with
these health problems are more likely to get a secondary
infection.
Diagnosis
Colds are diagnosed by observing a person’s symp-
toms and symptom history. There are no laboratory tests
readily available to detect the cold virus. However, a
doctor may do a throat or nasal culture, or blood test to
rule out a secondary infection.
Influenza is sometimes confused with a cold, but
the flu causes much more severe symptoms, and is gen-
erally accompanied by a fever. Allergies to molds or pol-
lens also can cause a runny nose and eyes. Allergies are
usually more persistent than the common cold. An aller-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Rhinovirus magnified 100,000 times. Rhinovirus causes the
common cold. (CHSP/Custom Medical Stock Photo. Repro-
duced by permission.)
gist or a physician can do tests to determine if the cold-
like symptoms are being caused by an allergic reaction.
Also, some people get a runny nose when they go out-
side in winter and breathe cold air. This type of runny
nose, however, is not a symptom of a cold.
Treatment
The patient should drink plenty of fluids and eat nu-
tritious foods. In fact, the old adage, “Feed a cold, starve
a fever” was scientifically proven true in 2002. Dutch
scientists found that cold-fighting immune responses
rose after consuming a full meal while fasting increased
those that combat most fevers. Chicken soup with gin-
ger, scallions, and rice noodles is nutritious and has
properties that help the patient to recover. Rest, to allow
the body to fight infection, is very important. Gargling
with saltwater (half teaspoon salt in one cup of water)
helps to soothe a sore throat. A vaporizer also will make
the patient feel more comfortable. Rubbing petroleum
jelly or some other lubricant under the nose will prevent
irritation from frequent nose blowing. For babies, nasal
mucus should be suctioned gently with an infant nasal
aspirator. It may be necessary to soften the mucus first
with a few drops of salt water.
Herbals
Herbals can be taken to stimulate the immune sys-
tem, for antiviral activity, and to relieve symptoms. The
following herbs are used to treat colds:
• Ginger ( Zingiber officinale) reduces fever and pain, has
a sedative effect, settles the stomach, and suppresses
cough.
• Forsythia (Forsythia suspensa) fruit can be taken as a
tea for its anti-inflammatory, fever reducing, and an-
timicrobial properties.
529
Common cold
Common cold
• Honeysuckle ( Lorticera japonica) flower can be taken
as a tea for its anti-inflammatory, fever reducing, and
antimicrobial properties.
•Aniseed ( Pimpinella anisum ) can be added to tea to
expel phlegm, induce sweating, ease nausea, and ease
stomach gas.
• Slippery elm powdered bark ( Ulmus fulva) can be
taken as a tea or slurry or capsules to soothe sore
throat, to ease cough, and to thin mucous.
• Echinacea ( Echinacea purpurea or augustifolia) re-
lieved cold symptoms in clinical studies. The usual
dosage is 500 mg of crude powdered root or plant
thrice on the first day, then 250 mg four times daily
thereafter. This may also be taken as a tincture.
• Goldenseal ( Hydrastis canadensis ) has fever reducing,
antibacterial, anti-inflammatory, and antitussive proper-
ties. The usual dose is 125 mg three to four times daily.
Goldenseal should not be taken for more than one week.
Goldenseal may also be prepared as a tincture.
• Astragalus (Astragalus membranaceus) boosts the im-
mune system and improves the body’s response to
stress. The common dose is 250 mg of extract four
times daily.
• Cordyceps (Cordyceps sinensis ) modulates and boosts
the immune system and improves respiration. The
usual dose is 500 mg two to three times daily.
• Elder ( Sambucus ) has antiviral activity, increases
sweating, decreases inflammation, and decreases nasal
discharge. The usual dose is 500 mg of extract thrice
daily.
• Stinging nettle ( Urtica dioica ) has antihistamine and
anti-inflammatory properties. The common dose is 300
mg four times daily.
• Schisandra ( Schi sandra chinensis) helps the body fight
disease and increases endurance.
• Grape (Vitis vinifera ) seed extract has antihistamine
and anti-inflammatory properties. The usual dose is 50
mg three times daily.
• Eucalyptus (Eucalyptus globulus ) or peppermint
(Mentha piperita) essential oils added to a steam va-
porizer may help clear chest and nasal congestion and
disinfect room air.
• Boneset infusion (Eupatroium perfoliatum ) relieves
aches and fever.
• Yarrow (Achillea millefolium ) is a diaphoretic.
• Supplemental larch from the inner bark of the western
larch tree has been shown in some clinical trials to fight
persistent colds and ear aches.
530
Chinese medicines
Chinese herbal treatments are based on the specific
symptoms of colds and include a variety of Radix , Rhi-
zoma. Semen , and Herba species. Chinese patent medi-
cines for cold include:
• Wu Shi Cha (Noon tea): once or twice daily.
•Yin Qiao Jie Du Rian (Honeysuckle and Forsythia
Tablet to Overcome Toxins): four to six, twice daily.
• Sang Ju Gan Mao (Mulberry Leaf and Chrysanthemum
to Treat Common Cold): one packet of infusion or four
to eight tablets, twice or thrice daily.
• Ling Yang Gan Mao Rian (Atelopis Tablet for Common
Cold): four to six, twice daily.
•Ban Lan Gen Chong Ji (Isatidis Infusion): one packet
twice or thrice daily.
• Huo Xiang Zheng Qi (Agastache to Rectify Qi): 6 g or
four to six tablets.
Other remedies
The effectiveness of zinc lozenges for preventing or
treating the common cold is controversial. Numerous
studies have generated contradicting results. It has been
suggested that the citric acid, sorbitol, or mannitol in
some lozenges may bind zinc and reduce effectiveness,
hence the varying results of these studies. The recom-
mended dosage is to suck on one lozenge every two
hours while awake beginning at the first cold symptoms.
Side effects are bad taste, nausea, and vomiting.
Ayurvedic medicine practitioners recommend gar-
gling with a mixture of water, salt, and turmeric powder
or astringents such as alum, sumac, sage, and bayberry
to ease a sore throat.
Homeopaths recommend microdoses of Viscue
album, Natrum muriaticum, Allium cepa, or Nux vomica.
Allopathic treatment
There are no known medicines proven to shorten or
cure the common cold. Antibiotics are useless against a
cold, and can enhance bacterial resistance, if used care-
lessly. Nonprescription products to relieve cold symp-
toms usually contain antihistamines, decongestants,
and/or pain relievers. Over-the-counter cold remedies
should not be given to infants without consulting a doc-
tor first. Care should be taken not to exceed the recom-
mended dosages, especially when combination medica-
tions or nasal sprays are taken. Aspirin should not be
given to children with a cold because of its association
with a risk of Reye’s syndrome, a serious disease.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Antihistamines are taken to relieve the symptoms of
sneezing, runny nose, itchy eyes, and congestion. Side
effects are dry mouth and drowsiness, especially with
the first few doses. Some people have allergic reactions
to antihistamines. Common over-the-counter antihista-
mines include Chlor-Trimeton, Dimetapp, Tavist, and
Actifed. The generic name for two common antihista-
mines are chlorpheniramine and diphenhydramine.
Decongestants reduce congestion and open inflamed
nasal passages, making breathing easier. Decongestants
can make people feel jittery or keep them from sleeping.
They should not be used by people with heart disease,
high blood pressure, or glaucoma. Some common decon-
gestants are Neo-Synepherine, Novafed, and Sudafed.
The generic names of common decongestants include
phenylephrine, phenylpropanolamine, pseudoephedrine,
and in nasal sprays naphazoline, oxymetazoline, and xy-
lometazoline. Nasal sprays and nose drop decongestants
can act more quickly and strongly than ones found in
pills or liquids because they are applied directly in the
nose. Congestion returns after a few hours. Persons can
become dependent on nasal sprays and nose drops, so
they should not be used for more than a few days.
Many over-the-counter medications are combina-
tions of both antihistamines and decongestants; an ache
and pain reliever, such as acetaminophen (Datril, Tylenol,
Panadol) or ibuprofen (Advil, Nuprin, Motrin,
Medipren); and a cough suppressant (dextromethorphan).
Common combination medications include Tylenol Cold
and Flu, Triaminic, Sudafed Plus, and Tavist D.
Expected results
Given time, the body will make antibodies to cure it-
self of a cold. Most colds last seven to 10 days. Most
people start feeling better within four or five days. Occa-
sionally, a cold will lead to a secondary bacterial infec-
tion that causes strep throat, bronchitis, pneumonia,
sinus infection, or a middle ear infection.
Prevention
Prevention focuses on strengthening the immune
system by eating a healthy diet low in sugars and high in
fresh fruits and vegetables, practicing meditation to re-
duce stress, getting adequate sleep, and getting regular
moderate exercise. Some steps persons can take to pre-
vent catching a cold and to reduce their spread include:
• washing hands well and frequently
• covering the mouth and nose when sneezing
• avoiding close contact with someone who has a cold
during the first two to four days of their infection
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Bronchial tubes — The major airways from the
back of the throat to the lungs and their main
branches.
Coronavirus — A genus of viruses that causes res-
piratory disease and gastroenteritis.
Corticosteroids — A group of hormones produced
naturally by the adrenal gland or manufactured
synthetically. They are often used to treat inflam-
mation. Examples include cortisone and pred-
nisone.
Eustachian tube — A thin tube between the middle
ear and the pharynx. Its purpose is to equalize
pressure on either side of the ear drum.
Rhinovirus — A virus that infects the upper respira-
tory system and causes the common cold.
• not sharing food, eating utensils, or cups
• avoiding crowded places where cold viruses can spread
• keeping hands away from the face
• avoiding cigarette smoke
• taking Echinacea; 250 mg up to four times daily for
three weeks on, one week off
• taking astragalus; 250 mg to 500 mg daily.
• taking a multivitamin with zinc
• taking vitamin C; 500 mg
• taking Anas barbariae hepatis ; one dose weekly
In 2002, researchers discovered that transmission of
the rhinovirus may be prevented through the use of anti-
septic skin cleansers containing salicylic acid or pyroglu-
tamic acid. The cleansers have properties that can kill the
viruses and help prevent hand-to-hand transmission, but
further research on their effectiveness remains to be done.
Resources
BOOKS
Castleman, Michael. “Cold and Flu Therapy.” In Nature’s
Cures. Emmaus, PA: Rodale Press, 1996.
Silverstein Alvin, et al. Common Cold and Flu (Diseases and
People ). Springfield, MA: Enslow Publishers, 1996.
Ying, Zhou Zhong, and Jin Hui De. “Exterior Invasion.” In
Clinical Manual of Chinese Herbal Medicine and
Acupuncture. New York: Churchill Livingston, 1997.
PERIODICALS
"Antispetic Skin Cleansers May Prevent Rhinovirus Transmis-
sion.” Clinical Infectious Diseases (February 1, 2002): ii.
531
Common cold
Conjunctivitis
Bourassa, Nicole. “Larch: This Immune Booster Fights Tena-
cious Colds and Ear Infections.” Natural Health (March
2002): 35.
Elkins, Rita. “Combat Colds and Flu.” Let’s Live 68 (January
2000): 81+.
Jackson, Jeffrey L., Cecily Peterson, and Emil Lesho. “A Meta-
Analysis of Zinc Salts Lozenges and the Common Cold.”
Archives of Internal Medicine 157 (1997): 2373-2376.
Le Page, Michael. “Eat to Treat: The Maxim “Feed a Cold,
Starve a Fever” May be Right After All.” New Scientist
(January 19, 2002): 15.
Marshall, Shaun. “Zinc Gluconate and the Common Cold: Re-
view of Randomized Controlled Trials.” Canadian Family
Physician 44 (1998): 1037-1042.
Mayo Health Clinic. “Zinc: A Weapon Against the Common
Cold?” Mayo Health Oasis http://www.mayohealth.org/
mayo/9709/htm/zinc.htm. (9 September 1997).
Belinda Rowland
Teresa G. Odle
Coneflower see Echinacea
Conjunctivitis
Definition
Conjuctivitis is an inflammation (redness) of the lin-
ing of the white part of the eye and the underside of the
eyelid (conjunctiva). It can be caused by infection, aller-
gic reaction, or physical agents like infrared or ultravio-
let light.
Description
Conjunctivitis is a common eye problem because
the conjunctivae are continually exposed to microorgan-
isms and environmental agents that can cause infections
or allergic reactions. Conjunctivitis can be acute or
chronic depending upon how long the condition lasts, the
severity of symptoms, and the type of organism or agent
involved. It can affect one or both eyes. If it is caused by
infection, it can be easily transmitted to others during
close physical contact, particularly among children in a
daycare center. Other names for conjunctivitis include
pinkeye and redeye.
Causes & symptoms
Conjunctivitis may be caused by a viral infection,
such as a cold, acute respiratory infection, or disease
such as measles, herpes simplex, or herpes zoster. Symp-
toms may include mild to severe discomfort in one or
532
both eyes; redness; swelling of the eyelids; and a watery,
yellow, or greenish discharge. The symptoms may last
anywhere from several days to weeks. Infection with an
adenovirus, however, may also cause a significant
amount of pus-like discharge and a scratchy sensation in
the eye. These symptoms may also be accompanied by
swelling and tenderness of the lymph nodes near the ear.
Bacterial conjunctivitis may occur in adults or chil-
dren. It is caused by such organisms as Staphylococcus,
Streptococcus pneumoniae , and Haemophilus. Symp-
toms of bacterial conjunctivitis include a pus-like dis-
charge and crusty eyelids after awakening. Redness of
the conjunctivae can be mild to severe and may be ac-
companied by swelling. Persons with symptoms of con-
junctivitis who are sexually active may possibly be in-
fected with chlamydia or with the bacteria that cause
gonorrhea. There may be large amounts of pus-like dis-
charge. Symptoms may include hypersensitivity to light
(photophobia), a watery mucous discharge, and tender-
ness in the lymph nodes near the ear that may persist for
up to three months.
Conjunctivitis may also be caused by such environ-
mental hazards as wind, smoke, dust, and allergic reac-
tions caused by pollen, dust, or grass. Symptoms range
from itching and redness to a mucous discharge. Persons
who wear contact lenses may develop allergic conjunc-
tivitis caused by the various eye solutions and foreign
proteins contained in them.
Other less common causes of conjunctivitis include
looking at the sun, sun lamps, plant lamps, or the electrical
arcs used during welding, as well as defective tear ducts.
Diagnosis
Accurate diagnosis of conjunctivitis centers on tak-
ing the patient’s history to learn when symptoms began,
how long the condition has been going on, the symptoms
experienced, and other predisposing factors. Diagnostic
tests may include an eye examination, culture, or labora-
tory test. The discharge may be cultured and Gram-
stained to determine the organism responsible for causing
the condition. Cultures and smears are relatively painless.
Treatment
Conjunctivitis caused by gonococcal or chlamydial
infection usually requires prescription antibiotics. Inter-
nal immune enhancement with dietary supplements can
aid in the resolution of allergic and viral conjunctivitis.
Removal of the allergic agent is an essential step in treat-
ing allergic conjunctivitis. As with any of the recom-
mended treatments, however, if no improvement is seen
within 48-72 hours, a physician should be consulted.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Nutritional therapy
The following dietary changes may be helpful in
managing conjunctivitis:
• Taking 25,000 IU (international units) of beta-carotene
twice daily for 7 days.
• Taking 500-1000 mg of vitamin C three times daily
for 7 days.
• Taking 25 mg of zinc with meals three times daily for 7
days.
Homeopathy
There are a number of homeopathic remedies de-
signed to treat acute conjunctivitis. These include Argen-
tum nitricum (silver nitrate), pulsatilla (windflower), bel-
ladonna, Arsenicum album (arsenic trioxide), sulphur
(elemental sulphur) and eyebright ( Euphrasia offici-
nalis). Eye drops prepared with homeopathic remedies
can be a good substitute for pharmaceutical eye drops.
Herbal therapy
Herbal eyewashes made with eyebright ( 1 tsp dried
herb steeped in 1 cup of boiling water for 10 minutes,
then strained and used at once) or chamomile ( Matri-
caria recutita ; 2-3 tsp in 1 pint of boiling water) may be
helpful. Eyewashes should be strained and cooled before
use. They should be discarded promptly after use, as old
infusions may become unsterile.
Other simple home remedies may help relieve the
discomfort associated with conjunctivitis. A boric acid
eyewash (1 tsp boric acid in 1 cup of water) can be used
to clean and soothe the eyes. A warm compress applied
to the eyes for 5-10 minutes three times a day can help
relieve the discomfort of bacterial and viral conjunctivi-
tis. A clean washcloth soaked in warm water can be used
as a warm compress. The patient should close both eyes
and apply the compress to the affected eye. A cool com-
press or cool, damp tea bags (of black tea or chamomile
tea) placed on the eyes can ease the discomfort of con-
junctivitis.
Allopathic treatment
The treatment of conjunctivitis depends on what
caused the condition. In all cases, warm compresses ap-
plied to the affected eye several times a day may help to
reduce discomfort.
Conjunctivitis due to a viral infection, particularly
those due to adenoviruses, are usually treated by apply-
ing warm compresses to the eye(s) and applying topical
antimicrobial ointments to prevent secondary bacterial
infections.
Eyelid
Conjunctiva
Cornea
Lens
Conjunctivitis is the inflammation of the conjunctiva, a thin,
delicate membrane that covers the eyeball and lines the
eyelid. It may be caused by a viral infection, such as a cold
or acute respiratory infection, or by such diseases as
measles, herpes simplex, or herpes zoster. (Illustration by
Electronic Illustrators Group. The Gale Group.)
Viral conjunctivitis may cause blindness and should be
referred to an ophthalmologist. Topical steroids are com-
monly prescribed in combination with antiviral therapy.
In cases of bacterial conjunctivitis, a physician may
prescribe an antibiotic eye ointment or eye drops con-
taining sodium sulfacetamide (Sulamyd) to be applied
daily for 7-14 days. Patients should contact their doctors
if the eyes fail to improve after 72 hours. Antibiotic eye
drops are instilled (put in drop by drop) into the eye by
having the patient tilt the head back and pulling down
the lower eye lid. The patient is asked to look upward
while the medication is instilled into the conjunctival
sac. It is important to avoid touching the dropper to the
skin, in order to prevent the eye discharge from contami-
nating the antibiotic solution. After the drops have been
instilled, the patient should gently close the eyes for 1
minute in order not to squeeze out any of the medication.
For cases of conjunctivitis caused by a gonococcus
(the bacteria that causes gonorrhea), a physician may pre-
scribe an injection of ceftriaxone (Rocephin) and a topical
antibiotic ointment containing erythromycin or bactracin
to be applied four times daily for 2-3 weeks. For chlamy-
dial infections, a topical antibiotic ointment containing
erythromycin (Ilotycin) may be prescribed to be applied
1-2 times daily. To apply an antibiotic ointment, the eye
should be gently wiped with a sterile cotton ball moist-
ened with sterile water to remove any discharge. Then, the
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
533
Conjunctivitis
Conjunctivitis
lower eyelid can be pulled down and a thin ribbon of oint-
ment applied in the lower conjunctival sac. If possible,
single-dose dispensers of ointment should be used as a
protection against contamination of the medication. The
eyelids can be closed and massaged gently to distribute
the ointment. Patients may find that their vision is blurry
for a few minutes after the ointment is applied, but this is a
normal side effect. In addition to topical antibiotics, oral
erythromycin or tetracycline therapy may be indicated for
3—4 weeks. Sexual partners should also be treated.
Children with conjunctivitis should typically receive
topical antibiotics, according to clinical evidence pub-
lished in 2002. But the evidence re-emphasized that
adults who have non-gonococcal conjunctivitis usually
do not need antibiotic treatment, because antibiotic resis-
tance is a growing problem.
Allergic conjunctivitis can be treated by removing
the allergic substance from a person’s environment, if
possible; by applying cool compresses to the eye; and by
administering eye drops 4-6 times daily for four days.
Also, the antihistamine diphenhydramine hydrochloride
(Benadryl) may help to relieve itchy eyes. In 2002, a new
study showed that loteprednol and azelastine are two po-
tential treatments for allergic conjunctivitis. Some doc-
tors have prescribed ophthalimic steroids, but they can
cause complications in patients. These potential new
treatments offer alternatives to steroids for patients with
allergic conjunctivitis.
Expected results
If conjunctivitis is treated properly, its prognosis is
good. Conjunctivitis caused by an allergic reaction
should clear up once the allergen is removed. Allergic
conjunctivitis, however, will likely recur if the individual
again comes into contact with the particular allergen.
Conjunctivitis caused by bacteria or a virus, if treated
properly, usually resolves in 10-14 days. If there is no
relief of symptoms in 48-72 hours; or if there is moder-
ate to severe eye pain or changes in vision; or if the con-
junctivitis is suspected to be caused by herpes simplex, a
physician should be notified immediately. If untreated or
if treatment fails and is not corrected, conjunctivitis may
cause visual impairment by spreading to such other parts
of the eye as the cornea.
Prevention
Conjunctivitis can be prevented in many cases; in
others, the course of the disease can be shortened by fol-
lowing some simple practices:
• Washing hands frequently using antiseptic soap; using
single-use towels during the disease to prevent spreading
the infection.
534
KEY TERMS
Adenovirus — A virus that affects the upper respi-
ratory tract.
Chlamydia — A common sexually transmitted dis-
ease in the United States that often accompanies
gonorrhea. It is caused by a rickettsia called
Chlamydia trachomatis.
Gonococcus — The bacterium Neisseria gonor-
rheae . The gonococcus causes gonorrhea, a sexu-
ally transmitted infection of the genitals and uri-
nary tract that may occasionally affect the eye,
causing blindness if not treated.
Herpes simplex virus — A virus that can cause
fever and blistering on the skin, mucous mem-
branes, or genitalia.
Herpes zoster virus — Acute inflammatory virus at-
tacking the nerve cells on the root of each spinal
nerve with skin eruptions along a sensory nerve
ending.
Staphylococcus — A genus of bacteria that resem-
bles a cluster of grapes, that can infect various
body systems.
• Avoiding chemical irritants and known allergens.
• In areas where welding occurs, using the proper protec-
tive eye wear and screens to prevent damaging the eyes.
• Using a clean tissue to remove discharge from eyes,
and washing hands to prevent the spread of infection.
• If medication is prescribed, finishing the course of an-
tibiotics as directed to make sure that the infection is
cleared up and does not recur.
• Avoiding wearing eye makeup or contact lenses during
the infection. Never share eye makeup with others.
Resources
BOOKS
Jonas, Wayne B. and Jennifer Jacobs. Healing with Homeopa-
thy: The Doctor's Guide. New York: Warner Books, 1996.
Newell, Frank, ed. Ophthalmology: Principles and Concepts.
8th ed. St. Louis: Mosby-Year Books Inc., 1996.
Schwab, Ivan R., and Chandler R. Dawson. “Conjunctiva." In
General Ophthalmology, 14th ed. Daniel G. Vaughan,
Taylor Asbury, and Paul Riordan-Eva, eds. Norwalk, CT:
Appleton and Lange, 1995.
Uphold, Constance R. and Mary Virginia Graham. "Problems
of the Eyes." In Clinical Guidelines in Adult Health.
Gainesville, FL: Barmarrae Books, 1994.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Zand, Janet, Allan N. Spreen, and James B. LaValle. Smart
Medicine for Healthy Living. Garden City Park, NY:
Avery Publishing Group, 1999.
PERIODICALS
Guttman, Cheryl. “Lotepredol, Azelastine Provide Potent Arse-
nal for Acute, Chronic Allergic Conjunctivitis: Longer-
term use Proving Safe, Effective for Patients with both
Seasonal and Perennial Allergies.” Ophthalmology Times
(April 15, 2002): 30.
Kane, Kevin Y., et al. “When Should Acute Nonveneral Con-
junctivitis be Treated with Topical Antibiotics? (Clinical
Inquiries: from the Family Practice Inquiries Network).”
Journal of Family Practice (April 2002).
Mai Tran
Teresa G. Odle
Constipation
Definition
Constipation is an acute or chronic condition in
which bowel movements occur less often than usual or
consist of hard, dry stools that are painful or difficult to
pass. Bowel habits vary, but an adult who has not had a
bowel movement in three days or a child who has not had
a bowel movement in four days is considered constipated.
Description
Constipation is one of the most common medical
complaints in the United States. It can occur at any age
and is more common among individuals who resist the
urge to move their bowels at the body’s signal. This often
happens when children start school or enter daycare and
feel shy about asking permission to use the bathroom.
Constipation is more common in women than in men
and is especially apt to occur during pregnancy. Age alone
does not increase the frequency of constipation, but elderly
people are more likely to suffer from the condition.
Although this condition is rarely serious, it can lead to:
• bowel obstruction
• chronic constipation
• hemorrhoids (a mass of dilated veins in swollen tissue
around the anus)
• hernia (a protrusion of an organ through a tear in the
muscle wall)
• spastic colitis (irritable bowel syndrome, a condition
characterized by alternating periods of diarrhea and
constipation)
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Constipation is an acute or chronic condition in which
bowel movements occur less often than usual or consist of
hard, dry stools that are painful or difficult to pass. (Illustra-
tion by Electronic Illustrators Group. The Gale Group.)
• laxative dependency
Chronic constipation may be a symptom of colorec-
tal cancer, depression, diabetes, diverticulosis (small
pouches in the muscles of the large intestine), lead poi-
soning, or Parkinson’s disease. An opioid overdose (as
in excessive codeine from cough suppressants or heroin
addiction) also may result in constipation.
In someone who is elderly or disabled, constipation
may be a symptom of bowel impaction, a more serious
condition in which feces are trapped in the lower part of
the large intestine. A doctor should be called if an elderly
or disabled person is constipated for more than a week or
if a child seems to be constipated.
A doctor should be notified whenever constipation
occurs after starting a new prescription, vitamin, or min-
eral supplement or is accompanied by blood in the stools,
changes in bowel patterns, fever, or abdominal pain.
Causes & symptoms
Constipation usually results from not getting enough
exercise, not drinking enough water or clear fluids, or
from a diet that does not include an adequate amount of
fiber-rich foods like beans, bran cereals, fruits, raw veg-
etables, rice, and whole-grain breads.
Other causes of constipation include anal fissure (a
tear or crack in the lining of the anus), chronic kidney
failure, colon or rectal cancer, depression, hypercalcemia
535
Constipation
Constipation
(abnormally high levels of calcium in the blood), hy-
pothyroidism (underactive thyroid gland), illness requir-
ing complete bed rest, irritable bowel syndrome, imbal-
anced bowel from food and flora allergies, and stress.
Constipation can also be a side effect of:
• aluminum salts in antacids
• antihistamines
• antipsychotic drugs
• aspirin
• belladonna ( Atopa belladonna, source of atropine, a
medication used to relieve spasms and dilate the pupils
of the eye)
• beta blockers (medications used to stabilize irregular
heartbeat, lower high blood pressure, reduce chest pain)
• blood pressure medications
• calcium channel blockers (medication prescribed to treat
high blood pressure, chest pain, some types of irregular
heartbeat and stroke, some non-cardiac diseases)
• codeine or opioids.
• diuretics (drugs that promote the formation and secre-
tion of urine)
• iron or calcium supplements
• narcotics (potentially addictive drugs that relieve pain
and cause mood changes)
• tricyclic antidepressants (medications prescribed to
treat chronic pain, depression, headaches, and other ill-
nesses)
An adult who is constipated may feel bloated, have
a headache, swollen abdomen, pass rock-like feces, or
strain, bleed, or feel pain during bowel movements. A
constipated baby may strain, cry, draw the legs toward
the abdomen, or arch the back when having a bowel
movement.
Diagnosis
Everyone becomes constipated once in a while, but
a doctor should be notified if significant changes in
bowel patterns last for more than a week or if symptoms
continue more than three weeks after increasing activity
and fiber and fluid intake.
The patient’s observations and medical history help
a primary care physician diagnose constipation. The doc-
tor uses his fingers to see if there is a hardened mass in
the abdomen and may perform a rectal examination.
Other diagnostic procedures include a barium enema,
which reveals blockage inside the intestine; laboratory
analysis of blood and stool samples for internal bleeding
or other symptoms of systemic disease; and a sigmoi-
536
doscopy (examination of the sigmoid area of the colon
with a flexible tube equipped with a magnifying lens).
Physical and psychological assessments and a de-
tailed history of bowel habits are especially important
when an elderly person complains of constipation.
Treatment
Initially, alternative practitioners will suggest that the
patient drink an adequate amount of water each day (six to
eight glasses), exercise on a regular basis, and eat a diet
high in soluble and insoluble fibers. Soluble fibers include
pectin, flax, and gums. Insoluble fibers include psyllium
and brans from grains like wheat and oats. Fresh fruits and
vegetables contain both soluble and insoluble fibers, and
since constipation is aggravated by folate, calcium, and
magnesium deficiencies, sources of these nutrients, such as
asparagus, spinach, parsley, and other dark green leafy
vegetables, should be part of the daily diet. Various fruit
juices can also help maintain normal bowel function; sor-
bitol, the natural sugar found in apple juice has known laxa-
tive properties. Castor oil, applied topically to the abdomen
and covered by a heat source (a heating pad or hot water
bottle), can help relieve constipation when used nightly for
20-30 minutes. For babies, about 1 tablespoon of com symp
mixed with warm water might help relieve constipation.
Acupressure
This form of acupuncture is said to relax the ab-
domen, ease discomfort, and stimulate regular bowel
movements when diet and exercise fail to do so. After
lying down, patients close their eyes and take deep
breaths. For two minutes, the practitioner applies gentle
fingertip pressure to a point about two inches below the
navel. Acupressure can also be applied to the outer
edges of one elbow crease and maintained for 30 sec-
onds before pressing the crease of the other elbow. This
should be done three times a day to relieve constipation.
Aromatherapy
Six drops of rosemary (Rosmarinus officinalis) and
six drops of thyme ( Thymus spp.) diluted by one ounce
of almond oil, olive oil, or another carrier oil can relieve
constipation when used to massage the abdomen. A cir-
cular motion for massage is recommended, beginning up
the right side of the abdomen, coming across the top, and
down the left side. Massaging the leg from knee to hip in
the morning, at night, and before trying to move the
bowels is said to relieve constipation.
Herbal therapy
A variety of herbal therapies can be useful in the
treatment of constipation. Several herbs, including
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
chamomile (Matricaria recutita), dandelion root
(Taraxacum officinale), and burdock ( Arctium lappa), act
as bitters which stimulate the movement of the digestive
and excretory systems. There are also laxative herbs that
assist with bowel movement. Two of these are senna and
buckthorn. These laxative herbs are stronger acting on
elimination than bitters and can sometimes cause cramp-
ing (mixing them with a calming herb like fennel or car-
away can help reduce cramping). Both senna and buck-
thorn are powerful herbs that are best used with direction
from an experienced practitioner, since they can have ad-
verse side effects and the patient may become dependent
on them. In fact, practitioners caution that senna can
cause severe cramping.
Yoga
The knee-chest position, said to relieve gas and
stimulate abdominal organs, involves:
• standing straight with arms at the sides
• lifting the right knee toward the chest
• grasping the right ankle with the left hand
• pulling the leg as close to the chest as possible
• holding the position for about eight seconds
• repeating these steps with the left leg
The cobra position, which can be repeated as many
as four times a day, involves:
• lying on the stomach with legs together
• placing the palms just below the shoulders, holding el-
bows close to the body
• inhaling, then lifting the head (face forward) and chest
off the floor
• keeping the navel in contact with the floor
• looking as far upward as possible
• holding this position for three to six seconds
• exhaling and lowering the chest
The spine twist is another pose that is recommended
for daily use in relieving constipation. Practicing relax-
ation and meditation can also have a powerful effect on
the digestive system. Slow, steady music can relieve ten-
sion that leads to constipation.
Allopathic treatment
If changes in diet and activity fail to relieve occa-
sional constipation, an over-the-counter laxative may be
used for a few days. Preparations that soften stools or
add bulk (bran, psyllium, ducosate sodium) work more
slowly but are safer than Epsom salts and other harsh
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
laxatives or herbal laxatives containing senna (Cassia
senna) or buckthorn ( Rhamnus purshianna), which, if
used long term, can harm the nerves and lining of the
colon because they are peristaltic stimulants.
A woman who is pregnant should never use a laxa-
tive. She can use flaxseed, bran, ducosate sodium, prunes,
or oatmeal. Anyone who is experiencing abdominal pain,
nausea, or vomiting should also avoid laxatives. A warm-
water or mineral oil enema can relieve constipation, and a
non-digestible sugar (lactulose) or special electrolyte solu-
tion is recommended for adults and older children with
stubborn symptoms. If a patient has an impacted bowel,
the doctor may insert a gloved finger into the rectum and
gently dislodge the hardened feces.
In 2002, a new study compared a non-toxic food in-
gredient called polyethylene glycol to lactulose for re-
lieving constipation in children. A preliminary study
showed that it may work faster, prove easier to adminis-
ter, and be just as safe and effective. However, more re-
search was suggested before recommending the sub-
stance over lactulose.
Expected results
Changes in diet and exercise usually eliminate the
problem of constipation.
Prevention
Most Americans consume between 11-18 grams of
fiber a day. Consumption of 30 grams of fiber and be-
tween 6-8 glasses of water each day can generally prevent
constipation, and 35 grams of fiber a day (an amount
equal to five servings of fruits and vegetables, and a large
bowl of high-fiber cereal) can relieve constipation. Fiber
supplements containing psyllium (, Plantago psyllium)
usually become effective within about two days and can
be used every day without causing dependency. Pow-
dered flaxseed ( Linium usitatissimum) works the same
way. Insoluble fiber, like wheat or oat bran, is as effective
as psyllium but may give the patient gas at first.
Daily use of 500 mg vitamin C and 400 mg magne-
sium can prevent constipation. If symptoms do occur,
each dosage can be increased by 100 mg a day, up to a
maximum of 5,000 mg vitamin C and 1,000 mg magne-
sium. Use of preventive doses should be resumed after
relief occurs. If the patient developes diarhea, the vita-
min C should be decreased. Calcium is also important.
Children over five can take up to 1,300 mg and adults
ages 19-50 can take up to 2,000 mg.
Sitting on the toilet for 10 minutes at the same
time every day, preferably after a meal, can induce reg-
ular bowel movements. This may not become effective
537
Constipation
Contact dermatitis
for a few months, and it is important to defecate when-
ever necessary.
Resources
BOOK
The Editors of Time-Life Books. The Medical Advisor: The
Complete Guide to Alternative and Conventional Treat-
ments. Alexandria, VA: Time-Life, Inc., 1996.
Gottlieb, Bill, ed. New Choices in Natural Healing. Emmaus,
PA: Rodale Press, Inc., 1995.
Inlander, Charles B. The Consumer’ s Medical Desk Reference.
New York: Stonesong Press, 1995.
PERIODICALS
“Go for Natural Laxative Relief, but Best if not from Senna or
Cascara.” Environmental Nutrition (May 2002): 7.
Goldstein, Laura. “Corn Syrup Does the Trick.” Prevention
(June 2002): 172.
Gremse. David A, et al. “Comparison of Polyethylene Glycol
3350 and Lactulose for Treatment of Chronic Constipa-
tion in Children.” Clinical Pediatrics (May 2002): 225.
Harari, D., et al. "Bowel Habit in Relation to Age and Gender:
Findings from the National Health Interview Survey and
Clinical Implications.” Archives of Internal Medicine
(February 1996): 315-320.
Karlsrud, K. and P. Schneider. "Tummy Troubles.” Parents
(April 1997): 83-84.
OTHER
Griffith, H. Winter, M.D. “Constipation.” Thrive Online, http://
www.thriveonline.com/health/. (March 1998).
Kathleen Wright
Teresa G. Odle
Constitutional homeopathic remedies see
Homeopathy, constitutional prescribing
Consumption see Tuberculosis
Contact dermatitis
Definition
Contact dermatitis is the name given to any skin in-
flammation that results from surface contact. There are
two kinds of contact dermatitis, irritant and allergic.
Description
Thousands of natural and synthetic substances can
cause contact dermatitis, which is the most common skin
condition requiring medical attention, and the foremost
source of work-related disease. Florists, domestic work-
ers, hairdressers, food preparers, and employees in heavy
538
industry, construction, carpentry, dry cleaning, farming,
health care, and the military are the people most at risk
of contracting work-related contact dermatitis. Ameri-
cans spend roughly $300 million a year in their quest for
relief from contact dermatitis, not counting the consider-
able sums devoted by governments and businesses to
regulating and policing the use of skin-threatening
chemicals in the workplace. But exactly how many peo-
ple suffer from contact dermatitis remains unclear; a
1997 article in the Journal of the American Medical As-
sociation notes that figures ranging from 1-15% have
been put forward for Western industrial nations.
Causes & symptoms
Irritant contact dermatitis (ICD) is the more com-
monly reported of the two types of contact dermatitis,
accounting for about 80% of cases. It can be caused by
soaps, detergents, solvents, adhesives, fiberglass, and
other substances that are able to directly injure the skin.
Most attacks are mild and confined to the hands and
forearms, but can affect any part of the body that comes
in contact with the irritating substance. The symptoms
can take many forms: redness, itching, crusting,
swelling, blistering, oozing, dryness, scaliness, thicken-
ing of the skin, and a feeling of warmth at the site of
contact. In extreme cases severe blistering can occur and
open sores can form. Occupations that require frequent
skin exposure to water, such as hairdressing and food
preparation, can make the skin more susceptible to ICD.
Allergic contact dermatitis (ACD) results when re-
peated exposure to an allergen (an allergy-causing sub-
stance) triggers an immune response that inflames the
skin. Tens of thousands of drugs, pesticides, cosmetics,
food additives, commercial chemicals, and other sub-
stances have been identified as potential allergens. Fewer
than 30, however, are responsible the majority of ACD
cases. Common culprits include poison ivy, poison oak,
and poison sumac; fragrances and preservatives in cos-
metics and personal care products; latex items, including
gloves and condoms; and formaldehyde. Many people
find that they are allergic to the nickel in inexpensive
costume jewelry. ACD is usually confined to the area of
skin that comes in contact with the allergen, typically the
hands or face. Symptoms range from mild to severe and
resemble those of ICD. A patch test may be needed to
determine which kind of contact dermatitis a person is
suffering from.
Diagnosis
Diagnosis begins with a physical examination and
asking the patient questions about his or her health and
daily activities. When contact dermatitis is suspected, the
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
doctor attempts to learn as much as possible about the pa-
tient’s hobbies, workplace duties, use of medications and
cosmetics, etc. — anything that might shed light on the
source of the disease. In some cases an examination of
the home or workplace is undertaken. If the dermatitis is
mild, responds well to treatment, and does not recur, ordi-
narily the investigation is at an end. More difficult cases
require patch testing to identify the specific allergen.
Two methods of patch testing are currently used.
The most widely used method, the Finn chamber
method, employs a multiwell aluminum patch. Each well
is filled with a small amount of the allergen being tested
and the patch is taped to normal skin on the patient’s
upper back. After 48 hours the patch is removed and an
initial reading is taken. A second reading is made a few
days later. The second method of patch testing involves
applying a small amount of the test substance directly to
normal skin and covering it with a dressing that keeps air
out and keeps the test substance in (occlusive dressing).
After 48 hours the dressing is taken off to see if a reac-
tion has occurred. Identifying the allergen may require
repeated testing, can take weeks or months, and is not al-
ways successful. Moreover, patch testing works only
with ACD, though it is considered an essential step in
ruling out ICD.
Treatment
Herbal therapy
Herbal remedies have been used for centuries to treat
skin disorders, including contact dermatitis. An experi-
enced herbalist or naturopathic doctor can recommend
the remedies that will be most effective for a person’s
condition. Among the herbs often recommended are:
• Burdock ( Arctium lappa). Burdock is taken internally
as a tea or tincture.
• Calendula ( Calendula officinalis). Calendula is a natur-
al antiseptic and anti-inflammatory agent. It is applied
topically in a lotion, ointment, or oil to the affected area.
• Aloe (Aloe barbadensis). Aloes soothes skin irritations.
Its gel is applied topically to the affected area.
Poison ivy, poison oak, and poison sumac are com-
mon culprits in cases of allergic contact dermatitis. Fol-
lowing exposure to these plants, the development of the
characteristic rash may be prevented by washing the area
with soap and water within 15 minutes of exposure. The
leaves of jewelweed ( Impatiens spp.), which often grows
near poison ivy, may neutralize the poison ivy allergen if
rubbed on the skin right after contact. Several topical
herbal remedies may help relieve the itching associated
with allergic contact dermatitis, including the juice of
plantain leaves ( Plantago major)', a paste made of equal
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
The abdomen of a male patient afflicted with contact der-
matitis, triggered by an allergic reaction to a nickel belt
buckle. (Photograph by Dr. P Marazzi, Custom Medical Stock
Photo. Reproduced by permission.)
parts of green clay and goldenseal root (Hydrastis
canadensis)', a paste made of salt, water, clay, and pep-
permint (Mentha piperita) oil; and calamine lotion.
Homeopathy
A homeopath treating a patient with contact der-
matitis will do a thorough investigation of the individ-
ual’s history and exposures before prescribing a remedy.
Common homeopathic remedies include:
• Rhus toxicodendron
• Croton tiglium
• ledum
• anacardium
• graphites
• sulfur
Allopathic treatment
The best treatment for contact dermatitis is to identi-
fy the allergen or irritating substance and avoid further
contact with it. If the culprit is, for instance, a cosmetic,
avoidance is a simple matter, but in some situations, such
as an allergy to an essential workplace chemical for
which no substitute can be found, avoidance may be im-
possible or force the sufferer to find new work or make
other drastic changes in his or her life. Barrier creams
539
Contact dermatitis
Copper
KEY TERMS
Antibiotics — Substances used against microorgan-
isms that cause infection.
Corticosteroids — A group of anti-inflammatory
substances often used to treat skin conditions.
Immune response — The protective reaction by the
immune system against foreign antigens (sub-
stances that the body perceives as potentially dan-
gerous). The immune system combats disease by
neutralizing or destroying antigens.
and such protective clothing as gloves, masks, and long-
sleeved shirts are ways of coping with contact dermatitis
when avoidance is impossible, though they are not al-
ways effective.
For the symptoms themselves, treatments in mild
cases include cool compresses and nonprescription lo-
tions and ointments. When the symptoms are severe, cor-
ticosteroids applied to the skin or taken orally are used.
Contact dermatitis that leads to a bacterial skin infection
is treated with antibiotics.
Expected results
If the offending substance is promptly identified and
avoided, the chances of a quick and complete recovery
are excellent. Otherwise, symptom management — not
cure — is the best that medical treatment can offer. For
some people, contact dermatitis becomes a chronic and
disabling condition that can have a profound effect on
employability and quality of life.
Prevention
Avoidance of known or suspected allergens or irritat-
ing substances is the best prevention. If avoidance is diffi-
cult, barrier creams and protective clothing can be tried.
Skin that comes in contact with an offending substance
should be thoroughly washed, the sooner the better.
Resources
BOOKS
Swerlick, Robert A., and Thomas J. Lawley. “Eczema, Psoriasis,
Cutaneous Infections, Acne, and Other Common Skin Dis-
orders.” In Harrison's Principles of Internal Medicine. An-
thony S. Fauci, et al., eds. New York: McGraw-Hill, 1998.
Ullman, Dana. The Consumer’ s Guide to Homeopathy: The
Definitive Resources for Understanding Homeopathic
Medicine and Making It Work for You. New York: G.P.
Putnam’s Sons, 1995.
540
Wolf, John E., Jr. “Contact Dermatitis.” In Conn’s Current
Therapy. Robert E. Rakel. ed. Philadelphia: W.B. Saun-
ders, 1998.
PERIODICALS
Leung, Donald Y. M., et al. “Allergic and Immunologic Skin
Disorders.” Journal of the American Medical Association
278 (1997): 1914+.
Rietschel, Robert L. “Occupational Contact Dermatitis.” Lancet
349(1997): 1093+.
Mai Tran
Copper
Description
Copper is an essential mineral that plays an impor-
tant role in iron absorption and transport. It is consid-
ered a trace mineral because it is needed in very small
amounts. Only 70-80 mg of copper are found in the
body of a normal healthy person. Even though the body
needs very little, copper is an important nutrient that
holds many vital functions in the body.
Copper is essential for normal development of the
body because it:
• Participates in a wide variety of important enzymatic
reactions in the body.
• Is a component of or a cofactor for approximately 50
different enzymes. These enzymes need copper to func-
tion properly.
• Is essential for iron absorption and transport. Iron is
needed to make hemoglobin, a main component of red
blood cells. Therefore, copper deficiency is often
linked to iron-deficiency anemia.
• Is required to build elastin and collagen, which are an
important components of bones and connective tissues.
Therefore, copper is believed to protect the bones and
joints against degeneration and osteoporosis.
• Is required for melanin production. People with copper
deficiency may have pale skin and hair.
• Is a key mineral for the immune system. Copper pro-
motes wound healing. Studies show that premature in-
fants or children with genetic copper defects are at high
risk of getting infections and would significantly im-
prove with copper supplementation.
• Attacks free radicals. Copper is a strong antioxidant. It
works by attaching itself to the enzyme Superoxide dis-
mutase (SOD). Copper also binds to a protein to form
ceruloplasmin, which is an antioxidant.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• Helps the body produce energy. Copper participates in
many oxidative reactions that break down fats in fat tis-
sue to produce much needed energy. Copper deficiency
has been associated with high cholesterol levels.
• Is necessary for normal functioning of insulin. Copper
deficiency is also associated with poor blood glucose
control.
• Is needed for normal functioning of the cardiovascular
system.
• Protects the structure and function of the nervous sys-
tem, including the brain. Copper protects nerve fiber by
maintaining myelin, the insulating sheath that sur-
rounds nerve cells. It also aids the transmission of
nerve signals in the brains.
General use
Copper supplements may be beneficial in treating or
preventing copper deficiency. Copper deficiency used to
be relatively rare because the body requires so little of it,
only about 2 mg per day. In addition, it is available natu-
rally in a variety of foods such as whole grains, shellfish,
nuts, beans, and leafy vegetables. Additional sources of
copper are the copper water pipes that run through
homes or the copper cookware in the kitchen. These
sources leach copper into the water we drink and the
food we eat. The level of copper in drinking water is
sometimes so high that it becomes a public concern.
However, scientists now realize that copper deficiency,
especially borderline cases, is more common than once
thought. Copper deficiency is currently on the rise due to
a decrease of whole foods in the diet and high consump-
tion of fatty and processed foods.
It was discovered in 2001 that vegetarian diets gen-
erally contain more copper, but that the absorption effi-
ciency was lower for lacto-ovo vegetarians than for non-
vegetarians. The study also showed that the increased
amounts of copper in the vegetarian diets allow for
greater copper content.
Besides dietary causes, certain diseases or condi-
tions may reduce copper absorption, transport or in-
crease its requirements, resulting in abnormally low cop-
per blood levels. Increased copper intake through diet or
supplementation may be necessary in the following con-
ditions:
• premature infants fed only cow’s milk
• pregnant women
• malnutrition
• celiac disease, sprue, cystic fibrosis, or short-bowel
syndrome (these diseases cause poor absorption of di-
etary copper)
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Sample of copper. (Science Photo Library, National Audubon
Society Collection/Photo Researchers, Inc. Reproduced with
permission.)
• kidney disease
• high consumption of zinc or iron (these minerals inter-
fere with copper absorption)
• highly processed foods (copper is stripped away during
food processing)
• Menkes syndrome (copper deficiency is caused by ge-
netic defects of copper transport; Menkes syndrome pa-
tients cannot use copper supplied by the diet efficiently)
Symptoms of copper deficiency include:
• anemia
• malnourished infants
• prominently dilated veins
• pale hair or skin
• poorly formed bones
• nervous system disorders
• high cholesterol levels
• heart disease
• loss of taste
• increased susceptibility to infections
• infertility
• birth defects
Exceeding the daily requirement is dangerous, how-
ever, because copper toxicity commonly occurs. Copper
toxicity is a very serious medical problem. Acute toxicity
due to ingestion of too much supplement, for example,
may cause nausea, vomiting, abdominal pain, diarrhea,
dizziness, headache, and a metallic taste in the mouth.
541
Copper
Copper
Chronic toxicity is often caused by genetic defects of
copper metabolism, such as Wilson’s disease. In this dis-
ease, copper is not eliminated properly and is allowed to
accumulate to toxic levels. Copper is therefore present at
high concentration where it should not be, such as in the
liver, the lens of the eye, kidneys, or brain.
Disease prevention
Copper is a good antioxidant. It works together with
an antioxidant enzyme, superoxide dismutase (SOD), to
protect cell membranes from being destroyed by free
radicals. Free radicals are any molecules that are missing
one electron. Because this is an unbalanced and unstable
state, a radical is desperately finding ways to complete
its pair. Therefore, it reacts to any nearby molecules to
either steal an electron or give away the unpaired one. In
the process, free radicals initiate chain reactions that de-
stroy cell structures. Like other antioxidants, copper
scavenges or cleans up these highly reactive radicals and
changes them into inactive, less harmful compounds.
Therefore, it can help prevent cancer. In 2001, a study
reported that concentrations of copper sulfate and ascor-
bate may inhibit breast cancer growth. With further
study, the combination may even prove useful as a
chemotherapy agent for certain breast cancer patients.
Copper may also help prevent degenerative diseases
or conditions such as premature aging, heart disease, au-
toimmune diseases, arthritis, cataracts, Alzheimer’s
disease, or diabetes.
Osteoporosis
Copper may play a role in preventing osteoporosis.
Calcium and vitamin D have long been considered the
mainstay of osteoporosis treatment and prevention.
However, a recent study has shown that they can be even
more effective in increasing bone density and preventing
osteoporosis if they are used in combination with copper
and two other trace minerals, zinc and manganese.
Rheumatoid arthritis
Copper has been a folklore remedy for rheumatoid
arthritis since 1500 b.c. in ancient Egypt. Some people
believe that wearing jewelry made of copper may relieve
arthritic symptoms. To evaluate the effect of copper for
the treatment of rheumatoid arthritis. Dr. Walker and his
colleagues conducted a study of 77 arthritic patients. Pa-
tients were divided into two groups: treatment group
wearing copper jewelry and placebo group wearing noth-
ing or aluminum jewelry. In this study, patients who
wore copper bracelets felt significantly better than those
in the placebo group. In addition, patients in the treat-
ment group reported recurrences of symptoms after the
542
bracelets were removed. To explain the effects of the
copper bracelets, these researchers suggested that copper
contained in the bracelets was dissolved in sweat and
then absorbed through the skin. They suspected that cop-
per’s effectiveness may be related to its role as an antiox-
idant. They also believe that copper may function as both
an anti-inflammatory agent and as an antioxidant. Thus,
it is possibly effective in reducing inflammatory re-
sponse to such conditions as rheumatoid arthritis.
Preparations
Copper is contained in many multivitamin/mineral
preparations. It is also available as a single ingredient in
the form of tablets. These tablets should be swallowed
whole with a cup of water, preferably with meals, to
avoid stomach upset. A person may choose any of the
following preparations: copper gluconate, copper sulfate,
or copper citrate. However, copper gluconate may be the
least irritating to the stomach.
Zinc and copper compete with each other for ab-
sorption in the gastrointestinal tract. As a result, exces-
sive copper intake may cause zinc deficiency, and vice
versa. Therefore, a person should take zinc and copper
supplements together in ratios of 10: 1 or 15:1.
Precautions
Those adding copper supplements to their diets
should consider:
• Informing their doctors for proper instruction and mon-
itoring of side effects. Copper toxicity due to excessive
doses of copper supplements has been reported.
• Although there currently is no recommended daily al-
lowance (RDA) established for copper, 2 mg of copper
per day is considered sufficient and safe. Nausea and
vomiting may occur in persons taking more than 20 mg
of copper daily.
• It is not known if copper supplementation may harm a
growing fetus. However, as with any drugs, pregnant or
nursing women should not take copper or any other sup-
plements or drugs without first consulting their doctors.
• In certain areas, drinking water may contain high levels
of copper. Periodic checks of copper levels in drinking
water may be necessary.
• Because individual antioxidants often work together as
a team to defend the body against free radicals, the bal-
ance between copper, zinc, and iron must be main-
tained. Excessive intake of one nutrient might result in
a deficiency of other minerals and decreased resistance
to infections and increased risk of heart disease, dia-
betes, arthritis, and other diseases.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Side effects
A person should stop taking copper supplements
and seek medical help immediately if having the follow-
ing signs or symptoms:
• anemia
• nausea
• vomiting
• abdominal pain
Interactions
Factors that increase copper concentrations
Certain disorders have been known to increase cop-
per levels. Persons with these conditions should not take
copper supplements as they may cause copper toxicity.
• recent heart attacks
• lupus erythematosus
• cirrhosis of the liver
• schizophrenia
• leukemia and some other forms of cancer
• viral infections
• ulcerative colitis (This inflammatory bowel disease
may cause accumulation of copper in the body. Exces-
sive amount of copper may worsen many symptoms of
this disease by increasing susceptibility to infections
and inhibiting wound healing.)
• Wilson’s disease (This disease causes accumulation of
copper in the tissues. As a result, patients have liver dis-
ease, mental retardation, tremor and poor muscle coor-
dination. They also have copper deposits in the cornea
of the eye. To manage this disease, patients are put on a
low-copper diet and given penicillamine, a drug that at-
taches itself to copper and increases its excretion.)
Resources
BOOKS
Lieberman,, Shari and Nancy Bruning. “Copper.” In The Real
Vitamin & Mineral Book: Using Supplements for Opti-
mum Health Garden City Park, NY: Avery Publishing
Group, 1997.
Passwater, Richard A. All About Antioxidants. Garden City
Park, NY: Avery Publishing Group, 1998.
PERIODICALS
Gonzalez, M. J, et al. “Inhibition of Human Breast Carcinoma
Cell Proliferation by Ascorbate and Copper.” The Journal
of Nutrition 131, no. 11 (November 2001): 3142S.
Hunt, Janet R., and Richard A. Vanderpool. “Apparent Copper
Absorption from a Vegetarian Diet.” American Journal of
Clinical Nutrition 74, no. 6 (December 2001): 803-805.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Antioxidants — Antioxidants are nutrients that de-
activate reactive molecules (free radicals) and pre-
vent harmful chain reactions.
Lacto-ovo vegetarian — People who do not eat
meat, but do include dairy products and eggs in
their diets.
Minerals — Inorganic chemical elements that are
found in plants and animals and are essential for
life. There are two types of minerals: major miner-
als, which the body requires in large amounts,
and trace elements, which the body needs only in
minute amounts.
Reginster, Jean-Yves, Anne Noel Taquet, and Christiane Gos-
set. “Therapy for Osteoporosis: Miscellaneous and Exper-
imental Agents.” Endocrinology and Metabolism Clinics
(June 1998): 453^163.
Uauy, Ricardo, Manuel Olivarez, and Mauricio Gonzales. “Es-
sentiality of Copper in Humans.” American Journal of
Clinical Nutrition 67 suppl (1998): 952S-959S.
OTHER
“Copper” The Merck Manned of Diagnosis and Therapy, [cited
October 2002]. <http://www.merck.com>.
Rosenstein, Elliot D., and Jacques R. Caldwell. “Therapies:
Trace Elements in the Treatment of Rheumatic Condi-
tions.” In Rheumatic Diseases Clinics of North America.
Part II. [cited May 2000]. <http://www.mdconsult.com>.
Mai Tran
Teresa G. Odle
Coptis
Description
Coptis is the underground stem (rhizome) or root of
the plant Coptis chinensis. It is used in traditional Chi-
nese medicine as a stomachic (a medication to improve
digestive functions) and an antiseptic. Other related
species are also called coptis and used in similar ways in
other parts of the world. Coptis anemonaefolia is used in
Japan. Coptis trifolia is used in North America, and Coptis
teeta grows in India and is used in Ayurvedic medicine.
Coptis is a low, creeping perennial evergreen that
grows in damp boggy spots in woods. The plant produces
a mass of thread-like golden rhizomes that are used in
543
Coptis
Coptis
healing. C. chinensis is native to the cooler parts of Asia
and is extensively cultivated in Szechwan province in
China. C. trifolia is native to eastern North America as far
south as the mountains of Tennessee. Other names for the
various species of coptis used in healing include
goldthread, Chinese goldthread mouth root, cankerroot,
yellowroot, coptidis, mishmi bitter, and chonlin. The Chi-
nese name for C. chinensis is huang lian.
General use
Coptis, or huang lian , has a long history of use in
China. In traditional Chinese medicine (TCM), coptis is
used to treat conditions associated with excess dampness
and excess heat, such as insomnia and irritability. Heat
in TCM means excessive activity, not high temperature,
although the diseased part of the body could be red or in-
flamed. Coptis is said to have a cold nature and a bitter
taste. In TCM, coptis is considered one of the 50 funda-
mental herbs. It is associated with the heart, liver, stom-
ach, and large intestine.
More specifically, coptis is used to treat such gas-
trointestinal problems as diarrhea, vomiting, and bacte-
rial dysentery. It is also used to treat chronic gall bladder
inflammations. Other gastrointestinal conditions treated
with coptis include abdominal cramps, acid reflux
(heartburn), ineffective or painful bowel movements,
and bloody stools. Coptis is effective as a hemostatic,
which means that it can be used to stop bleeding.
Chinese herbalists also use preparations made from
coptis to relieve high fever and delirium. These prepara-
tions can be used as a gargle to relieve sore throats. Ex-
ternally coptis can be used as a mouthwash to treat all
kinds of mouth sores, including canker sores, tongue ul-
cers, and swollen gums. As an eyewash it is used for
conjunctivitis (pink eye). On the skin it is used topically
to treat acne, boils, carbuncles, burns, and infected cuts.
C. triflora is used in North America in some similar
ways. In an interesting parallel, some Native American
tribes used their native species of coptis as a wash for eye
and mouth problems in much the same way as the Chi-
nese. It was also used as a gargle for sore throats. Al-
though it is not as popular in North America as in China,
modern North American herbalists use coptis to treat indi-
gestion. It is also used externally as a douche to treat vagi-
nal infections. The herb is used in similar ways in India.
Modem scientific research supports many of the tra-
ditional uses of coptis. All species of this herb contain
the compound berberine, which is a white or yellow
water-soluble alkaloid. Berberine is known to have
strong antibiotic effects. In test tube studies, berberine
was shown to inhibit the growth of streptococcal bacteria
responsible for some forms of pneumonia. This antibac-
544
terial activity supports the use of coptis to treat skin,
mouth, eye, and vaginal infections.
Berberine also is known to stimulate the production
of saliva, gastric juice, pancreatic juice, and bile, sug-
gesting that there is a chemical basis for the traditional
use of coptis in treating gastrointestinal disorders.
Berberine is also found in such other healing plants as
goldenseal, barberry, and Oregon grape. Preliminary
test tube studies of berberine suggest that it may also be
effective against fungal infections, some viruses, and
certain intestinal parasites. The high level of interest in
berberine in the research community means that more
studies of coptis may soon be available.
Preparations
The rhizomes and roots of coptis are harvested in
the in the autumn and are used either dried or fresh. The
herb is available powdered or as a tincture. The dosage
varies according to the condition being treated. The ac-
tions of coptis are similar to the actions of goldenseal
(. Hydrastis canadensis), and it is sometimes substituted
for goldenseal in herbal remedies.
In Chinese herbalism, coptis is rarely used alone,
but can be found as an ingredient in many formulas.
These include hoelen and polyphorus, leonoris and
achyranthes, tang gui and gardenia, and at least half a
dozen other formulas.
Precautions
Berberine is known to cause contractions of the
uterus in laboratory animals. For this reason, it is recom-
mended that pregnant women not take coptis or any
other herb containing berberine.
Side effects
No unwanted side effects have been reported when
coptis is used in the amounts recommended by herbalists.
Interactions
Coptis is has been used for thousands of years in
China in conjunction with other herbs with no reported
interactions. Since coptis is used most extensively in
Asian medicine, there are no studies of its interactions
with Western pharmaceuticals.
Resources
BOOKS
Chevallier, Andrew. Encyclopedia of Medicinal Plants. New
York: DK Publishing, Inc., 1996.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Berberine — A white or yellow water-soluble alka-
loid with antibacterial properties. Coptis, gold-
enseal, and barberry are all plants that contain
berberine.
Hemostatic — A type of medication that is given to
stop bleeding.
Rhizome — A rootlike underground plant stem that
typically produces new shoots from its upper sur-
face and new roots from the lower one. Coptis rhi-
zomes are the parts of the plant most commonly
used for medicinal purposes.
Stomachic — A type of medication that is given to
tonify the stomach or improve digestive functions.
Tincture — An alcohol-based extract prepared by
soaking plant parts.
Molony. David. Complete Guide to Chinese Herbal Medicine.
New York: Berkeley Books, 1998.
PDR for Herbal Medicines. Montvale, NJ: Medical Economics
Company, 1999.
ORGANIZATIONS
American Association of Oriental Medicine (AAOM). 433
Front Street, Catasauqua, PA 18032. (610) 266-2433.
OTHER
“Coptis chinensis.” Plants for a Future, http://www.pfaf.org.
Tish Davidson
Cordyceps
Description
Cordyceps sinensis, also called Chinese caterpillar
fungus, Cs-4, Dong Chong Xia Caoor , or semitake , is a
fungus native to the Tibetan plateau in China. The fungus
is parasitic, and grows in the moth caterpillar. Spores enter
the host, germinate, and ultimately kill the larva. Although
species of cordyceps are seen in Europe and the Americas,
only the Chinese form has been used medically.
General use
Cordyceps has a long history of use in Chinese medi-
cine. Its traditional roles have been restorative; improving
the quality of life, and increasing energy and longevity.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Traditional uses of the thousand year “rejuvenation”
herb include the following:
• impotence treatment
• increase fertility
• stimulate immune system
• improve resistance to bacteria
• increase resistance to viruses
• relieve fatigue
• vitality tonic for mind and body, especially in aging men
While most of the cordyceps research has been con-
ducted in China, published studies in Europe and else-
where indicate that the fungus may have many potential-
ly useful properties. A Korean study of a related species
of cordyceps indicates that it has components that may
inhibit coagulation, making it potentially beneficial in
stroke and heart attack prevention. A hot water extract
of the fungus appeared to stimulate the immune system.
This immune modulation effect is seen in other studies,
which have reported that cordyceps may be useful in
treating Hepatitis B. A study from Thailand reported
that Cordyceps nipponica may have value in the treat-
ment of malaria. Additional studies have indicated its
possible benefit in preventing a recurrence of Lupus
nephritis. However, another study that looked at herbs
used as performance enhancers (to improve exercise and
athletic performance), was unable to validate cordyceps’
value for this purpose.
Another review concluded that cordyceps may be
promising as a possible aid for fatigue, stress, heart
health, lung function, and toxin exposure.
Cordyceps has physiological properties and benefits
if used over time as a tonic, but taking it for a specific dis-
ease or problem remains an area needing further human
studies and research. The traditional use of cordyceps
was as an ongoing daily tonic, beginning in mid-life.
Preparations
Cordyceps capsules are available in varying
strengths (400 mg, 450 mg, 615 mg, and 800 mg). The
liquid preparation is sold in 1 gram per 1 .5 ml strength.
Precautions
Cordyceps appears to be an exceptionally safe prod-
uct, with no established toxic dose. In 1996, there were
two reports of cordyceps products contaminated with
lead, but this does not appear to be an ongoing problem.
There is a risk of allergic reactions to either the fun-
gus or other ingredients in the formulation.
545
Cordyceps
Corns and calluses
KEY TERMS
Fungus — A plant that lacks both leaves and flow-
ers, and lives on decaying matter. The fungi may
be single-celled or grow quite large. The group of
fungi includes molds, yeasts, smuts, and mush-
rooms.
Lupus nephritis — Kidney damage associated with
Systemic lupus erythematosis, an autoimmune
disease. The kidney damage is gradual, but leads
to complete kidney failure.
Parasitic — Behaving like a parasite; an organism
that lives on, with, or in another organism. It
draws its energy from the host, without providing
any benefit to the host.
Standardized — To cause to conform to a standard.
In medicine and pharmacy, this means that a
given weight of an herb will contain a standard-
ized percentage or weight of the active principle.
Formulations of cordyceps are not standardized.
Products are labeled in terms of the quantity of dried
fungus contained, but there is no way to determine the
amount of active components in any product. Because of
this, activity may vary between brands, and between in-
dividual samples from the same company.
Side effects
Side effects appear to be mild. Patients have report-
ed stomach upset, dry mouth, and nausea.
Interactions
At this time, the only established interaction is due
to the anticoagulant effects of the fungus, which may in-
crease the risk of bleeding in patients taking warfarin
(commonly known by the brand name Coumadin) or
other anticoagulant drugs.
Because of the many different activities that have
been attributed to cordyceps, it seems likely that other
drug interactions will be reported in the future.
Resources
BOOKS
Jones, K. Cordyceps: Tonic Food of Ancient China. New Mexi-
co: Sylvan, 1997.
PERIODICALS
Bucci, L. R. “Selected Herbals and Human Exercise Perfor-
mance.” American Journal of Clinical Nutrition (August
2000): 624S-36S.
546
Chen, Y. J„ M. S. Shiao, S. S. Lee, and S. Y. Wang. "Effect of
Cordyceps sinensis on the Proliferation and Differentia-
tion of Human Leukemic U937 Cells.” Life Science
(1997): 2349-59.
Der Marderosian, A., Beutler, et al., editors. “Review of Natur-
al Products.” Facts & Comparisons (February 2004).
Isaka, M., M. Tanticharoen, P. Kongsaeree, and Y. Thebtara-
nonth. “Structures of Cordypyridones A-D, Antimalarial
N-hydroxy- and N-methoxy-2-pyridones from the Insect
Pathogenic Fungus Cordyceps nipponica ."Journal of Or-
ganic Chemistry (July 13, 2001): 4803-8.
Pegler, D. N., Y. J. Yao, and Y. Li. “The Chinese Caterpillar
Fungus.” Mycologist (February 8, 1994).
Wu, T. N„ K. Yang, C. M. Wang, J. S. Lai, K. N. Ko, P. Y.
Chang, and S. H. Liou. “Lead Poisoning Caused by Cont-
aminated Cordyceps, a Chinese Herbal Medicine: Two
Case Reports.” Science of the Total Environment (April 5,
1996): 193-5.
Yu, K. W., K. M. Kim, and H. J. Suh. “Pharmacological Activi-
ties of Stromata of Cordyceps Scarabaecola.” Phytother
Res (March 17, 2003): 244-9.
Samuel Uretsky, Pharm.D.
Corns and calluses
Definition
A com is an overgrowth of skin on a bony promi-
nence, usually occurring on the feet and toes. It mani-
fests as a rough and painful bump. A callus is a rough,
thickened lump of dead skin that is usually painless. It
may be found on the feet, the hands, or anywhere else
there is repeated friction and pressure.
Description
Corns and calluses affect about 5 % of the popula-
tion of the United States. Women have corns more often
than men, probably due to wearing ill-fitted shoes more
often. Although calluses may form anywhere on the
body, they are generally found on the heels and balls of
the feet, the knees, and the palms of the hands. Calluses
are usually larger than corns — they may measure more
than an inch (2.5 cm) wide. Calluses usually only hurt if
pressure is applied to them.
Causes & symptoms
Corns and calluses form to prevent injury to skin
that is repeatedly pinched, rubbed, or irritated. Heredi-
tary calluses may develop where there is no apparent
friction. This condition runs in families and occurs most
often in children.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
The most common causes of the formation of corns
and calluses are:
• shoes that have very high heels and shoes that do not fit
properly
• tight socks or stockings
• deformities of the toes
• walking or standing on a hard surface for an extended
time
• jobs or hobbies that cause steady or recurring pressure
on the same spot
Corns may be extremely sore and surrounded by in-
flamed, swollen skin. A sharp pain will probably occur
whenever downward pressure is applied, and a dull ache
may be felt at other times.
Diagnosis
Corns can be recognized on sight. They are some-
times mistaken for warts. However, if the lesion is a
wart, it will bleed when scraped with a sharp implement.
A callus will not bleed, but will shed a layer of dead
skin. This can provide the basis of a general diagnosis.
Treatment
Standing and walking correctly can sometimes elim-
inate excess foot pressure and minimize the development
and recurrence of corns and calluses. Bodywork systems
such as Aston-Patterning, the Feldenkrais method, and
rolflng, may help to correct body imbalances that lead to
corns and calluses.
Two or three daily applications of calendula {Cal-
endula officinalis) salve can soften skin and prevent in-
flammation. A mixture of one teaspoon of lemon juice,
one teaspoon of dried chamomile (Martricaria recutita ),
and one crushed garlic clove {Allium sativa) can be ap-
plied directly to dissolve thickened skin.
A recommended Ayurvedic remedy is the nightly ap-
plication of a paste made by combining one teaspoon of
aloe vera gel with one half teaspoon of turmeric {Cur-
cuma longa). The corn or callus should be covered with
the paste and bandaged overnight. It should be soaked in
warm water for 10 minutes every morning, and given a
daily massage with mustard oil {Brassica cruciferae).
Allopathic treatment
The attention of a physician may be required if there
is numbness, reduced feeling, or severe pain. Occasion-
ally, an orthopedist may have to perform surgery to cor-
rect toe deformities or remove bits of bone that may be
causing corns or calluses to develop. Medical attention is
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Corns on toes. (Custom Medical Stock Photo. Reproduced by
permission.)
not usually required unless diabetes mellitus, poor cir-
culation, or other problems make self-care difficult. The
first step in home care of corns and calluses is to identify
and eliminate sources of pressure and friction. Dough-
nut-shaped pads, wads of cotton, lamb’s wool, or other
kinds of inserts can be used to cushion affected areas.
Soaking the feet in a solution of Epsom salts, or using
hydrocortisone creams, petroleum jelly, or lanolin lo-
tions can soften calluses. After which, they can be re-
duced or removed by rubbing the area with a pumice
stone. This is not recommended for corns, however, as
rubbing just makes them more painful.
It is important to consult with a healthcare provider
if there is broken skin because it may become infected.
In the case of an infection, affected layers of skin need to
be removed, and pus may need to be drained. Oral an-
tibiotics may be given to eliminate the infection. Corti-
sone may be injected into the affected area to decrease
pain or inflammation.
Expected results
Most corns and calluses disappear within three
weeks after the pressure that caused them is eliminated.
However, if the causes of the condition are not remedied
completely, or are allowed to recur, the corns and callus-
es may return. If there is continual pain associated with
corns, it can change the way a person stands or walks.
Such changes may eventually cause pain and dysfunc-
tion in the ankles, back, hips, or knees.
547
Corns and calluses
Cornsilk
KEY TERMS
Bursitis — An inflammation of the tissue sac, called
a bursa, which surrounds and helps lubricate the
joints.
Orthopedist — A specialist who is concerned with
the bones, muscles, and joints and their points of
interaction.
Pumice stone — A volcanic rock that can be used
to remove overgrowths and smooth the skin.
Wart— A small, fleshy skin growth caused by a
virus.
If a com develops near a toe joint, bursitis may re-
sult, causing severe pain and inflammation. If cracks or
other breaks in the skin develop, a staph infection may
result. This is especially serious for people who have di-
abetes or poor circulation, as gangrene may develop
from a resistant infection.
Prevention
Corns and calluses can usually be prevented by
wearing shoes that fit properly. Feet should be measured,
while standing, whenever buying new shoes. It is best to
shop for shoes late in the day, when feet are likely to be
swollen. It is also important to buy shoes with toe-wig-
gling room and to try new shoes on both feet. Pointy-
toed shoes and high heels should be avoided. Worn down
or uneven shoe soles and heels should be replaced or re-
paired. Corrective footwear or special insoles may be
necessary. Socks and stockings should also be fitted ap-
propriately at the feet. Gloves, kneepads, and other pro-
tective gear should be worn as needed to prevent mbbing
and friction, especially when engaging in heavy work or
sports activities. Cutting or paring dead skin should be
avoided, as it may lead to further injury or infection.
Resources
BOOKS
Editors of Time-Life Books. The Medical Advisor: The Com-
plete Guide to Alternative and Conventional Treatments.
Alexandria, VA: Time-Life, 1996.
Gottlieb, Bill, ed. New Choices in Natural Healing. Emmaus,
PA: Rodale Press, 1995.
ORGANIZATIONS
American Podiatric Medical Association. 9312 Old Georgetown
Road, Bethesda, MD 20814-1698. http://www.apma.org.
Patience Paradox
Cornsilk
Description
Cornsilk (Zea mays ) is an herbal remedy made from
stigmas, the yellowish thread-like strands found inside the
husks of corn. The stigmas are found on the female flower
of com, a grain that is also known as maize and is a mem-
ber of the grass family (Gramineae or Poaceae). The stig-
mas measure 4-8 in (10-20 cm) long and are collected for
medicinal use before the plant is pollinated. Cornsilk can
also be removed from corn cobs for use as a remedy.
If fertilized, the stigmas dry and become brown.
Then yellow corn kernels develop. Corn is native to
North America and now grows around the world in warm
climates.
Cornsilk is also known as mother’s hair, Indian corn,
maize jagnog, Turkish corn, yu mi xu, and stigmata maydis.
General use
Some historians believe that corn has grown for
more than 7,000 years in North America. About the time
that Christopher Columbus brought the first corn to Eu-
rope, the grain grew throughout North and South Ameri-
ca. The venerable plant’s stigmas have long been used in
folk medicine to treat urinary conditions including in-
flammation of the bladder and painful urination.
Cornsilk also served as a remedy for heart trouble,
jaundice, malaria, and obesity. Cornsilk is rich in vita-
min K, making it useful in controlling bleeding during
childbirth. It has also been used to treat gonorrhea.
For more than a century, cornsilk has been a remedy
for urinary conditions such as acute and inflamed blad-
ders and painful urination. It was also used to treat the
prostate. Some of those uses have continued into modern
times; cornsilk is a contemporary remedy for all condi-
tions of the urinary passage.
Drinking cornsilk tea is a remedy to help children
stop wetting their beds, a condition known as enuresis. It
is also a remedy for urinary conditions experienced by
the elderly.
Cornsilk is used to treat urinary tract infections and
kidney stones in adults. Cornsilk is regarded as a sooth-
ing diuretic and useful for irritation in the urinary sys-
tem. This gives it added importance, since today, physi-
cians are more concerned about the increased use of an-
tibiotics to treat infections, especially in children. Even-
tually, overuse can lead to drug-resistant bacteria. Also,
these drugs can cause complications in children.
Furthermore, cornsilk is used in combination with
other herbs to treat conditions such as cystitis (inflam-
548
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
mation of the urinary bladder), urethritis (inflammation
of the urethra), and parostitis (mumps).
Cornsilk is said to prevent and remedy infections of
the bladder and kidney. The tea is also believed to dimin-
ish prostate inflammation and the accompanying pain
when urinating.
Since cornsilk is used as a kidney remedy and in the
regulation of fluids, the herb is believed to be helpful in
treating high blood pressure and water retention. Corn-
silk is also used as a remedy for edema (the abnormal
accumulation of fluids).
Cornsilk is used to treat urinary conditions in coun-
tries including the United Sates, China, Haiti, Turkey,
and Trinidad. Furthermore, in China, cornsilk as a com-
ponent in an herbal formula is used to treat diabetes.
In addition, cornsilk has some nonmedical uses.
Cornsilk is an ingredient in cosmetic face powder. The
herb used for centuries to treat urinary conditions ac-
quired another modern-day use. Cornsilk is among the
ingredients in a product advertised to help people pass
their drug tests.
Preparations
Some herbalists say that cornsilk is best used when
fresh, but it is also available in dried form. Cornsilk can
be collected from the female flower or from corn cobs. In
addition, cornsilk is available commercially in powdered
and capsule form and as an extract. Cornsilk is usually
brewed as a tea, a beverage that is said to be soothing.
Cornsilk tea or infusion can be made by pouring 1
cup (240 ml) of boiling water over 2 tsp (2.5 g) of dried
cornsilk. The mixture is covered and steeped for 10-15
minutes. The tea should be consumed three times daily.
In addition, a tincture of 1 tsp (3-6 ml) of cornsilk
can be taken three times daily. Tincture can be purchased
over the counter, or made at home by mixing the herb
with water or alcohol at a ratio of 1 :5 or 1 : 10.
Cornsilk is also available in capsule form. The usual
dosage for 400-mg capsules is two capsules. These are
taken with meals three times daily.
A remedy for bedwetting
Herbal remedies can be part of the treatment when
children wet their beds. Methods of stopping this behav-
ior include having the child exercise during the day,
drink fewer beverages in the evening, and drink a cup of
cornsilk tea one hour before bedtime. Cornsilk could be
the only ingredient in the tea. However, cornsilk can be
part of an herbal combination if bedwetting is caused by
lack of nervous control of the bladder.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Cornsilk combinations
Cornsilk combines well with other herbs to remedy
a range of urinary conditions. One remedy for a bed-wet-
ting tea is to combine one part of cornsilk, St. John’s
wort, horsetail, wild oat, and lemon balm.
An herbal practitioner can recommend other combi-
nation remedies to treat more complicated conditions. For
example, when a person has cystitis, cornsilk can be com-
bined with yarrow, buchu, couchgrass, or bearberry.
Furthermore, cornsilk may be an ingredient in a
commercial remedy taken to maintain the urinary tract
system. Other ingredients could include yarrow and
marsh mallow.
Precautions
Cornsilk is safe when taken in proper dosages, ac-
cording to sources including PDR (Physician' s Desk
Reference) for Herbal Medicines,, the 1998 book based
on the findings of Germany’s Commission E. The com-
mission published its findings about herbal remedies in a
1997 monograph.
Before beginning herbal treatment, people should
consult a physician, practitioner, or herbalist. Herbs like
cornsilk are not regulated by the U.S> Food and Drug
Administration (FDA), a process that involves research
and testing.
If a person decides to collect fresh cornsilk, atten-
tion should be paid to whether the plants were sprayed
with pesticides.
Side effects
There are no known side effects when cornsilk is
taken in designated therapeutic dosages.
Interactions
Information is not available about whether there is
an interaction when cornsilk is taken with medication.
People taking medications should first check with their
doctor or health practitioner before using cornsilk.
Resources
BOOKS
Duke, James A. The Green Pharmacy. Emmaus, PA: Rodale
Press, Inc., 1997.
Keville, Kathi. Herbs for Health and Healing. Emmaus, PA:
Rodale Press, Inc., 1996.
Medical Economics Staff. PDR for Herbal Medicines. Mont-
vale, NJ: Medical Economics Company, 1998.
Ritchason, Jack. The Little Herb Encyclopedia. Pleasant
Grove, UT: Woodland Health Books, 1995.
549
Cornsilk
Cornus
Squier, Thomas Broken Bear with Lauren David Peden. Herbal
Folk Medicine. New York: Henry Holt and Company, 1997.
PERIODICALS
Edney, Mark T, et al. "Putting Antimicrobials to Best Use in
Pediatric Urology.” Contemporary Urology (July 2002):
35-39.
ORGANIZATIONS
American Botanical Council. P.O. Box 201660, Austin, TX
78720. (512) 331-8868. http://www.herbalgram.org/.
Herb Research Foundation. 1007 Pearl St., Suite 200. Boulder,
CO 80302. (303) 449-2265. http://www.herbs.org.
OTHER
HealthWorld Online, http://www.healthy.net (January 17, 2001).
Holistic Online, http://www.holisticonine.com (January 17,
2001).
Liz Swain
Teresa G. Odle
Cornus
Description
Cornus (Cornus officinalis) is a tree used in Chinese
medicine. Its Chinese name is shan zhu yu. Cornus is
shrub that grows to a height of 30 ft (10 m) in the wood-
land regions of East Asia from China to Korea. The fruit
is used in healing. It is harvested when ripe, then dried
for future use. The small fruits can also be eaten as food,
either raw or cooked. They contain about 8.6% sugar and
have a slightly astringent taste. The bark from the stem is
also used as an anti-malarial tonic.
Chinese cornus should not be confused with the
North American tree Cornus florida, better known as
dogwood or American boxwood. Dogwood and Chinese
cornus are in the same plant family but have somewhat
different healing properties. The bark of Cornus florida
is used in Western herbal healing.
General use
Cornus has been used in China for more than 2,000
years. In the Chinese system of health, yin aspects must
be kept in balance with yang aspects. Ill health occurs
when the energies and elements of the body are out of
balance or in disharmony. Health is restored by taking
herbs and treatments that restore this balance.
Cornus is strongly associated with the kidneys, the
reproductive system, and, to a lesser extent, the liver. It is
made into a slightly warm yin tonic and classified as
550
having a sour taste. In Chinese medicine sour herbs are
believed to help control body fluids and conditions such
as bed-wetting, excessive sweating, heavy or prolonged
menstruation, and premature ejaculation.
Cornus is rarely used alone. It is an ingredient in
many herbal formulas where it is used to stabilize and
bind. It has astringent properties that are thought to boost
the power of other herbs. Cornus can be combined with
both yin and yang herbs to remedy deficiencies in either
area because it conserves jing, the essence of life. In Chi-
nese medicine jing, when referring to a man, means
sperm. The ability to conserve jing is a result of the sta-
bilizing and binding properties and the ability to control
body fluids.
Although the results are not completely clear, some
studies have shown that the fruit of cornus has antibacte-
rial and antifungal properties. In some studies extracts of
the fruit inhibited the growth of some strains of Staphy-
lococcus bacteria. It may also be effective against Salmo-
nella and Shigella , both bacteria that cause gastrointesti-
nal disturbances.
Cornus fruit is also used in formulas that strengthen
the back and knees, both areas associated with kidney
jing. It is also used in formulas that control body fluids
and treat excessive sweating, urine leakage, sperm leak-
age (spermatorrhea), and heavy, prolonged menstruation.
Cornus is also an ingredient in formulas that treat ringing
of the ears (tinnitus), poor hearing, dizziness, extreme
shock, and a wide range of other conditions. The bark is
boiled, and the resulting astringent decoction is used in
formulas that treat fevers and as an anti-malarial. Inter-
estingly, in Western herbalism the bark of dogwood,
cornus’s cousin, is also used against malaria. Cornus is
also used to treat diabetes, arthritis, and impotence.
Two Chinese studies published in 1997 and 1998 in
The American Journal of Chinese Medicine found that
extracts of cornus increased the blood flow to the kidney
and spleen and increased the motility of human sperm.
Few scientific studies have been done on this herb out-
side of China.
Preparations
Both cornus fruit and bark usually are prepared as a
decoction that can be added to other tonics and healing
formulas. They can also be prepared as a tincture. The
dosage varies depending on the formula.
Some formulas that contain cornus include:
• eight immortal long life pill
• phellodendron
• supreme creation
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Decoction — Decoctions are made by boiling an
herb, then straining the solid material out. The re-
sulting liquid is the decoction.
Tincture — An alcohol-based extract prepared by
soaking plant parts.
Yang — Yang aspects are qualities such as warmth,
activity, light, and activity.
Yin — Yin aspects are the opposite of yang aspects
and are represented by qualities such as cold, still-
ness, darkness, and passiveness.
• Buddha’s yang
• dragon jing
• endocrine health
• essence restorative
Precautions
People experiencing painful or difficult urination
should not use cornus.
Side effects
Since cornus is rarely used alone, it is difficult to
separate any side effects it may cause from those caused
by other herbs in the formula. No side effects have been
reported.
Interactions
Cornus is has been used for thousands of years in
conjunction with other herbs with no reported interac-
tions. Since cornus is used almost exclusively in Chinese
medicine, there are no studies of its interactions with
Western pharmaceuticals. Although it should not be used
while taking a diuretic since cornus is an antidiuretic.
Resources
BOOKS
Molony, David. Complete Guide to Chinese Herbal Medicine.
New York: Berkeley Books, 1998.
Teegaurden, Ron. The Ancient Wisdom of the Chinese Tonic
Herbs. New York: Warner Books, 1998.
ORGANIZATIONS
American Association of Oriental Medicine. 433 Front Street,
Catasauqua. PA 18032. (610)266-2433.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Plants For a Future. The Field, Penpol, Lostwithiel, Cornwall,
PL22 ONG, England. (+44 1208) 872963. http://www.
scs.leeds.ac.uk/pfaf/.
OTHER
Healthlink Online, http://www.healthlink.com.au/.
Tish Davidson
Coronary artery disease see Heart disease
Coronary thrombosis see Heart attack
Corydalis
Description
Corydalis is the name of a group of herbs used in differ-
ent parts of the world to relieve pain. Corydalis yanhusuo is
a species used primarily in Chinese herbal medicine. C. gar-
iana, native to the Himalayas, is used medicinally in India. A
related species, Corydalis cava, is used in European herbal-
ism. Another closely related species, is Corydalis canaden-
sis (also called Dicentra canadensis) and known by the
common name corydalis or turkey com, is found in North
America. There are other species of Corydalis found
throughout the world. Although the names are somewhat
confusing, many are used by herbal therapists in similar
ways and are included under the umbrella label corydalis.
C. yanhusuo is a small herb that grows in mixed sun
and shade at the edge of woodlands. It is native to
Siberia, northern China, and Japan, but is cultivated in
other cool parts of China. C. yanhusuo grows to about 8
in (20 cm) in height and has narrow leaves and pink
flowers. The rhizome (underground stem) is used in
healing. C. yanhusuo is called yan hu suo in Chinese.
Some sources suggest that C. yanhusuo is used inter-
changeably with the related species C. solida, which is
called by the same Chinese name.
C. cava is a perennial that grows in shady forests. It
is native to southern Europe and has spread throughout
the continent. C. cava grows to a height of about 1 1 in
(30 cm). Its flowers range in color from red to yellowish
to white, with occasional lilac, brownish-red, or dark
blue flowers. The tubers (knobby, fleshy underground
stems) are used medicinally. Alternative names for the
North American species of corydalis include turkey corn,
squirrel corn, and early fumitory.
General use
In traditional Chinese medicine (TCM), C. yanhusuo
is said to have a warm nature and a pungent, bitter taste. It is
551
Corydalis
Cotton root bark
associated with the heart, liver, and spleen. C. yanhusuo is
used to relieve pain resulting from almost any cause. It is es-
pecially used to treat menstrual cramps, chest pains, and ab-
dominal pain. Corydalis is also the preferred herb in treating
pain from traumatic injuries. Some herbalists report that fry-
ing corydalis in vinegar enhances its ability to ease pain.
Along with its ability to relieve pain, C. yanhusuo is
used as a general aid to blood circulation and to promote
the circulation of qi, or vital energy. Some Chinese herbal-
ists also report using corydalis as a sedative and to lower
blood pressure. The herb is frequently found in combina-
tion with other plants in Chinese formulas that treat stab-
bing pain sensations, painful periods, and the like.
In Western medicine, the various corydalis species
are used to treat shaking and involuntary tremors. They
can be used to treat people with Parkinson’s disease.
Corydalis is also used as a painkiller; a diuretic; a seda-
tive that slows the pulse and depresses the central ner-
vous system; and a tonic that invigorates the circulation.
Occasionally it is used to treat mild forms of depression.
In fact, the uses of the various corydalis species are sur-
prisingly similar around the world.
Research scientists have isolated several potent al-
kaloid compounds from corydalis. The strongest of these
is corydaline. It has the ability to block certain receptors
in the brain associated with the sensation of pain. There
is good evidence from Chinese studies that corydalis is
effective in relieving pain and menstrual cramps. Evi-
dence for the other uses of corydalis is limited to test
tube and animal studies. One 1999 study at the Universi-
ty of Maryland Dental School found that an extract of C.
yanhusuo was successful in reducing artificially induced
inflammation in the paws of rats, although it was less
successful than some other TCM herbs that were tested.
Preparations
Corydalis tubers and rhizomes are dug either in the
spring or fall, before or after the leaves are actively
growing. They are dried and kept in a cool place before
use. Corydalis can be made into a tea, a tincture, or a de-
coction. Commercial extracts are also available.
Corydalis is usually combined with other herbs. One
popular treatment for menstrual pain is a decoction of
corydalis and cinnamon. In traditional Chinese medi-
cine, corydalis is found in almost all formulas to treat
menstrual pain, other pain formulas, and formulas to im-
prove the circulation.
Precautions
Chinese herbalists report that pregnant women should
not take corydalis. Since corydalis contains a compound
that depresses the central nervous system, it should be
552
KEY TERMS
Corydaline — An alkaloid derived from corydalis
that has some effectiveness as a pain reliever.
Decoction — A liquid made by simmering an herb
in water and then straining it.
Diuretic — A substance or medication that increas-
es the production of urine.
Qi — In traditional Chinese medicine, the vital life
force or energy that permeates the body.
Tincture — An alcohol-based extract prepared by
soaking plant parts.
used cautiously when using other central nervous system
depressant drugs or alcohol. This herb should be taken
under the supervision of a trained herbalist.
Side effects
Although no poisonings from corydalis have been re-
ported, overdose is likely to produce shaking and tremors.
Interactions
Some Western herbalists report that corydalis is incom-
patible with tannic acid and vegetable astringents. Corydalis
has been used in many Asian formulas without any reported
interactions. Few, if any, scientific studies have been done
on its interactions with Western pharmaceuticals.
Resources
BOOKS
Chevallier, Andrew. Encyclopedia of Medicinal Plants. New
York: DK Publishing, Inc., 1996.
PDR for Herbal Medicines. Montvale, NJ: Medical Economics
Company, 1999.
ORGANIZATIONS
American Association of Oriental Medicine (AAOM). 433
Front Street, Catasauqua, PA 18032. (610) 266-2433.
OTHER
“Corydalis.” Plants for a Future, <http://www.pfaf.org.>
Tish Davidson
Cotton root bark
Description
Cotton root and the cotton plant are known as
Gossypium herhaceum. Cotton is a member of the mal-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
low or Malvaceae family. The cotton plant is an ever-
green shrub that is native to Asia and Africa. It is also
grown in the southern United States, Egypt, and coun-
tries along the Mediterranean Sea. The plant was culti-
vated to produce cotton fiber for clothing. Cotton root
bark, the inner bark, and cotton seeds are all used as
herbal remedies. While the seeds also served as a food,
cotton root bark has been known for centuries as a “fe-
male medicine.”
The herbal remedy is known as cotton root bark,
Gossypium herbaceum , and cotton.
General use
Gossypium is the Latin word for cotton-producing
plant, and this evergreen shrub has been cultivated for thou-
sands of years in India. That form of cultivation was brought
to China and Egypt in approximately 500 B.c. Europeans
brought cotton cultivation to the New World in 1774.
Traditional uses
While Gossypium herbaceum was grown to produce
cotton fiber, other parts of the plant served as medical
remedies and food products. Cotton root bark was used
as a folk remedy for numerous female conditions rang-
ing from nonmenstrual bleeding from the uterus to in-
ducing labor contractions. While it was used to make
childbirth easier, cotton root bark was also taken as an
abortifacient (to induce miscarriages).
Cotton root bark was not just a woman’s remedy.
Chewing on the roots was said to stimulate the sexual or-
gans, giving cotton root the reputation of being an aphro-
disiac. The root also had uses not related to reproduction.
Cotton was also a remedy for conditions including snake
bite, dysentery, and fever. Furthermore, cotton seed was
once a food product and a remedy. A seed oil emulsion
was given as an intravenous treatment for people with
nutritional deficiencies.
Some of cotton root bark’s remedial uses came to
North America with the Africans enslaved by Europeans.
Women used cotton bark root to stimulate menstrual
flow and for help with difficulties during childbirth. Cot-
ton had a different use when slave owners raped women;
they drank cotton root tea to induce abortions.
Contemporary uses
Contemporary uses of cotton root bark cover nearly
every aspect of the female reproductive system. General-
ly, a tea made from this herb is consumed for such condi-
tions as producing a normal menstrual cycle. Numerous
other uses are listed in such sources as the PDR (Physi-
cian’s Desk Reference) for Herbal Medicines,, the 1998
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
book based on the findings of Germany’s Commission E.
The European group's findings about herbal remedies
were published in a 1997 monograph.
Cotton root bark is used as an aid during childbirth
and as a remedy for the absence of menstruation, irreg-
ular menstruation, and painful menstruation. Pregnant
women take cotton root bark to increase uterine contrac-
tions, to expel the afterbirth, and to help with the secre-
tion of milk. Cotton root bark is also taken for difficul-
ties experienced during menopause.
Furthermore, cotton root bark is currently used as a
male contraceptive in China because it’s said to immobi-
lize the sperm. Cotton root bark supposedly blocks pro-
duction of sperm without affecting a man’s potency. As
of June 2000, clinical trials were underway regarding
this use of cotton root bark.
In addition, cotton root bark still has a reputation as an
aphrodisiac. Evidence of this property of the herb, howev-
er, is anecdotal. No clinical research or studies have proved
that cotton root bark stimulates or increases sexual desire.
In addition to the medicinal uses of cotton root, oil
from cotton seed is currently used in soap and in the pro-
duction of margarine, shortening, cooking oil, and salad oil.
Preparations
While cotton root bark was taken as a tea in folk
medicine, other forms of the herb are used in contempo-
rary alternative medicine. Cotton root bark is currently
used as a liquid extract or a tincture. The dosage for both
the tincture and liquid extract is 0.5-1 tsp (2 — 4 ml) of ei-
ther solution. This amount can be divided into two daily
doses; a single dose consists of 20-40 drops (0.25-0.5
tsp). The extract or tincture can be added to a small
amount of water.
Cotton root bark can be combined with goldenseal
( Hydrastis canadensis) in herbal preparations.
Precautions
Cotton root bark has varied uses, and opinions are var-
ied about whether this remedy is safe to use. According to
the PDR for Herbal Medicines, cotton root bark is safe
when taken in therapeutic doses. Other herbalists state that
no part of Gossypium herbaceum should be taken internally
without first consulting with a doctor or health practitioner.
This precaution is particularly important for pregnant
women. Although cotton root bark is a remedy for condi-
tions related to childbirth, manufacturers of herbal products
advise women to seek medical advice before using it.
Although health risks have not been reported, poison-
ings have occurred when animals ate cotton-seed cakes
over a long period of time. Some of those cases were fatal.
553
Cotton root bark
Cough
KEY TERMS
Abortifacient — A drug or substance that induces
an abortion.
Aphrodisiac — A drug or other agent that is reput-
ed to arouse sexual desire.
Gossypol — A chemical found in cotton seed oil
that is thought to immobilize sperm.
In addition, gossypol is a chemical found in cottonseed
oil that is believed to immobilize sperm. Men who cook
with this oil may find themselves temporarily infertile.
Side effects
Cotton root bark has not been identified as produc-
ing side effects.
Interactions
There are no identified interactions associated with
taking cotton root bark.
Resources
BOOKS
PDR for Herbal Medicines. Montvale, NJ: Medical Economics
Co., 1998.
Ritchason, Jack. The Little Herb Encyclopedia. Pleasant
Grove, UT: Woodland Health Books, 1995.
Squier, Thomas Broken Bear, with Lauren David Peden.
Herbal Folk Medicine. New York: Henry Holt and Com-
pany, 1997.
ORGANIZATIONS
American Botanical Council. P.O. Box 201660, Austin TX,
78720. (512) 331-8868. http://www.herbalgram.org/.
Herb Research Foundation. 1007 Pearl St., Suite 200. Boulder,
CO 80302. (303) 449-2265. http://www.herbs.org.
OTHER
Health Mall Online, http://www.healthmall.com.
Liz Swain
Cough
Definition
A cough is a forceful release of air from the lungs
that can be heard. Coughing protects the respiratory sys-
tem by clearing it of irritants and secretions.
554
Description
While people can generally cough on purpose, a
cough is usually a reflex triggered when an irritant stimu-
lates one or more of the cough receptors found at differ-
ent points in the respiratory system. These receptors then
send a message to the cough center in the brain, which in
turn tells the body to cough. A cough begins with a deep
breath in, at which point the opening between the vocal
cords at the upper part of the larynx (glottis) shuts, trap-
ping the air in the lungs. As the diaphragm and other
muscles involved in breathing press against the lungs, the
glottis suddenly opens, producing an explosive outflow of
air at speeds greater than 100 mi (160 km) per hour.
In normal situations, most people cough once or
twice an hour during the day to clear the airway of irri-
tants. However, when the level of irritants in the air is
high or when the respiratory system becomes infected,
coughing may become frequent and prolonged. It may in-
terfere with exercise or sleep, and it may also cause dis-
tress if accompanied by dizziness, chest pain, or breath-
lessness. In the majority cases, frequent coughing lasts
one to two weeks and tapers off as the irritant or infection
subsides. If a cough lasts more than three weeks, it is
considered a chronic cough, and physicians will try to de-
termine a cause beyond an acute infection or irritant.
Coughs are generally described as either dry or pro-
ductive. A dry cough does not bring up a mixture of
mucus, irritants, and other substances from the lungs
(sputum), while a productive cough does. In the case of a
bacterial infection, the sputum brought up in a productive
cough may be greenish, gray, or brown. In the case of an
allergy or viral infection it may be clear or white. In the
most serious conditions, the sputum may contain blood.
Causes & symptoms
In the majority of cases, coughs are caused by respi-
ratory infections, including:
• colds or influenza, the most common causes of coughs
• bronchitis, an inflammation of the mucous membranes
of the bronchial tubes
• croup, a viral inflammation of the larynx, windpipe,
and bronchial passages that produces a bark-like cough
in children
• whooping cough, a bacterial infection accompanied by
the high-pitched cough for which it is named
• pneumonia, a potentially serious bacterial infection
that produces discolored or bloody mucus
• tuberculosis, another serious bacterial infection that
produces bloody sputum
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• fungal infections, such as aspergillosis, histoplasmosis,
and cryptococcoses
Environmental pollutants, such as cigarette smoke,
dust, or smog, can also cause a cough. In the case of ciga-
rette smokers, the nicotine present in the smoke paralyzes
the hairs (cilia) that regularly flush mucus from the respi-
ratory system. The mucus then builds up, forcing the
body to removed it by coughing. Post-nasal drip, the irri-
tating trickle of mucus from the nasal passages into the
throat caused by allergies or sinusitis, can also result in a
cough. Some chronic conditions, such as asthma, chron-
ic bronchitis, emphysema, and cystic fibrosis, are charac-
terized in part by a cough. A condition in which stomach
acid backs up into the esophagus (gastroesophageal re-
flux) can cause coughing, especially when a person is
lying down. A cough can also be a side effect of medica-
tions that are administered via an inhaler. It can also be a
side effect of beta-blockers and ACE inhibitors, which are
drugs used for treating high blood pressure.
Diagnosis
To determine the cause of a cough, a physician
should take an exact medical history and perform an
exam. Information regarding the duration of the cough,
what other symptoms may accompany it, and what envi-
ronmental factors may influence it aid the doctor in his
or her diagnosis. The appearance of the sputum will also
help determine what type of infection, if any, may be in-
volved. The doctor may even observe the sputum micro-
scopically for the presence of bacteria and white blood
cells. Chest x rays may help indicate the presence and
extent of such infections as pneumonia or tuberculosis. If
these actions are not enough to determine the cause of
the cough, a bronchoscopy or laryngoscopy may be or-
dered. These tests use slender tubular instruments to in-
spect the interior of the bronchi and larynx.
Treatment
Coughs due to bacterial or viral upper respiratory
infections may be effectively treated with complemen-
tary therapies. The choice of remedy will vary and be
specific to the type of cough the patient has. Lingering
coughs or coughing up blood should be treated by a
trained practitioner.
Nutrition & diet
Many health practitioners advise increasing fluid in-
take and breathing in warm, humidified air as ways of
loosening chest congestion. Avoiding mucous-producing
foods can be effective in healing a cough condition.
These mucous-producing foods can vary, based on indi-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
vidual intolerance, but dairy products are a major mu-
cous-producing food for most people. Other foods to
avoid are sugar and foods high in sodium. Others recom-
mend hot tea flavored with honey as a temporary home
remedy for coughs caused by colds or flu.
Various vitamins may be helpful in preventing or
treating conditions (including colds and flu) that lead to
coughs. They include vitamin C, vitamin E, zinc, vita-
min A, and folic acid.
Herbal medicine
There are many Western herbs, as well as herbs used
in traditional Chinese medicine (TCM), that soothe the
throat, quiet coughs, and act as expectorants. Some in-
clude:
• marsh mallow
• licorice
• aniseed
• fritillaria
• loquat
Homeopathic remedies
Depending on the type of cough and its duration,
several homeopathic remedies include:
• Aconite for dry coughs with fever
• Antimonium tartaricum for productive coughs
• Bryonia for intense, dry coughs accompanied by thirst
• Drosera for violent coughing
• Rumex crispus for tickling coughs
Allopathic treatment
Treatment of a cough generally involves addressing
the condition causing it. An acute infection such as pneu-
monia may require antibiotics, an asthma-induced cough
may be treated with the use of bronchodialators, or an
antihistamine may be administered in the case of an al-
lergy. Cough medicines may be given if the patient can-
not rest because of the cough or if the cough is not pro-
ductive, as is the case with most coughs associated with
colds or flu. The two types of drugs used to treat coughs
are antitussives and expectorants.
Expected results
Because the majority of coughs are related to the
common cold or influenza, most will end in 7-21 days.
The outcome of coughs due to a more serious underlying
disease depends on the pathology of that disease.
555
Cough
Cradle cap
KEY TERMS
Antitussives — Drugs used to suppress coughing.
Expectorant — Drug used to thin mucus.
Gastroesophageal reflux — Condition in which
stomach acid backs up into the esophagus.
Glottis — The opening between the vocal cords at
the upper part of the larynx.
Larynx — A part of the respiratory tract between
the pharynx and the trachea, having walls of carti-
lage and muscle, and containing the vocal cords.
Sputum — The mixture of mucus, irritants, and other
substances expelled from the lungs by coughing.
Prevention
It is important to identify and treat the underlying
disease and origin of the cough. Avoid smoking and
coming in direct contact with people experiencing cold
or flu symptoms. Wash hands frequently during episodes
of upper-respiratory illnesses.
Resources
BOOKS
The Burton Goldberg Group. Alternative Medicine: The Defin-
itive Guide. Tiburon, CA: Future Medicine Publishing
Inc., 1999.
Chandrasoma, Parakrama, and Clive R. Taylor. Concise Pathol-
ogy. East Norwalk, CT: Appleton and Lange, 1991.
Schumann, Lorna. “Alterations in Respiratory Function." In
Perspectives on Pathophysiology. Lee-Ellen Copstead, ed.
Philadelphia: W.B. Saunders, 1994.
Time-Life Books Editors. The Alternative Advisor. Alexandria,
VA: Time-Life Books, 1997.
PERIODICALS
Philp, Elizabeth B. “Chronic Cough." American Family Physi-
cian 56 (October 1, 1997).
ORGANIZATIONS
National Heart, Lung, and Blood Institute Information Center.
P.O. Box 30105, Bethesda, MD 20824. (301)251-1222.
Coughwort see Coltsfoot
Crab lice see Lice infestation
Cradle cap
Definition
Cradle cap is a form of seborrheic dermatitis, a
minor inflammatory disease of the scalp, face, and occa-
556
sionally other areas of the body. It is a common scalp
problem in infants and younger children.
Description
Cradle cap appears as thick, oily yellowish or brown-
ish patches on the skin, particularly the scalp. It is also
often found around the eyebrows, around the nose, be-
hind the ears, and in the genital area. The skin itself often
appears to be red, flaky, and irritated underneath the oily
patches. It most often effects children who are between
two weeks and two years old. Although cradle cap may
be unsightly, it is usually not harmful to the child.
Causes & symptoms
During infancy and early childhood, the glands that
produce sweat and oil are in a highly reactive state. Cra-
dle cap is most likely due to a buildup of sweat and oil
produced by these overactive glands. This buildup may
also cause an irritation of the skin. Sometimes an over-
growth of the yeast called Pityrosporum ovale may also
contribute to the condition. Occasionally, cradle cap is a
symptom of more serious problems.
Diagnosis
Cradle cap is easily recognizable, and usually it re-
quires no further diagnosis. However, if the rash seems
to be very itchy or irritating, it may be necessary to rule
out eczema. If there are additional symptoms, a health-
care provider should be consulted for a physical exam
and possible testing.
Treatment
Most remedies for cradle cap can be applied directly
to the oily patches on the skin. Tannins, for example, can
help to slow down oil production, as well as clear away
the cradle cap. Warm caffeinated tea, German chamomile
tea ( Matricaria recutita), burdock tea (Arctium lappa), or
diluted witch hazel extract ( Hamamelis virginiana,) can
be rubbed into the skin with a cloth several times per day.
A comfrey rinse can also be used. It should be rubbed
onto the affected area with a washcloth. The rinse can be
used after shampooing or bathing, or it can be applied to
dry skin. This treatment can be given nightly for up to ten
days until the symptoms are gone. The comfrey rinse can
be made by boiling two ounces (about 57 grams) of com-
frey root, Symphytum officinale, in one quart (or one liter)
of water. The tea should be simmered for 20 minutes and
then allowed to cool. A batch of the comfrey rinse can be
used and stored in the refrigerator for up to four days.
A rule of thumb in science is that like dissolves like;
therefore, any type of food grade oil can be used to dis-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
solve the oily buildup found in cradle cap. Olive oil,
wheat germ oil, and sesame oil are particularly favored.
Aromatherapy may be used by adding in 1-2 drops of
the essential oil of lavender, Lavandula angustifolia.
The oil should be applied to the skin and left overnight.
It can then be removed gently and slowly with a baby
brush or a fine-tooth comb. The area should be washed
or shampooed afterwards with a very mild soap.
Slippery elm (Ulmus fulva) is useful in soothing a
variety of skin problems, and can be applied to affected
areas several times per day. The herb can also be misted
liberally with water or used as a tea. Ointments containing
Calendula offinalis or plantain (Plantago major ) are also
appropriate to use on areas of cradle cap. These herbs can
often clear up an outbreak in as little as four days.
Internal remedies for cradle cap can be quite effec-
tive. These include tincture of burdock root, which can
help to balance oil and sweat production. Burdock is also
a good general tonic to take to keep the skin healthy.
Burdock should be given for at least three weeks for full
effect. A tincture of the wild pansy flower, Viola tricolor,
can also be given. Biotin, a B vitamin, works well for
cradle cap and can be given at dosages of 10 micrograms
(meg) for age 0-6 months; 15 meg for age 6-12 months,
and 20 meg for age one to three years.
Allopathic treatment
Generally, cradle cap does not need to be treated
medically. If the condition is resistant to treatment or it
starts spreading, however, an over-the-counter dandruff
shampoo may be used once per day until the cradle cap
has improved. Shampoos containing coal tar derivatives
may be highly irritating and are not recommended for
use on children under two.
A 0.5% or 1% hydrocortisone cream is available
over-the-counter and can be applied two or three times
per day to stubborn cases of cradle cap. If a Pityrospo-
rum ovale infection is suspected, a dermatologist may
prescribe ketoconazole (Nizoral) cream or shampoo.
These medications are strong and should be used for as
short a time as possible.
If crusting, pus, redness, or pain are present, a
physician should be consulted. There may be an underly-
ing infection caused by the infant’s scratching, which
can introduce bacteria into the skin. Antibiotics may
have to be prescribed. Other symptoms, such as poor
growth or diarrhea may point to immune system prob-
lems requiring medical assessment and treatment.
Expected results
Usually cradle cap will eventually resolve with no
aftereffects, even without treatment. However, it can take
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
This young boy is afflicted with seborrheic dermatitis.
(Custom Medical Stock Photo. Reproduced by permission.)
quite some time to clear. Most home remedies should
clear up cradle cap in a few weeks or months.
Prevention
Washing the hair more often than two or three times
per week may dry the skin out, making it more vulnerable
to cradle cap, so limited hair washing is recommended.
Resources
BOOKS
Foley, Denise, et al. The Doctors Book of Home Remedies for
Children: From Allergies and Animal Bites to Toothache
and TV Addiction, Hundreds of Doctor-Proven Techniques
and Tips to Care for Your Kid. Emmaus, PA: Rodale Press,
1999.
Kemper, Kathi J., M.D. The Holistic Pediatrician. New York:
HarperPerennial, 1996.
OTHER
DermaMed Pharmaceutical Incorporated. http://www.derma
med.com/aboutscalp.htm (January 17, 2001).
Health World Online, http://www.healthy.net/asp/templates/
book.asp?PageType=Book&ID=787 (January 17, 2001).
Patience Paradox
Cramp bark
Description
Cramp bark ( Viburnum op ulus) is a deciduous tree
or shrub that is native to Europe and the eastern United
States. It is a member of the Caprifoliaceae family. It is
also cultivated for use as an ornamental tree or shrub.
557
Cramp bark
Cramp bark
Other names for cramp bark include guelder rose, snow-
ball tree, king’s crown, high cranberry, rose elder,
water elder, Whitsun rose. May rose, dog rowan tree,
Whitsun bosses, silver bells, and gaiter berries.
Cramp bark grows in low grounds, woodlands, thick-
ets, and hedges. This large shrub grows 5-10 ft (1.5-3 m)
tall. The flowers, which appear in spring and summer, are
large (3-5 in [8-13 cm] across), flat-topped clusters of
snow-white florets. The inner florets are very small, com-
plete flowers while the florets along the outer edge of the
cluster are large and showy but cannot produce fruit. The
fruits, which appear in August, are drooping clusters of
bright red oval shiny, translucent berries. Cramp bark
berries are edible, but have a very bitter taste. The leaves
of cramp bark are lobed and turn a rich purple color in the
fall. The bark is grayish-brown, faintly cracked length-
wise, and has scattered brown-colored warts. The bark
has a strong odor and a bitter, astringent taste.
Constituents and bioactivities
Cramp bark contains a wide variety of biologically
active compounds. The constituents of cramp bark are
very similar to those of a close relative called black haw
(Viburnum prunifolium). Cramp bark and black haw may
be used interchangeably under certain conditions but
should not be considered interchangeable in the strict
sense. The constituents of cramp bark include:
• acid compounds (acetic, baldrianic, capric, chloro-
genic, cinnamic, citric, malic, ursolic, and valerianic)
• amyrins (alpha-amyrin and beta-amyrin)
• astragalin
• beta-sitosterol
• coumarins (scopoletin and scopoline)
• elements (aluminum, calcium, chromium, cobalt,
iron, magnesium, manganese, phosphorus, potassi-
um, selenium, silicon, sodium, tin, and zinc)
• esculetin
• glucosides (viburnine)
• glycosides (quercetin)
• hydroquinones (arbutin, methylarbutin, and free hydro-
quinone)
• myricyl alcohol
• paeoniside
• pectin
• protein
• resin
• tannins (catechin and epicatechin)
• viopudial
558
Cramp bark has antispasmodic (relieves muscle
spasms), anti-inflammatory (relieves inflammation),
nervine (calms and soothes the nerves), hypotensive
(lowers blood pressure), astringent (causes local contrac-
tion), emmenagogic (induces menstruation), and seda-
tive (reduces activity and excitement) properties. The
berries of cramp bark have antiscorbutic (effective against
scurvy) properties due to their vitamin C content.
General use
Historically, the Native American Meskwaki people
used cramp bark to treat cramps and pains located anywhere
in the body, whereas the Penobscot people used cramp bark
to treat mumps and swollen glands. Cramp bark was named
for its primary medicinal use — to relieve muscle cramps and
other conditions caused by muscle overcontraction.
Cramp bark is presently used to relieve any overly
tense muscle or muscle spasm of the body. This includes
the muscles of the uterus, air passages, intestines, arms,
legs, and back. In addition, it can be used to prevent mus-
cle tension and pain. Cramp bark is also used to treat
symptoms that are associated with excess muscle tension,
including menstrual pain (dysmenorrhea) caused by
uterine muscle contractions, and breathing difficulties as-
sociated with asthma. Colic, spastic constipation, irri-
table bowel syndrome, and the physical indications of
nervous tension are also treated with cramp bark.
Cramp bark has also been used to treat hysteria, ner-
vous complaints, debility, convulsions, fits, lockjaw,
heart palpitation, tension headaches, spasmodic stricture
(narrowing of a passage), bladder muscle spasms, high
blood pressure, rheumatism, circulatory problems, and
heart disease. It is effective in treating cases of arthritis
in which joint pain and weakness have led to severe mus-
cle contractions. Cramp bark relaxes the muscles, allow-
ing improvement in blood circulation that can return nor-
mal function to the arthritic joints.
Cramp bark is used to treat excessive blood loss dur-
ing menstruation and menopause, and to induce men-
struation in women with light or delayed periods. A
woman may treat dysmenorrhea prophylactically (before
symptoms appear) by taking cramp bark the day before
painful menstruation is expected. Cramp bark is also
used to treat endometriosis and threatened miscarriage.
In addition to its medicinal uses, cramp bark has a
few culinary applications. Cramp bark berries have been
used to make jelly and alcoholic beverages, and they are
used in certain food dishes.
Preparations
The bark of cramp bark is peeled off the tree during
the spring and summer months. The bark should be
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
peeled off in strips carefully in order not to kill the tree.
The bark is chopped up and dried. Cramp bark can be
made into a decoction (a water extract), a tincture (an al-
coholic extract), or a lotion. Liquid preparations of
cramp bark have a reddish-brown color, a slight odor,
and an astringent taste.
The decoction is prepared by adding 2 tsp of the
dried bark to 1 cup water. The mixture is brought to a
boil, the heat is reduced, and the decoction is simmered
gently for 10-15 minutes.
Although the recommended doses of the decoction are
variable, it is safe to drink up to three cups daily. The dose
of decoction for menstrual pain is 0.5 cup every three hours.
Tinctures are more concentrated and act faster
(within 30 minutes) than teas or decoctions. The tincture
may be taken for long-term conditions caused by muscu-
lar tension such as irritable bowel syndrome. Again, the
recommended doses vary somewhat, but up to 8 ml may
be taken three times a day. The suggested dose of tinc-
ture for irritable bowel syndrome is 0.5 tsp in hot water
twice a day. The suggested dose of tincture for menstrual
cramps is 1 tsp in water three times a day.
A lotion prepared from cramp bark may be rubbed
into the skin to relieve painful muscles.
To relieve cramping and back pain at night, cramp bark
may be mixed with lobelia ( Lobelia inflata). Cramp bark
may also be used with Mexican yam ( Dioscorea villosa ) for
ailments of the gastrointestinal and genitourinary systems.
Precautions
Some sources state that the berries of cramp bark
are toxic and should not be eaten.
Side effects
Cramp bark is safe for both short- and long-term
use. As of June 2000, there were no indications that
cramp bark causes any side effects. Pregnant women and
women who are lactating (breast-feeding), however,
should not use any herbal medicines without first con-
sulting a physician.
Interactions
As of mid 2000, there were no indications of any in-
teractions between cramp bark and any other drug or
herbal medicine.
Resources
BOOKS
Chevallier, Andrew. The Encyclopedia of Medicinal Plants.
New York: DK Publishing, Inc., 1996.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Antiscorbutic — An agent that is effective against
scurvy, like the vitamin C found in cramp bark.
Astringent — A substance that constricts or binds
skin cells.
Emmenagogue — A substance or medication given
to bring on a woman's menstrual period.
Prophylactic — Use of a treatment to prevent a dis-
ease or condition before symptoms appear.
Sedative — A substance or medication used to
soothe or reduce nervous irritation or overstimula-
tion.
Tincture — An alcoholic solution prepared from
herbal medicinal agents.
ORGANIZATIONS
American Botanical Council. P.O. Box 201660, Austin TX,
78720. (512) 331-8868. http://www.herbalgram.org/.
Herb Research Foundation. 1007 Pearl St., Suite 200, Boulder,
CO 80302. (303) 449-2265. http://www.herbs.org.
OTHER
Alternative Medicine Foundation. HerhMed. http://www.
amfoundation.org/herbmed.htm.
“Cramp bark.” Planet Botanic, http://www.planetbotanic.com/
cramp.htm.
Belinda Rowland
Cranberry
Description
The cranberry plant, a familiar source of berries
used in juices and relishes in the United States, has been
in existence since the Iron Age. The Romans were the
first to recognize its medicinal uses by the local inhabi-
tants of what is now England. Herbalist Henry Lyte doc-
umented its healing effects in 1578. Since then, the cran-
berry plant has been a popular folk remedy for a variety
of illnesses, including gout, rheumatism, diarrhea, con-
stipation, scurvy, fevers, skin infections and other skin
problems such as eczema. Cranberries are well known as
a treatment for such women’s health problems as cystitis,
and urinary and genital infections.
Currently, there are approximately 150 species of cran-
berry. The best known and most popular is the American
559
Cranberry
Cranberry
High-bush cranberry in Michigan. (Photograph by Robert J.
Huffman/Field Mark Publications. Reproduced by permission.)
cranberry ( Vaccinium macrocarpon ), because of the size
and juiciness of its fruit. It is a member of the Heath (Eri-
caceae) family. Vaccinium macrocarpon is a low-lying fruit
plant grown commercially in North America. The shrub
bears beautiful pink flowers that grow into rounded reddish-
black berries. The berries are harvested early in the fall, and
made into juices, jellies, or relishes. Juice made from cran-
berries is a popular, tart fruit drink. The United States
presently produces about 98% of the world’s cranberries.
Scientists have learned that the chemical composi-
tion of cranberries includes many substances that pro-
mote healing, such as:
• Proanthocyanidins and anthocyanins. These bioflave-
noids make up the pigment of the leaves, and produce
the color of the berries. More importantly, proantho-
cyanidins are responsible for cranberry’s best-known
medicinal effect, preventing bladder and urinary tract
infections by inhibiting bacterial colonization. They
may also help relieve diarrheal symptoms.
• Organic acids, including quinic, malic, and citric acids.
Quinic acid is considered the most important among
these organic acids. These compounds, which are re-
sponsible for the sour taste of cranberries, acidify the
urine and prevent kidney stones.
• Vitamins and minerals. Cranberries are rich sources of
vitamins including vitamin A, carotene, thiamine, ri-
boflavin, niacin, and vitamin C. They also contain
many essential minerals such as sodium, potassium,
calcium, magnesium, phosphorus, copper, sulfur,
iron, and iodide. These vitamins and minerals are strong
antioxidants that enable cranberries to help protect the
body against such infections as colds or influenza. Be-
cause of their high vitamin C content, cranberries were
used in the past to prevent a vitamin C deficiency
known as scurvy.
• Fiber. Like many other fruits, cranberries are a good
source of fiber.
General use
Prevention and treatment of urinary
tract infections
Urinary tract infections (UTIs) are extremely com-
mon in women, affecting one of every two females dur-
ing their lifetime. Men have urinary infections as well,
but less frequently than women. A woman contracts a uri-
nary tract infection when bacteria gets into the relatively
short female urethra and moves up to the bladder. Once in
the bladder, the bacteria grow and spread to other parts of
the urinary tract. If left untreated, UTIs can cause serious
kidney infections that may require hospitalization. The
disease is relatively easy to treat, but tends to recur.
In the United States, urinary tract infections result in
more than five million medical treatment visits each
year. The most frequently prescribed treatment for uri-
nary tract infections is antibiotics. There are also simple
self-protective measures that women can take against
UTIs. These include:
• Drinking a lot of fluid, which increases the amount of
urine produced and helps to flush out infectious mi-
croorganisms.
• Emptying the bladder immediately after having inter-
course.
• Using oral contraceptives rather than a diaphragm,
which tends to put pressure on or irritate the urethra.
• Drinking cranberry juice as a preventive measure for
women.
As early as the 1840s, German physicians observed
that cranberry juice prevented urinary tract infections.
This effect was attributed to the cranberry’s high acidity.
560
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Recent research has confirmed the effectiveness of
cranberries in preventing UTIs. Two studies in the mid-
1990s, one involving women 65 years or older and the
other with younger women between the ages of 18 and
45, showed that cranberries are effective in preventing
bladder infections. Regardless of age, women can signif-
icantly reduce their risk of urinary tract infections by
consuming 10 ounces of cranberry juice daily. Scientists,
however, have learned that the effectiveness of cranberry
juice is not related to its acidity, as was previously be-
lieved. Researchers found that the cranberry’s antibacter-
ial properties come from its proanthocyanidins (or con-
densed tannins). Proanthocyanidins inhibit chia coli bac-
teria from attaching to the inside walls of the bladder, al-
lowing them to be easily flushed out with urine before
they multiply and cause infections.
A careful review of all studies involving the cran-
berry’s role in preventing UTIs concluded that cranberry
juice or concentrate is beneficial in preventing infections
in women, but its benefits have not been proven in chil-
dren or males. The reviewers also noted that many
women did not complete the full one-year study period.
Prevention of kidney stones
Kidney stones are most often caused by high levels
of ionized calcium (as in calcium salts) in the urine.
Cranberries can help prevent this condition because they
are rich in quinic acid, which increases the acidity of the
urine. As a result, the levels of ionized calcium in the
urine are lowered.
A person needs to drink 16 ounces of unsweetened
cranberry juice (two glasses) daily to effectively prevent
kidney stones. Cranberry capsules or powdered concen-
trates are also available. It is important not to consume too
much cranberry, because very high acidity in the urine ac-
tually increases the risk of kidney stones. A person would
need to drink at least one liter of cranberry juice per day
for a prolonged period of time for this to occur.
Prevention of colds and influenza
A daily glass of cranberry juice is a good source of
vitamin C and antioxidants. These nutrients help support
the body’s immune function and prevent cancer as well
as such common infections as colds or influenza.
Other uses
Cranberries may serve as a digestive aid. Because of
their high acidity, they help to digest fatty foods, and to
increase the appetite.
Some early laboratory studies suggest that cranber-
ries may help to prevent gingivitis (gum disease) and
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
coronary (heart) disease. These studies have not yet been
confirmed by clinical research in humans.
Cranberry has been a folk remedy for diarrhea. Pro-
ponents of this use suggest that the proanthocyanidins in
cranberries, in addition to having antibacterial activity,
also act as astringents. They cause proteins to clump to-
gether to form rigid cakes that prevent bacteria from using
the proteins for food. However, the effectiveness of cran-
berries in the treatment of diarrhea remains unproven.
Various cranberry preparations have also been used
to treat skin disorders such as acne, dermatitis, and pso-
riasis; bed-wetting; burns and wounds; and stress and
depression. There is currently insufficient scientific evi-
dence to support these uses.
A recent study suggests that cranberry juice may in-
hibit the formation of dental plaque by preventing bacte-
ria from collecting (coaggregating) on the tooth film
formed by proteins in the saliva. These preliminary find-
ings await further testing.
Preparations
There are many types of cranberry preparations
available, partly because cranberry products are among
the top 10 best sellers in the health food market. They
include:
• Cranberry juice. For prevention of urinary tract infec-
tions and kidney stones, recommended products in-
clude those containing pure cranberry juice rather than
mixtures that are only 25-27% cranberry juice. Four to
six ounces of unadulterated cranberry juice daily is rec-
ommended for the prevention of UTIs. Some herbalists
advocate the use of cranberry for treatment of mild uri-
nary tract infections; dosages of 10-32 oz (0.3-1 kg)
daily have been used. Cranberry juice may not be effec-
tive, however, for established infections. It should be
taken only as a complementary measure rather than as
an alternative to antibiotics in the treatment of active
UTIs. If a woman experiences such symptoms of cysti-
tis as chills, fever, fatigue, and burning pain during
urination, she should contact her doctor immediately
for antibiotic treatment.
• Dried cranberry powder capsules (475-500 mg). Be-
cause most commercial cranberry juice contains high
levels of sugar, these capsules may be a better alterna-
tive for diabetic patients or dieters. Each capsule equals
0.5 ounces of cranberry juice. Nine to 15 capsules daily
is the recommended dosage for the prevention of uri-
nary tract infections.
• Powdered concentrates. These forms of cranberry are
available in different strengths. Women should follow
the dosages recommended by manufacturers.
561
Cranberry
Cranberry
• Fresh or dried cranberries. Dried untreated cranberries
can be found in health food stores. They can be stored
up to a year. Cranberries are also available fresh or
frozen in most grocery stores or supermarkets. Because
of their tartness, most people may find it difficult to
consume them in sufficient quantity to obtain their
therapeutic benefits.
• Cranberry herbal teas. These products can be obtained
from health food stores or via the Internet.
Precautions
Cranberries should be used with care or modifica-
tion in patients with certain diseases, including:
• Active urinary tract infections. Cranberries should not
be substituted for antibiotic treatment, but used only as
a supplementary therapy.
• Irritable bowel syndrome (IBS). Large quantities of
cranberry juice or capsules may cause diarrhea in IBS
patients.
• Diabetes. Patients with diabetes should use sugar-free
cranberry juice, or take capsules or powdered concen-
trates.
Side effects
The most common side effects associated with ex-
cessive cranberry consumption are diarrhea and an in-
creased risk of developing kidney stones.
Regular cranberry consumption by women trying to
prevent UTIs may result in vulvovaginal candidiasis. Al-
terations in the normal vaginal bacteria may lead to in-
creased fungal growth.
Interactions
There are no identified drug interactions associated
with cranberry consumption.
Resources
BOOKS
Davies, Jill Rosemary. Healing Herbs — In a Nutshell: CRAN-
BERRY. Boston: Element Books. Inc., 2000.
Fetrow, Charles W., and Juan R. Avila. The Complete Guide to
Herbal Medicines. Springhouse, PA: Springhouse Corpo-
ration, 2000.
McCaleb, Robert, Evelyn Leigh, and Krista Morien. The Ency-
clopedia of Popular Herbs: Your Complete Guide to the
Leading Medicinal Plants. Rocklin, CA: Prima Health,
2000 .
Murray, Michael, and Joseph Pizzomo. Encyclopedia of Natur-
al Medicine. Rocklin, CA: Prima Health, 1998.
562
KEY TERMS
Antioxidants — A substance that is capable of
countering the damaging effects of oxidation in
the body's tissues. Ingredients in the cranberry
perform antioxidant functions in the body.
Astringent — Any acidic substance that draws to-
gether and constricts tissue.
Bioflavenoids — Plant substances that have a wide
range of properties, including anti-inflammatory,
anti-carcinogenic, and antioxidant.
Proanthocyanidins — Bioflavenoids found in cran-
berries, responsible for the fruit's effectiveness in
preventing urinary tract infections.
Vulvovaginal candidiasis — A yeast-like fungal in-
fection of the vulva and vagina, which can be re-
lated to regular consumption of cranberry.
PERIODICALS
Avorn J., M. Monane, J.H. Gurwitz, et al. "Reduction of Bac-
teriuria and Pyuria after Ingestion of Cranberry Juice.”
Journal of the American Medical Association (JAMA) 27 1
(1994): 751-4.
Jepson R.. L. Mihaljevic, and J. Craig. “Cranberries for pre-
venting urinary tract infection.” Cochrane Database Syst
Rev (2004).
Patel, D.A., B. Gillespie, J.D. Sobel, et al. “Risk factors for re-
current vulvovaginal candidiasis in women receiving
maintenance antifungal therapy: Results of a prospective
cohort study.” American Journal of Obstetrics and Gyne-
cology March (2004): 644-53.
Weiss, E.I., A. Kozlovsky, D. Steinberg, R., et al. “A high mole-
cular mass cranberry constituent reduces mutans strepto-
cocci level in saliva and inhibits in vitro adhesion to hy-
droxyapatite.” FEMS Microbiol Lett (March 2004): 89-92.
ORGANIZATIONS
American Association of Naturopathic Physicians. 601 Valley
St., Suite 105, Seattle, WA 98109. (206) 298-0126. Fax:
(206) 298-0129. <http://www.naturopathic.org>.
American Herbal Products Association. 8484 Georgia Ave.,
Suite 370, Silver Spring, MD 20910. (301) 588-1174.
<http ://w w w. ahpa. org> .
National Center for Complementary and Alternative Medicine
(NCCAM). NCCAM Clearinghouse, PO Box 8218, Silver
Spring, MD 20907-8218. (888) 644-6226. Fax: (301) 495-
4957. <http://nccam.nih.gov>.
Samuel Uretsky, Pharm.D.
Cranial manipulation see Craniosacral
therapy
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Craniosacral therapy
Definition
Craniosacral therapy is a holistic healing practice
that uses very light touching to balance the craniosacral
system in the body, which includes the bones, nerves, flu-
ids, and connective tissues of the cranium and spinal area.
Origins
The first written reference to the movement of the
spinal nerves and its importance in life, clarity, and
“bringing quiet to the heart” is found in a 4, 000- year-old
text from China. Craniosacral work was referred to as
“the art of listening.” Bone setters in the Middle Ages
also sensed the subtle movements of the body. They used
these movements to help reset fractures and dislocations
and to treat headaches.
In the early 1900s, the research of Dr. William
Sutherland, an American osteopathic physician, detailed
the movement of the cranium and pelvis. Before his re-
search it was believed that the cranium was a solid im-
movable mass. Sutherland reported that the skull is actu-
ally made up of 22 separate and movable bones that are
connected by layers of tissue. He called his work cranial
osteopathy. Nephi Cotton, an American chiropractor
and contemporary of Sutherland, called this approach
craniology. The graduates of these two disciplines have
refined and enhanced these original approaches and re-
named their work as sacro-occipital technique, cranial
movement therapy, or craniosacral therapy.
Dr. John Upledger, an osteopathic physician, and
others at the Department of Biomechanics at Michigan
State University, College of Osteopathic Medicine
learned of Sutherland’s research and developed it further.
He researched the clinical observations of various osteo-
pathic physicians. This research provided the basis for
Upledger’s work which he named craniosacral therapy.
Benefits
According to Upledger, craniosacral therapy is ide-
ally suited for attention-deficit hyperactivity disorder,
headaches, chronic middle ear infection, pain, and gen-
eral health maintenance. It is recommended for autism,
fibromyalgia, heart disease, osteoarthritis, pneumo-
nia, rheumatoid arthritis, chronic sinus infections, and
gastroenteritis (inflammation of the lining of the stom-
ach or small intestine). It is also used with other thera-
pies to treat chronic fatigue syndrome, back pain, and
menstrual irregularity. In addition, other craniosacral
practitioners have reported benefits for eye dysfunction,
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
WILLIAM SUTHERLAND 1873-1954
William Garner Sutherland studied osteopathy
under its founder, Andrew Taylor Still. Dr. Sutherland
made his own important discovery while examining the
sutures of cranial bones the skull bones that protect the
brain. What he noticed is that the sutures were designed
for motion. Sutherland termed this motion the Breath of
Life. Through his experiments and research he deter-
mined that primary respiration was essential to all other
physiological functions.
When Sutherland developed his techniques for
craniosacral therapy, he wanted it to serve as a vehicle
for listening to the body's rhythmic motions, and treat
the patterns of inertia, when those motions become
congested. He believed that the stresses — any trauma
either physical or emotional — created an imbalance in
the body that needed correction to restore it to full
health. The therapy is a hands-on method so that the
therapist can feel the subtleties of the patterns of move-
ment and inertia. Sutherland felt that this was the way
to encourage self-healing and restoration of the body's
own mechanisms, taking a holistic approach to creating
optimal health.
The Craniosacral Therapy Educational Trust, based
on Sutherland's pioneering work is located at 10 Norrn-
ington Close, Leigham Court Road, London SW16 2QS,
United Kingdom. Phone number is 07000 785778.
Jane Spear
dyslexia, depression, motor coordination difficulties,
temporomandibular joint dysfunction (TMD), hyperac-
tivity, colic, asthma in babies, floppy baby syndrome,
whiplash, cerebral palsy, certain birth defects, and other
central nervous system disorders.
Description
Craniosacral therapy addresses the craniosacral sys-
tem. This system includes the cranium, spine, and
sacrum which are connected by a continuous membrane
of connective tissue deep inside the body, called the dura
mater. The dura mater also encloses the brain and the
central nervous system. Sutherland noticed that cerebral
spinal fluid rises and falls within the compartment of the
dura mata. He called this movement the primary respira-
tory impulse; today it is known as the craniosacral
rhythm (CSR) or the cranial wave.
Craniosacral therapists can most easily feel the CSR
in the body by lightly touching the base of the skull or
the sacrum. During a session they feel for disturbances
563
Craniosacral therapy
Craniosacral therapy
in the rate, amplitude, symmetry, and quality of flow of
the CSR. A therapist uses very gentle touch to balance
the flow of the CSR. Once the cerebrospinal fluid moves
freely, the body’s natural healing responses can function.
A craniosacral session generally lasts 30-90 min-
utes. The client remains fully clothed and lays down on a
massage table while the therapist gently assesses the
flow of the CSR. Upledger describes several techniques
which may be used in a craniosacral therapy session. The
first is energy cyst release. “This technique is a hands-on
method of releasing foreign or disruptive energies from
the patient’s body. Energy cysts may cause the disruption
of the tissues and organs were they are located.’’ The
therapist feels these cysts in the client’s body and gently
releases the blockage of energy.
Sutherland first wrote about a second practice called
direction of energy. In this technique the therapist in-
tends energy to pass from one of his hands, through the
patient, into the other hand.
The third technique is called myofascial release.
This is a manipulative form of bodywork that releases
tension in the fascia or connective tissue of the body.
This form of bodywork uses stronger touch.
Upledger’s fourth technique is position of release.
This involves following the client’s body into the posi-
tions in which an injury occurred and holding it there.
When the rhythm of the CSR suddenly stops the thera-
pist knows that the trauma has been released.
The last technique is somatoemotional release. This
technique was developed by Upledger and is an offshoot
of craniosacral therapy. It is used to release the mind and
body of the residual effects of trauma and injury that are
“locked in the tissues.”
The cost of a session varies due to the length of time
needed and the qualifications of the therapist. The cost
may be covered by insurance when the therapy is per-
formed or prescribed by a licensed health care provider.
Precautions
This gentle approach is extremely safe in most
cases. However, craniosacral therapy is not recommend-
ed in cases of acute systemic infections, recent skull
fracture, intracranial hemorrhage or aneurysm, or hernia-
tion of the medulla oblongata (brain stem). Craniosacral
therapy does not preclude the use of other medical ap-
proaches.
Side effects
Some people may experience mild discomfort after a
treatment. This may be due to re-experiencing a trauma or
564
injury or a previously numb area may come back to life
and be more sensitive. These side effects are temporary.
Research & general acceptance
More than 40 scientific papers have been published
that document the various effects of craniosacral therapy.
There are also 10 authoritative textbooks on this therapy.
The most notable scientific papers include Viola M. Fry-
man’s work documenting the successful treatment of
1,250 newborn children with birth defects. Edna Lay and
Stephen Blood showed the effects on TMD, and John
Wood documented results with psychiatric disorders.
The American Dental Association has found craniosacral
therapy to be an effective adjunct to orthodontic work.
However, the conventional medical community has not
endorsed these techniques.
Training & certification
Craniosacral therapy is offered as part of the stan-
dard training in osteopathy, chiropractic, and rolfing.
Massage therapists, nurses, dentists, physical therapists,
and other health care practitioners can receive training
through a series of workshops and seminars. The Up-
ledger Institute offers two levels of national certification,
involving a rigorous three part exam process of written,
oral, and hands-on testing. The Milne Institute certifies
practitioners through a two year training program that
covers anatomy, physiology, symptomatology, psycholo-
gy, meditation practice, and training in sensitivity, per-
ception and intuition. Today there are around 40,000
practitioners certified to practice crainiosacral therapy.
Resources
BOOKS
Knaster, Mirka. Discovering the Body’ s Wisdom. New York:
Bantam Books, 1996.
Milne, Hugh. Heart of Listening: A Visionary Approach to
Craniosacral Work: Anatomy. Technique, Transcendence.
2nd ed. Berkeley, CA: North Atlantic Books, 1998.
Upledger,John E. “CranioSacral Therapy.” In Clinician s Com-
plete Reference to Complementary and Alternative Medi-
cine. Donald Novey, ed. St. Louis, MO: 2000.
Upledger, John E. Your Inner Physician and You: CranioSacral
Therapy Somatoemotional Release. Berkeley, CA: North
Atlantic Books, 1991.
Upledger, John E. and John Vredevoogd. Craniosacral Thera-
py. Seattle: Eastland Press, 1983.
ORGANIZATIONS
Milne Institute Inc. P.O. Box 2716, Monterey, CA 93942-2716.
(831) 649-1825. Fax: (831) 649-1826. http://www.mhne
institute.com. milneinst@aol.com.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Upledger Institute. 11211 Prosperity Farms Road, Palm Beach
Gardens, FL 33410. (800) 233-5880. Fax: (561) 622-
4771. http://www.upledger.com.
OTHER
Milne, Hugh. A Client’s Introduction to Craniosacral Work.
Pamphlet. Milne Institute.
Linda Chrisman
Creatine
Description
With its promises of bigger muscles and improved
athletic performance, creatine has generated more inter-
est and controversy than almost any other dietary supple-
ment. It is widely used by body builders and athletes of
all levels, from famous baseball sluggers to high school
jocks. Even without taking supplements, all people have
a small amount of this protein in their bodies. Some of it
comes from food, especially meat and fish, while the rest
is made by the body from amino acids. No one disputes
the fact that creatine plays an important role in convert-
ing food into energy. The real question is whether taking
extra amounts of creatine can make muscles bigger,
boost athletic performance, or improve the health of peo-
ple with muscle or nerve disease.
Creatine is considered important because it can
increase the amount of energy available to working
muscles. The protein is used by the body to make a
chemical compound called adenosine triphosphate
(ATP), the immediate fuel source used by muscles
during short but intense bursts of activity. Through its
conversion into phosphocreatine, a related substance,
creatine appears to delay muscle fatigue by re-supply-
ing muscles with ATP. Because creatine can be stored
for later use by cells, consuming extra amounts of the
protein may create a deeper energy reserve for mus-
cles and other tissues. Excess creatine is eliminated by
the kidneys. This means that creatine supplements
may be of little value in people who have sufficient
levels of the protein, since the kidneys automatically
remove extra amounts.
A significant amount of research is still required to
determine the long-term effects of taking creatine, proper
dosage, and whether age, gender, or the presence of exist-
ing diseases can affect use of the supplements. However,
as of 2002, studies found a lower risk of training-related
injuries in athletes who used the supplement and new
therapeutic uses of the supplement were being tested.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
General use
Creatine supplements are generally used by weight
lifters and athletes who wish to optimize their workouts
or enhance athletic performance. It is important to distin-
guish fact from myth regarding the possible benefits of
creatine. The scientific evidence suggests that creatine
may not have much usefulness as a muscle-enhancing
agent, though it does appear to moderately improve per-
formance in exercises or sports that require short, repeat-
ed bursts of high-energy activity. For example, creatine
may provide a slight energy boost to the muscles of a
weight lifter during extended repetitions or a basketball
player who makes yet another drive to the hoop. Howev-
er, creatine does not appear to increase aerobic capacity
or improve performance in endurance-type activities such
as marathon running. Apart from its uses in body building
and athletics, creatine may prove beneficial in the treat-
ment of certain diseases involving the muscles or nerves.
In one study of 16 physical education students, for
example, those who received 20 g a day of creatine for
about a week were more capable of maintaining speed
during a cycling exercise. The students peddled on a sta-
tionary bike for six seconds at a stretch, repeating the ex-
ercise 10 times and taking 30-second breaks between at-
tempts. A study of 14 active men, published in the Journal
of the American Dietetic Association in 1997, investigated
creatine supplementation and repetitive, high-intensity re-
sistance exercises involving the bench press and jump
squats. The authors reported that taking 25 mg a day of
creatine for one week enhanced muscular performance
during the resistance exercises and also increased body
mass. It is not certain if the higher body mass reflected in-
creases in muscle or simply excess water weight, which
may give the impression of bigger muscles.
In addition to individual studies, several articles in
medical journals have reviewed the scientific literature
concerning creatine. According to an article published in
the Journal of the American College of Nutrition in
1998, creatine supplements may boost performance dur-
ing certain physical exercises that require repeated, in-
tense efforts and allow only a short interval of rest be-
tween attempts. The author noted that using the protein
appears to increase body mass in men (though the initial
increase is probably water) and may increase lean body
mass when combined with resistance exercises over a
long period of time. A meta-analysis published in the In-
ternational Journal of Sports Medicine in 1997 dis-
cussed the possible benefits of creatine supplements and
how the protein may produce its effects. The authors
suggest that creatine may be able to delay muscle fatigue
and quicken recovery during repetitive, high-intensity
exercises by helping the body to re-supply muscles with
565
Creatine
Creatine
ATP. Once ATP reserves get low due to exertion, the
higher levels of creatine and phosphocreatine in muscles
facilitate the speedy production of new ATP. The authors
conclude that creatine supplements may be useful during
repetitive training exercises and could provide a compet-
itive edge in sports that require repeated, explosive
bursts of activity such as basketball or soccer.
One of the most thorough and authoritative investi-
gations of creatine supplementation was conducted by a
panel affiliated with the American College of Sports
Medicine (ACSM). This group, which reviewed over 100
studies involving creatine, published some of their find-
ings in early 2000 in Medicine and Science in Sports and
Exercise. The panel found that creatine can boost perfor-
mance in certain repetition-type exercises that involve
brief but powerful exertion. They noted that creatine does
not appear to make people stronger or improve aerobic
capacity. Creatine can produce weight gain after only a
few days, but this is most likely due to water retention.
Since most of the creatine research has been conducted in
healthy young men, there is limited information about
how age or gender may affect use of the protein. The
panel pointed out that, while creatine may produce a
small but significant boost in performance in very specif-
ic exercises, it usually cannot satisfy the overly high ex-
pectations of most people who use the supplement.
A 2002 European study reported that creatine sup-
plements could actually speed rehabilitation for injured
athletes. Patients who were immobilized in a leg cast for
two weeks were given a dietary supplement of creatine
before immobilization and then daily throughout the re-
habilitation. They showed faster recovery of strength and
muscle mass than subjects not receiving creatine.
Aside from sports, research also suggests that crea-
tine may be helpful in the treatment of certain diseases af-
fecting the muscles or nerves, including Huntington’s dis-
ease, Lou Gehrig’s disease (amyotrophic lateral sclero-
sis), and congestive heart failure. Creatine is not consid-
ered a cure for these diseases, but may help to alleviate
symptoms (such as muscle weakness and fatigue) or pos-
sibly extend survival. In one study involving mice, con-
ducted by researchers from Harvard Medical School and
Cornell University Medical College, creatine appeared to
provide protection against Lou Gehrig’s disease. The pro-
tein worked twice as well as Riluzole, a prescription drug
approved by the FDA for treatment of the disease.
Preparations
Dosage of creatine usually consists of a loading
dose of 10-30 g a day (divided into several doses) for
four to six days, followed by a maintenance dose of 2-5
g a day. It is not clear if the high loading dosage is actu-
566
ally necessary. The ACSM panel noted that smaller
dosages (3 g a day) achieve the same effects if taken for
several weeks.
Even without taking supplements, most people get
about 1 g of creatine through their diets. Some authori-
ties believe it is safer for people to avoid creatine supple-
ments altogether in favor of eating foods that contain the
protein. The best sources of creatine are meat, poultry,
and fish. Getting too much dietary creatine is not consid-
ered a significant risk because only small amounts of the
protein are contained in food.
Precautions
Creatine supplements are not known to be harmful
when taken in recommended dosages, though there are
some precautions to consider. People with kidney dis-
ease should not use creatine without medical supervi-
sion. Due to lack of sufficient medical study, creatine
should be used with caution in children under age 16,
women who are pregnant or breast-feeding, and people
with liver disease.
The long-term health risks associated with taking
creatine are unknown. Surprisingly, though, use of the
supplement is increasing, even among children and ado-
lescents. Some adults have used the drug on a long-term
basis without knowing the effects of long-term use.
Side effects
A slight weight gain due to water retention is proba-
bly the most common side effect. Nausea, cramping, de-
hydration, diarrhea, and increased blood pressure have
also been reported.
To avoid possible side effects, do not take creatine
immediately before or during exercise.
Drink plenty of fluids (six to eight glasses a day)
while using creatine in order to prevent dehydration.
Interactions
Taking creatine with large amounts of carbohydrates
may increase its effectiveness. Caffeine may decrease
the effects of the supplement.
Resources
BOOKS
Paoletti, Rodolfo. Creatine: From Basic Science to Clinical
Application. Boston: Kluwer, 1999.
PERIODICALS
“Creatine Supplementation Speeds Rehabilitation.' 1 Health and
Medicine Week (January 21, 2002): 6.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Amino acids — The building blocks of protein.
Meta-analysis — An analysis of previous medical
studies.
Kubetin, Sally Koch. “Demand Swells for Sports Supple-
ments." Family Practice News (February 15, 2002): 1.
Mujika, I., and S. Padilla. “Creatine Supplementation as an Er-
gogenic Acid for Sports Performance in Highly Trained
Athletes: A Critical Review." International Journal of
Sports Medicine 18, no. 7 (1997): 491-6.
“Studies Say Creatine is OK." Obesity, Fitness & Wellness
Week (January 12, 2002): 12.
Terjung. R. L.. P. Clarkson, E. R. Eichner, et al. “The Physio-
logical and Health Effects of Oral Creatine Supplementa-
tion [In Process Citation].” Medicine and Science in
Sports and Exercise 32, no. 3 (2000): 706-17.
Volek, J. S., W. J. Kraemer, J. A. Bush, et al. “Creatine Supple-
mentation Enhances Muscular Performance During High-
Intensity Resistance Exercise.” Journal of American Di-
etetic Association 97, no. 7 (1997): 765-70.
Williams, M. H., and J. D. Branch. “Creatine Supplementation
and Exercise Performance: An Update.” Journal of the
American College of Nutrition 17, no. 3 (1998): 216-34.
ORGANIZATIONS
American College of Sports Medicine. 401 W. Michigan St.,
Indianapolis, IN 46202-3233. cheister@acsm.org. <http://
www.acsm.org>.
Grand Forks Human Nutrition Research Center. 2420 2nd Ave
N., Grand Forks, ND 58202. <http://www.gfhnrc.ars.usda.
gov>.
Greg Annussek
Teresa G. Odle
Crohn's disease
Definition
Crohn’s disease is a type of inflammatory bowel
disease (1BD), resulting in swelling and dysfunction of
the intestinal tract.
Description
Crohn’s disease involves swelling, redness, and loss
of function of the intestine, especially the small intestine.
There is evidence that this inflammation is caused by a
misfire of the immune system, which attacks the body it-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
self instead of attacking foreign invaders, such as viruses
or bacteria. The inflammation of Crohn’s disease most
commonly occurs in the last part of the ileum (a section
of the small intestine), and often includes the large intes-
tine (the colon). However, inflammation may also occur
in other areas of the gastrointestinal tract, including the
mouth, esophagus, or stomach. Crohn’s disease differs
from ulcerative colitis, the other major type of IBD, in
two important ways:
• The inflammation of Crohn’s disease may be discontin-
uous, meaning that areas of involvement in the intestine
may be separated by normal, unaffected segments of
intestine. The affected areas are called “regional enteri-
tis,” while the normal areas are called “skip areas.”
• The inflammation of Crohn’s disease affects all the lay-
ers of the intestinal wall, while ulcerative colitis affects
only the lining of the intestine.
Also, ulcerative colitis does not usually involve the
small intestine; in rare cases it involves the terminal
ileum (so-called “backwash” ileitis).
In addition to inflammation, Crohn’s disease causes
ulcerations, or irritated pits, in the intestinal wall. These
pits occur because the inflammation has made areas of
tissue shed away.
While Crohn’s disease and ulcerative colitis are sim-
ilar, they are also very different. Although it can be diffi-
cult to determine whether a patient has Crohn’s disease
or ulcerative colitis, it is important to make every effort
to distinguish between these two diseases. Because the
long-term complications of the diseases are different,
treatment will depend on careful diagnosis of the specif-
ic IBD present.
Crohn’s disease may be diagnosed at any age, al-
though most diagnoses are made between the ages of
15-35. About 20-40 people out of 10,000 suffer from this
disorder, with men and women having an equal chance of
being stricken. Caucasians are more frequently affected
than other racial groups, and people of Jewish origin ap-
pear three to six times more likely to suffer from IBD.
IBD runs in families; an IBD patient has a 20% chance of
having other relatives who are fellow sufferers.
Crohn’s disease is a chronic disorder. While the
symptoms can be improved, there is no known cure for
the underlying disease.
Causes & symptoms
The cause of Crohn’s disease is unknown. No infec-
tious agent (virus, bacteria, or fungi) has been identified
as the etiologic agent. Still, some researchers have theo-
rized that some type of infection may have originally
been responsible for triggering the immune system, re-
567
Crohn's disease
Crohn's disease
A double-contrast barium x ray showing the colon of a pa-
tient with Crohn’s disease. (Custom Medical Stock Photo. Re-
produced by permission.)
suiting in the continuing and out-of-control cycle of in-
flammation that occurs in Crohn’s disease. Other evi-
dence for a disorder of the immune system includes the
high incidence of other immune disorders that may occur
along with Crohn’s disease.
The first symptoms of Crohn’s disease may include di-
arrhea, fever, abdominal pain, inability to eat, weight loss,
and fatigue. Some patients experience severe pain that
mimics appendicitis. It is rare, however, for patients to no-
tice blood in their bowel movements. Because Crohn’s dis-
ease severely limits the ability of the affected intestine to
absorb the nutrients from food, a patient with Crohn’s dis-
ease can have signs of malnutrition, depending on the
amount of intestine affected and the duration of the disease.
The combination of severe inflammation, ulceration,
and scarring that occurs in Crohn’s disease can result in
serious complications, including obstruction, abscess
formation, and fistula formation.
An obstruction is a blockage in the intestine. This
obstruction prevents the intestinal contents from passing
beyond the point of the blockage. The intestinal contents
“back up,” resulting in constipation, vomiting, and in-
tense pain. Although rare in Crohn’s disease (because of
the increased thickness of the intestinal wall due to
swelling and scarring), a severe bowel obstruction can
result in an intestinal wall perforation (a hole in the in-
testine). Such a hole in the intestinal wall would allow
the intestinal contents, usually containing bacteria, to
enter the abdomen. This complication could result in a
severe, life-threatening infection.
Abcess formation is the development of a walled-
off pocket of infection. A patient with an abscess will
have bouts of fever, increased abdominal pain, and may
have a lump or mass that can be felt through the wall of
the abdomen.
Fistula formation is the formation of abnormal chan-
nels between tissues. These channels may connect one
area of the intestine to another neighboring section of in-
testine. Fistulas may join an area of the intestine to the
vagina or bladder, or they may drain an area of the intes-
tine through the skin. Abscesses and fistulas commonly
affect the area around the anus and rectum (the very last
portions of the colon allowing waste to leave the body).
These abnormal connections allow the bacteria that nor-
mally live in the intestine to enter other areas of the
body, causing potentially serious infections.
Patients suffering from Crohn’s disease also have a
significant chance of experiencing other disorders. Some
of these may relate specifically to the intestinal disease,
and others appear to have some relationship to the imbal-
anced immune system. The faulty absorption state of the
bowel can result in gallstones and kidney stones. In-
flamed areas in the abdomen may press on the tube that
drains urine from the kidney to the bladder (the ureter).
Ureter compression can make urine back up into the kid-
ney, enlarge the ureter and kidney, and can potentially
lead to kidney damage. Patients with Crohn’s disease
also frequently suffer from:
• arthritis (inflammation of the joints)
• spondylitis (inflammation of the vertebrae, the bones of
the spine)
• ulcers of the mouth and skin
• painful, red bumps on the skin
• inflammation of several eye areas
• inflammation of the liver, gallbladder, and/or the chan-
nels (ducts) that carry bile between and within the liver,
gallbladder, and intestine
568
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
The chance of developing cancer of the intestine is
greater than normal among patients with Crohn’s dis-
ease, although this chance is not as high as among those
patients with ulcerative colitis.
Diagnosis
Diagnosis is first suspected based upon a patient’s
symptoms. Blood tests may reveal an increase in certain
types of white blood cells, an indication that some type
of inflammation or infection is occurring in the body.
The blood tests may also reveal anemia and other signs
of malnutrition due to malabsorption (low blood protein;
variations in the amount of calcium, potassium, and
magnesium present in the blood; changes in certain
markers of liver function). Stool samples may be exam-
ined to make sure that no infectious agent is causing the
diarrhea, and to see if the waste contains blood.
A colonoscopy may be performed to view the interi-
or of the colon. During colonoscopy, a doctor passes a
flexible tube with a tiny, fiber-optic camera device (an en-
doscope) through the rectum and into the colon. The doc-
tor can then carefully examine the lining of the intestine
for signs of inflammation and ulceration that might sug-
gest Crohn’s disease. A tissue sample (a biopsy) of the in-
testine can also be taken through the endoscope to exam-
ine under a microscope for evidence of Crohn’s disease.
Both an upper and lower GI (gastrointestinal) x ray
series can be helpful in determining how much of the in-
testine is involved in the disease. In the upper GI (also
called a small bowel series), the patient drinks a chalky
solution called barium, which acts as a contrast agent to
illuminate the gastrointestinal tract on x-ray film. After
the barium is ingested, x rays are taken at specific time
intervals as the barium passes through the stomach and
into and through the small intestine. The lower GI series
provides an x-ray study of the large intestine. The patient
is given an enema containing barium, and in some cases,
air is also pumped into the rectum to provide a clearer
view of the large intestine. This is called a double-con-
trast barium enema.
Treatment
Crohn’s disease is a chronic, often progressive, ill-
ness. A correct diagnosis and appropriate treatment with
anti-inflammatory medications is critical to controlling
the disease.
Some Crohn’s patients find that certain foods are
hard to digest, including milk, large quantities of fiber,
and spicy foods. Dietary adjustments are usually neces-
sary to minimize pain, diarrhea, and other symptoms.
Acupuncture and guided imagery may be useful
tools in treating any pain associated with Crohn’s dis-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
ease. Acupuncture involves the placement of thin needles
into the skin at targeted locations on the body known as
acupoints in order to harmonize the energy flow within
the human body. To treat chronic pain, such as that in-
volved with Crohn’s disease, an acupuncturist will fre-
quently place the acupuncture needles along what is
known as the large intestine meridian.
Guided imagery involves creating a visual mental
image of one’s pain in one’s mind. Once the pain can be
visualized, the patient can adjust the image to make it
more pleasing, and thus, more manageable.
Several herbal remedies are also available to lessen
pain symptoms and promote relaxation and healing.
These include peppermint oil, slippery elm ( Ulmus
rubra), marsh mallow ( Althaea oficinalis), and Chinese
herbs. However, Crohn’s patients should consult with
their healthcare professional before taking them. De-
pending on the preparation and the type of herb, these
remedies may aggravate the digestive tract or interact
with any prescription drugs that are being taken to con-
trol the inflammation of Crohn’s disease.
Allopathic treatment
Treatments for Crohn’s disease try to reduce the un-
derlying inflammation, the resulting malabsorption/mal-
nutrition, the uncomfortable symptoms of crampy ab-
dominal pain and diarrhea, and any possible complica-
tions (obstruction, abscesses, and fistulas).
Inflammation can be treated with a drug called sul-
fasalazine. Sulfasalazine is made up of two parts. One
part is related to the sulfa antibiotics; the other part is a
form of the anti-inflammatory chemical, salicylic acid.
Sulfasalazine is not well-absorbed from the intestine, so
it stays mostly within the intestine, where it is broken
down into its components. It is believed that the sali-
cylic acid component actively treats Crohn’s disease by
fighting inflammation. Some patients do not respond to
sulfasalazine, particularly those with more severe dis-
ease. These patients require steroid medications (such as
prednisone). Steroids, however, must be used carefully
to avoid the complications of these drugs, including in-
creased risk of infection and weakening of bones (os-
teoporosis)
In 2001, the Food and Drug Administration (FDA)
approved use of budesonide capsules for mild and mod-
erate cases of Crohn’s disease involving the small and
large intestines. Although a steroid, the makeup of
budesonide allows the drug to release into the intestines,
where it can be mostly metabolized. As a result, less of
the drug enters the patient’s system, meaning fewer un-
desirable side effects. Some potent immunosuppressive
drugs that interfere with the products of the immune sys-
569
Crohn's disease
Crohn's disease
tem and hopefully decrease inflammation may be used
for those patients who do not improve on steroids.
Serious cases of malabsorption/malnutrition may
need to be treated by providing nutritional supplements.
These supplements must be in a form that can be ab-
sorbed from the damaged, inflamed intestine. When pa-
tients are suffering from an obstruction, or during peri-
ods of time when symptoms of the disease are at their
worst, they may need to drink specially formulated,
high-calorie liquid supplements. Those patients who are
severely ill may need to receive their nutrition through a
needle inserted intravenously.
A number of medications are available to help de-
crease the cramping and pain associated with Crohn’s
disease. These include loperamide, tincture of opium,
and codeine. Some fiber preparations (methylcellulose
or psyllium) may be helpful, although some patients do
not tolerate them well.
The first step in treating an obstruction involves gener-
al attempts to decrease inflammation with sulfasalazine,
steroids, or immunosuppressive drugs. A patient with a se-
vere obstmction will have to stop taking all food and drink
by mouth, allowing the bowel to “rest.” Abscesses and
other infections will require antibiotics. Surgery may be re-
quired to repair an obstruction that does not resolve on its
own, to remove an abscess, or to repair a fistula. Such
surgery may involve the removal of a section of the small
intestine. In extremely severe cases of Crohn’s disease of
the colon that do not respond to treatment, a patient may
need to have the entire large intestine removed (an opera-
tion called a colectomy). In this case, a piece of the remain-
ing small intestine is pulled through an opening in the ab-
domen. This bit of intestine is fashioned surgically to allow
a special bag to be placed over it. This bag catches the
body’s waste, which no longer can be passed through the
large intestine and out of the anus. This opening, which
will remain in place for life, is called an ileostomy. Howev-
er, as an alternative to ileostomy, small intestines are now
often shaped into substitute rectal pouches, and the patient
may not always need the ileostomy.
Expected results
Crohn’s disease is a lifelong illness. The severity of
the disease can vary, and a patient can experience peri-
ods of time when the disease is not active and he or she
is symptom free. However, the complications and risks
of Crohn’s disease tend to increase over time. Well over
60% of all patients with Crohn's disease will require
surgery, and about half of these patients will require
more than one operation over time. About 5-10% of all
Crohn’s patients will die of their disease, primarily due
to massive infection.
570
KEY TERMS
Abscess — A walled-off pocket of pus caused by
infection.
Endoscope — A medical instrument that can be
passed into an area of the body (the bladder or in-
testine, for example) to allow examination of that
area. The endoscope usually has a fiber-optic
camera, which allows a greatly magnified image
to be shown on a television screen viewed by the
operator. Many endoscopes also allow the opera-
tor to retrieve a small sample (biopsy) of the area
being examined.
Fistula — An abnormal channel that creates an
open passageway between two structures that do
not normally connect.
Gastrointestinal tract — The entire length of the di-
gestive system, running from the stomach, through
the small intestine, large intestine, and out the
rectum and anus.
Immune system — The body system responsible for
producing various cells and chemicals that fight
infection by viruses, bacteria, fungi, and other for-
eign invaders. In autoimmune disease, these cells
and chemicals turn against the body itself.
Inflammation — The result of the body's attempts
to fight off and wall off an area that is infected. In-
flammation results in the classic signs of redness,
heat, swelling, and loss of function.
Obstruction — A blockage.
Ulceration — A pitted area or break in the continu-
ity of a surface, such as the skin or mucous mem-
brane.
Prevention
Crohn’s disease is a chronic, lifelong disorder. How-
ever, a study published in the New England Journal of
Medicine in June 2000 reported that methotrexate (a
chemotherapy drug) was found to prevent relapse
episodes in a clinical trial of Crohn's patients. The study
also found that human growth hormone was useful in re-
ducing symptoms of the disease.
Resources
BOOKS
Glickman, Robert. “Inflammatory Bowel Disease: Ulcerative
Colitis and Crohn's Disease.” In Harrison’s Principles of
Internal Medicine. Anthony S. Fauci et al., eds. New York:
McGraw-Hill, 1998.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Long, James W. The Essential Guide to Chronic Illness. New
York: HarperPerennial, 1997.
Saibil, Fred. Crohn’s Disease and Ulcerative Colitis. Buffalo,
NY: Firefly Books, 1997.
PERIODICALS
Peppercorn, Mark A., and Susannah K. Gordon. “Making
Sense of a Mystery Ailment: Inflammatory Bowel Dis-
ease.” Harvard Health Letter 22, no. 2 (December 1996):
4+.
Sachar, David. “Maintenance Strategies in Crohn’s Disease.”
Hospital Practice 31, no. 1 (January 15, 1996): 99+.
Karpa, Kelly Dowhower. “Crohn's disease patients find new re-
lief from old drug.” Drug Topics 145, no. 21 (November 5,
2001): 16;.
ORGANIZATIONS
Crohn’s & Colitis Foundation of America, Inc. 386 Park Av-
enue South, 17th Floor, New York, NY 10016-8804. (800)
932-2423.
Paula Ford-Martin
Teresa G. Odle
Croup
Definition
Croup is a common ailment of early childhood in-
volving inflammation of the larynx, trachea, bronchial
tubes, and lungs. The condition is characterized by a
harsh, barking cough, wheezing, and difficulty in
breathing.
Description
Croup is most likely to be found in children between
the ages of three months to six years. Most incidences
occur during the cold weather seasons.
Spasmodic croup is usually mild and may be due to
bacterial infection or allergies. For the most part, the
child will not have a fever. Viral croup, also called laryn-
gotracheobronchitis, is more severe and is often accom-
panied by fever. Both types follow a very similar course,
which depends on the severity of the illness.
In many instances, a child may have had a cold or
the flu just before the onset of croup symptoms. These
symptoms tend to come on very suddenly. It is not un-
common for a child with croup to waken in the middle of
the night coughing violently and gasping for breath. In
fact, the croup symptoms will usually be worse at night
and get better during the day.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Causes & symptoms
During the immune system response to an infection
or an allergic reaction, the respiratory passages become
swollen, and they are congested with mucus and fluid.
They also become more and more irritated. There is a
great deal of coughing, and the child may become
hoarse. The airways are narrowed, and the breathing is
difficult and noisy. This leads to the characteristic symp-
tom of stridor, or noisy aspiration, as the child attempts
to draw in air through narrowed passages. The constric-
tion of these airways is usually accompanied by a high-
pitched cough, often described as sounding like the bark
of a seal.
Diagnosis
Diagnosis of croup is primarily based on a good his-
tory taken by the health care provider, including the
physical symptoms of the illness, the presentation of the
illness, and its progression. If a physical exam is per-
formed, it will probably include listening with a stetho-
scope for the breathing sounds which are characteristic
of croup. When the symptoms appear to be severe, or the
history suggests it, x rays may be taken to rule out
epiglottitis (infection of the epiglottis) or aspiration of a
foreign body, which are emergency situations.
Treatment
Supportive measures
Most treatment can be done at home, using relaxing
and supportive measures to relieve symptoms. Steam in-
halation is quite helpful in this respect. A cool-mist hu-
midifier is recommended, as a hot vaporizer is often haz-
ardous, especially around young children.
One of the best ways to produce a lot of moist air in
a short time, is to make use of the bathroom shower. The
procedure is to close the bathroom door and turn on the
cool water shower faucet full blast. Then the child can
be a held while seated on a chair or the closed commode,
breathing in steam as it fills the room. This can be done
for up to 15 minutes, and often brings instant relief from
congestion.
Cool air seems to relax and soothe the respiratory
system. Therefore, taking a car ride with the window
rolled will sometimes effect good results in reducing the
coughing associated with croup.
There is a strong possibility of dehydration due to
the illness. Increasing fluid intake as much as possible
and insuring plenty of rest will enhance immune func-
tioning, helping the body to help itself. In addition,
smoking should be prohibited within the house.
571
Croup
Croup
To help ease croup, apply pressure for one minute to these acupressure points. At left, use gentle pressure on the point in
the center of the baby’s chest, midway between the nipples. At right, ease coughing by applying pressure about a half inch
below the large hollow under the collarbone, on the outer part of the chest near the shoulder. (Illustration by Electronic Illustra-
tors Group. The Gale Group.)
Herbs
Respiratory herbs can be used to soothe swollen and
irritated tissues, reduce inflammation, and gently loosen
and expel mucus. The following herbs should be given
three times per day diluted in water or other liquids until
symptoms are gone:
• Grindelia spp., gum weed, 1-2 ml
• Sambucus nigra, elder flowers, 2-4 ml
• Glycyrrhiza glabra, licorice root, 1-3 ml
• Verba scum thapsus, mullein, 2-4ml
•Astragalus senticocosus, 2-4 ml (This herb is an im-
mune system stimulant and should be given as a pre-
ventative for those who have chronic bouts of croup.)
Slippery elm bark can also be taken, as it is sooth-
ing to the throat.
Homeopathy
Aconite is the most favored remedy to use for
croup. If it does not work, Spongia can be tried, especial-
572
ly if the breathing sounds as if wood were being sawed.
Alternately, try Hepar sulphuris, indicated by a mucus-
filled cough. Give a dosage of 12X or 30C every 30 min-
utes until the child is able to fall asleep.
Allopathic treatment
In most cases, croup can be easily and successfully
treated at home. However, if the symptoms become se-
vere, the child will need to be seen by a physician.
Prompt medical attention is needed if:
• The child’s fever goes up to 104°F (39.9°C).
• The child seems pale or bluish around the mouth or fin-
gernails.
• The child refuses all liquids or can’t swallow.
• The child is drooling a great deal.
• The child’s breathing becomes increasingly rapid or
difficult.
Severe cases may warrant the use of inhalants, such as
epinephrine, to reduce swelling and give the child easier
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
breathing. Inhalants have limited effectiveness over time,
and care must be taken to avoid undesirable side effects.
Oxygen may also be administered in more severe cases.
Corticosteroids are given to decrease pain and swelling.
If a child is hospitalized for further observation or
treatment, intravenous (IV) fluids may be given to re-
duce dehydration. In a few very severe cases, a tube has
to be inserted through the nose or mouth (intubation) to
keep the airway passage open for breathing. There is a
slight risk of injury to the respiratory system during the
introduction and the removal of the tube.
Expected results
Croup ordinarily lasts three to seven days. Most
cases are mild and gradually improve with care. Some
children have recurring bouts with croup, but they usual-
ly outgrow this by seven years of age.
It is important to monitor a child with croup through-
out the night. An adult should probably consider sleeping
or resting nearby. If the child is having a serious struggle
with breathing, emergency services should be contacted
immediately. This means either calling 911 or making a
trip to the nearest emergency room. Hospital visits are nec-
essary in about one to 15% of the reported cases of croup.
Prevention
Croup is generally the result of an infectious dis-
ease. Avoiding exposure to others with respiratory infec-
tions is the best way to avoid getting croup. Children
should be taught to maintain good hygiene practices
such as not eating food from the silverware or dishes of
others and washing their hands. Care should be taken
with colds and the flu so that there is no progression to
symptoms of croup.
In general, an adequate intake of vitamins A and C,
bioflavonoids, and zinc can help to prevent the respira-
tory infections and allergic reactions that lead to croup.
Resources
BOOKS
Bunch, Bryan, ed. The Family Encyclopedia of Diseases: a
Complete and Concise Guide to Illnesses and Symptoms.
New York: Scientific Publishing, Inc., 1999.
The Editors of Time-Life Books. The Medical Advisor: The
Complete Guide to Alternative and Conventional Treat-
ments. Alexandria, VA: Time-Life, Inc., 1997.
OTHER
"Childhood Infections” The Nemours Foundation. http://kid-
shealth.org. (1999).
"The Common Cold” Natural Medicine Online. http://www.
nat-med.com. (2000).
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Aspiration — Accidental inhaling of an object such as
food into the airway passages. This is dangerous, in
that it may cause obstruction and difficulty breathing.
Corticosteroid — A hormonal drug that acts on the
immune system to control inflammation and
swelling.
Epiglottitis — A serious bacterial infection that can
develop rapidly and lead to airway obstruction.
Epinephrine — A hormonal drug used chiefly to
stimulate to the heart
Inflammation — Reaction by body tissues to infec-
tion or injury. Usually the area will be hot, red,
painful, and swollen due to the immune response.
Intravenous fluids — In cases of immediate need
for hydration, nourishment, or medicine, a needle
with tubing is inserted directly into the vein.
Intubation — A procedure in which a flexible tube
is carefully passed down the throat to keep the
breathing passage open.
Stridor — A noisy wheezing sound during breath-
ing that may indicate an airway obstruction.
"Croup” Merck & Co., Inc. http://www.merck.com.
“Croup and Your Young Child” American Academy of Pedi-
atrics. http://www.aap.org. (2000).
Patience Paradox
Crystal healing
Definition
A crystal is a mineral that is nearly transparent and col-
orless or has a slight color. Practitioners of crystal healing
believe that crystals, particularly quartz crystals such as
amethyst or clear quartz, contain energy that enhances heal-
ing of both body and mind. They believe that crystals can
be "charged” with this healing energy, in a manner similar
to the charging of a flashlight battery. The charged crystal
can then be used to alter the energy patterns in the person
receiving treatment. Some crystal healers also say that ar-
rowheads and other stones can be used to diagnose illness.
Origins
Aboriginal, shamanistic cultures throughout the
world, including Native Americans and the Inuit of
573
Crystal healing
Crystal healing
Woman experiencing crystal healing. (© Chris Lisle/Corbis. Reproduced by permission)
northern Canada, have long believed in the healing prop-
erties of semiprecious and precious stones. These views
were further developed and widely popularized during
the late twentieth century by New Age healers.
Benefits
Crystal healing is used to enhance healing of a wide
range of physical and mental ailments. For example,
amethyst is said to be useful against acne, atacamite against
venereal diseases, agate against ulcers, and lapis lazuli
against stroke symptoms. Crystals may also be used to
counter environmental hazards such as electromagnetic ra-
diation, food additives, and polluted air and water. They are
thought by some to minimize the detrimental effects of caf-
feine, tobacco, and alcohol. In addition, some practitioners
use crystals before and after surgery to minimize trauma.
Description
Although its effectiveness is disputed, crystal healing
is generally safe and inexpensive. Crystals are used in a
wide variety of ways. The best results are said to occur
when both the patient and the healer are holding crystals.
The healer may hold a stone in one hand while using the
574
other to touch the body part in need of healing. Crystals
may also be worn as pendants (this is said to be particu-
larly effective in treating thymus gland problems). Appro-
priate stones can be selected, healers say, by simply pick-
ing up various crystals and determining which ones seem
to harmonize with the frequencies of the patient’s body.
This may be indicated by a feeling of warmth or tingling.
Some healers work solely with crystals while others com-
bine them with aura or chakra work.
Preparations
Numerous techniques are used to prepare crystals
before therapeutic use. One such technique is clearing,
which involves using an invocation to remove negative
emotional energy from the stone. Another method is
cleansing, which is said to maintain the crystal’s existing
energy level but converts negative energy to positive. This
may be accomplished by immersing the stone for a mini-
mum of 24 hours in dry salt or saline solution. Crystals
can also be charged, like a battery, by exposing them to
running water, magnets, sunlight, moonlight, pyramids,
fire, laser light, or living animals, birds, fish, or plants.
Some practitioners attempt to charge stones by
putting them near a mother who is giving birth, or some-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Resources
KEY TERMS
Aura — A person's vital energy field; the energies
are said to be seen as colors and represent states
of being. Halos have been considered a type of
aura.
Chakra — A theoretical rotating wheel of energy
within the body, believed to cause illness when
out of alignment.
Placebo effect — The tendency of an ineffective
therapy to benefit a patient who believes in the
healing ability of the therapy.
one who is dying. Crystals have been wrapped in a new-
born’s placenta, then given to the child seven years later.
Gem stones that have been near meteorite fragments,
earthquakes, volcanoes, or trees struck by lightening are
also highly valued for healing properties.
Some healers believe that healing crystals can be
programmed with human thoughts. This may be done by
placing a crystal against the forehead, then visualizing a
desired outcome.
Precautions
Crystal healing is largely viewed as an enhancement
to other therapies. It should not be used exclusively in
cases of serious illness.
Side effects
There are few, if any, proven side effects to crystal
healing.
Research & general acceptance
Medical professionals place little credence in crystal
therapy, attributing any observed benefits to placebo ef-
fect. Their skepticism stems from a lack of scientific evi-
dence for the healing effects of crystals, and from differ-
ences of opinion among practitioners about how the ther-
apy actually works.
Training & certification
Practitioners of crystal healing tend to be New Age
spiritual healers. A number of schools in Europe and
North America offer courses in crystal therapy, but the
field is largely unregulated. Many individuals use crys-
tals for self-healing.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
BOOKS
Elsbeth, Marguerite. Crystal Medicine. St. Paul: Llewellyn
Publications, 1997.
ORGANIZATIONS
The International Association of Crystal Healing Therapists.
P.O. Box 344, Manchester, M60 2EZ, United Kingdom.
Telephone: (UK) 01200-426061. Fax: (UK) 01200-
444776. info@iacht.co.uk. http://www.iacht.co.uk/.
David Helwig
Cupping
Definition
Cupping is a technique used in traditional Chinese
medicine (TCM) for certain health conditions. Glass or
bamboo cups are placed on the skin with suction, which
is believed to influence the flow of energy and blood in
the body. Cupping should not be confused with the per-
cussive technique in Swedish massage called “cupping”
or “clapping.”
Origins
Cupping was originally called “horn therapy” in an-
cient China, but variations of it have been used in
Turkey, Greece, France, Italy, and Eastern Europe. Cup-
ping has a long history of use in acupuncture practice
and has been combined with bloodletting, but it is a ther-
apy in its own right. There are specialist cupping practi-
tioners in Japan.
Benefits
Cupping is a safe, non-invasive, and inexpensive
technique. It is used by practitioners of Chinese medi-
cine to treat colds, lung infections, and problems in the
internal organs. It is also used to treat muscle and joint
pain and spasms, particularly in the back. Cupping can
be used on people for whom the injection of acupuncture
needles poses a problem or risk. Cupping therapy is
thought to stimulate blood circulation.
Description
Practitioners of traditional Chinese medicine begin
treatment by diagnosing a patient through interviews,
close examinations of the pulse, tongue and other parts
of the body, and other methods. TCM strives to balance
575
Cupping
Cupping
Therapist performing cupping on a patient’s back. (Photo Researchers, Inc. Reproduced by permission.)
and improve the flow of qi, or life energy, which travels
throughout the body in channels called meridians. Ac-
cording to traditional Chinese medicine, illness is caused
when qi does not move properly in the body. Acupunc-
turists are trained to determine where qi is stagnated,
weak, or out of balance.
Acupuncturists use cupping for specific problems in
the flow of qi. Cupping disperses and moves qi by exert-
ing suction and pressure. Cupping is used when the qi is
blocked at certain points, or when qi needs to be drawn
to the surface of the body from deep within. For in-
stance, cupping is used to treat lung infections and colds,
because it is believed that the suction disperses and ener-
gizes the qi that has become blocked and stagnated in the
lungs. Cups can also pull out “wind-cold” that in Chi-
nese medicine is believed to cause lung infections.
Patients usually lie down for a cupping treatment.
Cups are made of bamboo or strong glass. To create a
vacuum, a flame from a lighter or a burning cotton ball
is placed in an upside-down cup. When the oxygen in
the cup is burned off, the cup is placed directly on the
skin, where it is held in place by a surprisingly strong
suction. Often, the skin inside the cup visibly rises.
There are also cups available that use pumps instead of
576
burning to create the proper suction. Cupping is general-
ly a painless procedure.
More than one cup at a time may be used to cover an
area thoroughly. Cups may be left in the same place for
several minutes, or removed quickly and placed else-
where. Cups are sometimes placed over acupuncture nee-
dles that have been inserted. Moving cupping may also be
performed, by first rubbing the skin with a small amount
of oil to allow the cups to slide around. After cupping, pa-
tients may remain lying down for several minutes. When
cups are used to treat colds and lung infections, patients
are advised to wrap up in blankets to stay warm after treat-
ment. Acupuncturists may also prescribe herbal remedies,
dietary changes, and other health recommendations.
Precautions
Cupping should be performed by experienced profes-
sionals. Although it is a simple treatment, people should
not attempt it on themselves. Improper glass vessels can
shatter and cause injury, and cupping may cause bruising.
Side effects
Cupping causes blood to be drawn to the surface of the
skin, which can cause red marks, swelling, and bmising.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
KEY TERMS
Meridian — Subtle channel in the body where qi
flows.
Qi — Universal life energy present in air, food,
water, sunlight, and the body.
Traditional Chinese medicine — System of healing
originating in ancient China using acupuncture,
herbal remedies, and other methods.
Resources
BOOKS
Fleischman, Dr. Gary F. Acupuncture: Everything You Ever
Wanted to Know. Barrytown, NY: Station Hill, 1998.
Williams, Tom, Ph.D. The Complete Illustrated Guide to Chi-
nese Medicine. Rockport, MA: Element, 1996.
ORGANIZATIONS
American Association of Acupuncture and Oriental Medicine.
433 Front St., Catasaugua, PA 18032. (610) 266-1433.
Douglas Dupler
Curanderismo
Definition
Curanderismo is a holistic system of Latin American
folk medicine. This type of folk medicine has character-
istics specific to the area where it is practiced
(Guatemala, Nicaragua, Honduras, Argentina, Mexico,
the southwestern region of the United States, etc.). Cu-
randerismo blends religious beliefs, faith, and prayer
with the use of herbs, massage, and other traditional
methods of healing. Curanderismo can be defined as a
set of traditional beliefs, rituals, and practices that ad-
dress the physical, spiritual, psychological, and social
needs of the people who use it.
The Spanish verb curar means to heal. Therefore,
curanderismo is translated as a system of healing. The
goal of curanderismo is to create a balance between the
patient and his or her environment, thereby sustaining
health.
The healer who practices curanderismo is referred to
as a curandero (male healer) or curandera (female heal-
er). Healing terms vary with the language and culture of
the area in which the system is practiced. For example, a
female healer in Argentina is called a remedieras.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Origins
Curanderismo in Mexico is based on Aztec, Mayan,
and Spanish influences. The ancient native cultures be-
lieved that a delicate balance existed between health, na-
ture, and religion. Illness occurred when one of these
areas was out of balance.
The use of nature’s resources was very important to
the native cultures. In the fifteenth century, the Huaxtepec
garden was developed by the Aztec leader Montezuma I.
This garden was a collection of several thousand medici-
nal plants. The Aztec priests used this garden to perform
research on the medicinal properties of the plants.
When the Spanish conquistadors came to Mexico in
the sixteenth century, they destroyed the garden and all
of the priests’ research because the Catholic Church con-
sidered these “sciences” to be blasphemous. Although
the written knowledge was destroyed, the plant wisdom
was remembered, passed down by the native peoples,
and became an integral part of curanderismo.
The Spanish missionaries who were sent to the New
World introduced the native peoples to the Catholic reli-
gion and European healing philosophies. Prayers to
Catholic saints were soon integrated into healing rituals.
Another doctrine that was passed on to the native peo-
ples by the Europeans was their belief in witchcraft, sor-
cery, and other superstitions, and the philosophy that ill-
ness is often caused by supernatural forces.
As the native and Spanish cultures intermingled
over the centuries, a new culture was formed, as was the
folk medicine of curanderismo.
Benefits
Curanderismo is used to treat ailments arising from
physical, psychological, spiritual, or social conditions.
Illness is said to be caused by either natural or supernat-
ural forces.
Naturally caused illness is treated with herbal medi-
cine, massage, and prayer. Much of this illness is thought
to be brought about by intense emotions caused by trau-
ma or a specific event. Susto, for example, is an illness
that is caused by fright. A startling event such as a fire,
earthquake, dog attack, car accident, or death may cause
the patient to become ill. Symptoms of susto are insom-
nia, diarrhea, extreme nervousness, sadness, depres-
sion, loss of appetite, loss of brilliance in the eyes, and
lack of dreams. The events are thought to dislodge a per-
son’s spirit from the body.
Bilis is an ailment that is the result of excessive
emotional stress. Bilis is caused by prolonged anger and
fear. The ailment is thought to occur when excessive bile
577
Curanderismo
Cuscuta
is trapped in the system and causes tension, irritability,
and loss of appetite.
Empacho and colic are ailments treated by massage
and herbs. Empacho is a blocked intestine disease where
the intestines are plugged by something indigestible such
as chewing gum or unbaked dough. To treat this condition,
the curandera performs a massage in which she pulls on
the skin of the back just above the coccyx (tailbone). When
the skin makes a snapping noise the food has been loos-
ened. Herbal tea is also given to complement the massage.
Colic is caused by excessive coldness of the stom-
ach, and mint is used for such digestive problems.
Supernaturally caused illnesses or conditions are ini-
tiated by witchcraft, sorcery, or hexes. Physical symptoms
might manifest as nervous breakdowns, paranoia, schizo-
phrenia, depression, or excessive worrying. Supernatural
forces can also create social problems. A person who has a
streak of continued bad luck, or who suffers from marital
problems, the loss of a job, or car troubles will deem the
problem to be caused by a supernatural force. To heal
these ailments and remove the hex or problem, the curan-
dera uses rituals, spiritual cleansings, herbs, and prayer.
Description
Prayer is the foundation of curanderismo. Curan-
deras have strong religious faith and believe that they
were given the ability to heal as a gift from God. Curan-
deras pray to spirits and/or Catholic saints for help in
healing their patients, often praying to specific saints for
particular conditions.
A traditional healing session may include one or
more of the following: spiritual cleansing ilimpia), ritual,
massage, and/or herbal therapy. Curanderas use a variety
of objects in their healing sessions, including herbs and
spices, eggs, lemons, flowers, fruits, holy water, pictures
of saints, crucifixes, candles, incense, and oils. Each ob-
ject has a specific purpose.
Holy water is used for protection from negativity or
evil spirits. Eggs and lemons are patted on the patient's
body to absorb negative energies. Rosemary, basil, and
rue branches are brushed on the body to remove negativity.
Candles are burned to absorb negative energy and
create a healing environment. Different colored candles
are burned for different reasons: red for strength, blue for
harmony, pink for good will, incense is used to purify
the room, while garlic and oils are used as protection
from negativity and bad spirits.
Research & general acceptance
Although much of the Hispanic community is cur-
rently devoted to the practice of curanderismo, many
578
KEY TERMS
Anthropology — The study of the origin and physi-
cal, social, and cultural development and behav-
ior of groups of people.
people fear that it will be lost from lack of interest on the
part of the younger generation or reliance on mainstream
medical procedures. There is a great deal of research on
curanderismo in the field of anthropology.
Training & certification
Curanderas are generally trained informally. The in-
formation is passed from generation to generation (i.e.,
mother to daughter). Often the curandera starts out as an
apprentice to a more experienced curandera.
Resources
BOOKS
Perrone, Bobette, Henrietta H. Stockel, and Victoria Kruger.
Medicine Women, Curanderas, and Women Doctors. Nor-
man, OK: University of Oklahoma Press, 1989.
Sandoval, Annette. Homegrown Heeding: Traditional Remedies
From Mexico. New York: Berkley Books, 1998.
Trotter, Robert T.. II, and Juan Antonio Chavira. Curanderis-
mo: Mexican American Folk Healing. 2nd ed. Athens,
GA: The University of Georgia Press, 1997.
Jennifer Wurges
Cuscuta
Description
Cuscuta is the name of a group of plants in the
morning glory family, of which the species Cuscuta ep-
ithymum is most commonly used in healing. A member
of the Cuscutaceae family, species of cuscuta are found
almost everywhere in the world, although cuscuta is
more often called dodder in English-speaking countries.
Other names include hellweed, devil’s gut, beggarweed,
strangle tare, scaldweed, dodder of thyme, greater dod-
der, and lesser dodder. In Chinese, cuscuta seeds are
called tu si zi.
Cuscuta is a parasitic plant. It has no chlorophyll
and cannot make its own food by photosynthesis. In-
stead, it grows on other plants, using their nutrients for
its growth and weakening the host plant. Agriculturalists
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
consider cuscuta a destructive weed and attempt to eradi-
cate it. It parasitizes wild and cultivated plants, and is es-
pecially destructive to such commercially valuable crops
as flax, alfalfa, beans, and potatoes. It also grows on
such common ornamentals as English ivy, petunias,
dahlias, and chrysanthemums. For medicinal purposes,
herbalists prefer C. epithymum that grows on thyme.
Cuscuta is a leafless plant with branching stems
ranging in thickness from thread-like filaments to heavy
cords. The seeds germinate like other seeds. The stems
begin to grow and attach themselves to nearby host
plants. Once they are firmly attached to a host, the cus-
cuta root withers away. The mature plant lives its entire
life without attachment to the ground. The stems of cus-
cuta are used in Western herbalism and the seeds are
used in traditional Chinese medicine (TCM).
General use
Despite the fact that cuscuta is unpopular with farm-
ers, it has a long history of folk use. In Western herbal-
ism, cuscuta was traditionally used to treat liver, spleen,
and gallbladder disorders such as jaundice; and to sup-
port liver function. It is still used, although rarely, in that
way by modern herbalists. It is also a mild laxative.
Other traditional Western claims for cuscuta are that it is
a mild diuretic, and that it can be used to treat sciatica
and scurvy. Externally, it can be gathered fresh and ap-
plied to the skin to treat scrofuladerma. Extracts of the
herb have a very bitter taste.
In traditional Chinese medicine, the seeds of cuscuta,
called tu si zi, have been used for thousands of years. In
the Chinese understanding of health, yin aspects inside the
person and outside in the environment must be kept in bal-
ance with yang aspects. Ill health occurs when the ener-
gies and elements of the body are out of balance or in
disharmony with nature. Health is restored by taking herbs
and treatments that restore internal and external balance.
According to traditional Chinese healers, cuscuta
seeds have a neutral nature and a pungent, sweet taste.
They are associated with the liver and kidneys and are
used in formulas that help both yin and yang deficien-
cies, depending on the patient’s condition and the other
herbs in the formula. Cuscuta was considered both an
aphrodisiac and a longevity herb because it slowed down
the loss of fluids from the body.
Contemporary Chinese herbalists use cuscuta in for-
mulas to treat a range of conditions, including:
• impotence
• premature ejaculation
• sperm leakage
• frequent urination
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
• ringing in the ears
• lower back pain
• sore knees
• white discharge from the vagina (leucorrhea)
• dry eyes
• blurred vision
• tired eyes
Cuscuta is one of nine herbs included in the manu-
facture of Equiguard, a Chinese herbal medicine recom-
mended for kidney and prostate disorders. Research per-
formed at New York Medical College indicates that the
combination of ingredients in Equiguard may well be ef-
fective in the treatment of prostate cancer. The prepara-
tion inhibited the growth of cancer cells, increased the
rate of self-destruction (apoptosis) of cancer cells, and
prevented the surviving cells from forming colonies.
Cuscuta is also used in the Indian system of Ayur-
vedic healing to treat jaundice, muscle pain, coughs, and
problems with urination.
Little scientific research has been done in the West
on cuscuta. A purgative compound has been isolated
from the herb, however, that supports its traditional use
as a liver and gallbladder tonic. Other research done at
Asian universities indicates that cuscuta seeds contain a
complex carbohydrate that stimulates the immune sys-
tem and has some antioxidant properties as well.
Preparations
In Western herbalism, the entire thread-like stems of
cuscuta are used. They are boiled in water along with
such herbs as ginger and allspice to make a decoction. In
Chinese herbalism, only the seeds are used. They are al-
most always used in combination with other herbs, as in
concha marguerita and ligastrum formulas.
Precautions
No special precautions are necessary when cuscuta
is used in the doses normally prescribed by herbalists.
Side effects
No side effects have been reported when cuscuta is
used in doses prescribed by herbalists.
Interactions
Cuscuta has been used for centuries with other Chi-
nese herbs without any reported interactions. Studies of
interactions between cuscuta and Western pharmaceuti-
cals have not yet been performed.
579
Cuscuta
Cuts and scratches
KEY TERMS
Antioxidant — An enzyme or other organic sub-
stance that is able to counteract the damaging ef-
fects of oxidation in living tissue.
Diuretic — Any substance that increases the pro-
duction of urine.
Sciatica — Pain in the lower back, buttocks, hips,
and thigh caused pressure on the sciatic nerve.
Scrofuloderma — Abscesses on the skin associated
with tuberculosis and caused by mycobacteria.
Scurvy — A disease caused by the absence of vita-
min C in the diet.
Yang aspects — Yang aspects, in nature and in the
human body, include such qualities as warmth,
activity, light, and forceful ness.
Yin aspects — Yin aspects are the opposite of yang
aspects and are represented by such qualities as
cold, stillness, darkness, and passivity.
Resources
BOOKS
Chevallier, Andrew. Encyclopedia of Medicinal Plants. New
York: DK Publishing, Inc., 1996.
Molony, David. Complete Guide to Chinese Herbal Medicine.
New York: Berkeley Books, 1998.
PDR for Herbal Medicines. Montvale, NJ: Medical Economics
Company, 1998.
Teegaurden. Ron. The Ancient Wisdom of the Chinese Tonic
Herbs. New York: Warner Books, 1998.
PERIODICALS
Bao, X., Z. Wang, J. Fang, et al. "Structural Features of an Im-
munostimulating and Antioxidant Acidic Polysaccharide
from the Seeds of Cuscuta chinensis.” Planta Medica 68
(March 2002): 237-243.
Hsieh. T. C., X. Lu, J. Guo et al. “Effects of Herbal Preparation
Equiguard on Hormone-Responsive and Hormone-Refrac-
tory Prostate Carcinoma Cells: Mechanistic Studies.” In-
ternational Journal of Oncology 20 (April 2002): 681-689.
ORGANIZATIONS
American Association of Oriental Medicine (AAOM). 433
Front Street, Catasauqua, PA 18032. (610) 266-2433.
OTHER
“Cuscuta epithymum." Plants for a Future, <www.pfaf.org>.
Tish Davidson
Rebecca J. Frey, PhD
580
Cuts and scratches
Definition
Cuts are wounds that break through the skin, and
sometimes reach the underlying tissue. Scratches are
usually superficial wounds where the skin is scraped by
a sharp object.
Description
The skin is a barrier between the environment and
the rest of the body. Usually it offers protection from the
invasion of infective organisms. If the skin is broken by
cutting or scratching, there is an increased possibility of
infection, along with pain and blood loss. Most cuts and
scratches are relatively minor and respond well to home
remedies. Deep cuts may require medical help and re-
pairing the skin with stitches to heal properly.
Causes & symptoms
A cut or scratch is often due to an accidental injury
or intentional violence. Age-related changes may be a
contributing factor, because the skin becomes more thin
and fragile with age, and thus, more susceptible to cuts
and scratches. Infection is a primary concern in dealing
with cuts and scratches. Signs of infection include red-
ness, pain or tenderness, local swelling, warmth, a dis-
charge from the wound site, fever, swollen lymph nodes,
and red streaks spreading out from the wound site.
Diagnosis
Minor cuts and scratches do not usually require di-
agnosis. However, if an infection sets in, the wound may
need to be assessed by a healthcare provider taking a his-
tory of the injury and performing a physical exam.
Treatment
Homeopathic topical preparations can be useful in
treating cuts and scratches. Calendulaand Hypericum
perforatum are herbs that can be applied topically as a
cream, gel, or ointment. Hypericum 30c can be taken in-
ternally, as well. It is particularly indicated if the cut is
very painful. Staphysagria 30c is indicated for deep cuts
and stab wounds. Aconite 30c may be given every 30
minutes for up to three to five doses if a person is very
anxious as well as injured.
Ayurvedic medicine recommends several simple
applications for minor cuts and scratches. These include
fresh aloe vera gel, plain ghee, and coconut oil. Licorice
( Glycirrhiza glabra ) and turmeric ( Curcuma longa ) can
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Abrasion Incision Laceration Puncture Avulsion Amputation
Examples of open wounds. (Illustration by Electronic Illustrators Group. The Gale Group.)
be added to any of these to make a paste that will help
the skin heal.
Western herbal remedies that promote the healing of
cuts and scratches include a strong tea made from Calen-
dula officinale flowers, which can be used as a soak or a
wash for wounds; distilled witch hazel ( Hamamelis vir-
giniana) which may also stop bleeding; goldenseal ( Hy-
drastis canadesis) powder or salve, a specific for skin
healing; a poultice of crushed plantain leaves (Plantago
spp.); and comfrey root salve ( Symphytum officinale).
Raw honey can also be directly applied to help disinfect
superficial wounds and to promote healing. Echinacea
spp. tincture can also be used as a disinfectant or antimi-
crobial to the affected site. The alcohol in the tincture
may cause the wound to sting. Topical applications
should not be used on a deep wound until some initial
healing has occurred.
According to aromatherapy, a spray of diluted es-
sential oils can be used as an antiseptic. They may also
repair skin damage and encourage new cell growth. Tea
tree, lavender, myrrh, benzoin, bergamot, chamomile,
tea tree, eucalyptus, juniper, rosemary, helichrysum,
eucalyptus, rose geranium, and sandalwood are all ap-
propriate to use on cuts and scratches. About 10 drops of
the full-strength oil should be added, singularly or blend-
ed, to two ounces of distilled water and one half ounce
of goldenseal tincture or alcohol. The essential oil mix-
ture should be shaken well before each use, and it can
then be sprayed on two or three times per day.
Vitamins E and A are necessary for the skin to heal
well and quickly. These vitamin oils can be squeezed direct-
ly from their capsules onto the affected areas several times
per day. They can be taken orally, as well, along with a mul-
tivitamin containing vitamins A, C, E, and B complex.
Healing following an injury is also speeded up by supple-
mentation with the amino acids arginine and glycine.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Bromelain, the digestive enzyme from pineapple, can be
taken between meals as needed to reduce inflammation.
Allopathic treatment
Most cuts and scratches are minor and can be han-
dled at home. A physician should be consulted if:
• The cut is very large or deep.
• There is uncontrolled bleeding.
• There is damage to muscles, nerves, or other deep tis-
sues.
• The wound edges are very jagged or do not seem to
join together for healing.
• The wound site is very dirty or contains difficult-to-re-
move foreign material, such as gravel.
• There is weakness or numbness below the injury.
• The cut is on the face, chest, fingers, genitals, back,
stomach, palm of the hand, or over a joint.
• There are signs of infection.
• The lymph nodes become swollen.
• The injured person has a history of diabetes, poor cir-
culation, mitral valve prolapse, an artificial heart valve,
or an artificial hip.
A cut or scratch should be washed with a mild soap
and water. Tweezers that have been disinfected by wash-
ing in hot, soapy water and soaking in rubbing alcohol
can be used to remove any dirt, glass, or gravel remaining
in the wound. Pressure can be applied directly to wound
with clean gauze pad until bleeding has stopped. The
wound can be protected while it heals by covering it with
an adhesive bandage. The use of an antibiotic or antisep-
tic ointment is optional. The use of rubbing alcohol and
hydrogen peroxide are not recommended for minor cuts
and scratches, as they can cause irritation of the wound.
581
Cuts and scratches
Cymatic therapy
Resources
KEY TERMS
Ghee — Butter heated to removed the fat, used in
Ayurvedic foods and remedies.
Keloids — An excessive overgrowth of collagen
scar tissue, often found in young women and
African Americans.
Lymph nodes — Structures that form white blood
cells and help fight infection in the body.
Poultice — Fresh chopped herbs applied to an in-
jured part of the body, and often covered with a
cloth, for healing pains, diseases, and infections.
Aspirin, acetaminophen, or nonsteroidal anti-inflam-
matory drugs (NSAlDs), such as ibuprofen, naproxen, or
ketoprofen can be taken to reduce pain. If there is a lot of
bleeding, however, aspirin and NSAIDs should be avoid-
ed because they may interfere with blood clotting. Keep-
ing the edges of the wound together can help keep dirt
out, speeds healing, and decreases scarring. Stitches are
helpful in this regard, but they, too, can cause scarring.
Butterfly bandages or steri-strips may also be used to
keep the wound closed. If a cut is more than 0.5 in (1.25
cm) deep, stitches will usually be needed.
Expected results
Most cuts and scratches are superficial, and heal
within a few days. Sometimes keloids form, and these
painless scars become gradually less prominent and visi-
ble over a period of months to years. Deep cuts may re-
sult in permanent decrease in function. Serious damage
may also result if an infected wound is left untreated.
Prevention
It is especially easy to get cuts and scratches while
working outdoors. Protective clothing and gloves are
therefore recommended for any kind of manual labor
outside the house. Using a moisturizer on the skin en-
sures that it will not become dried out. Dry skin is much
more susceptible to cuts, scratches, and cracking than
moist skin. Care should be taken to avoid accidents in
the home. The safety of problem areas should be ad-
dressed. For example, hardwood floors and stairs are
often slippery, as are loose rugs and broken steps or
floorboards. Also, the shower can be a major site of
home injuries. Furniture may have to be moved if there
are repeated accidents. Overexposure to the sun's rays
should be avoided, as it is a major cause of fragile skin
leading to injury. In addition, a tetanus booster shot is
recommended every 10 years.
582
BOOKS
Dollemore, Doug and Prevention Health Books for Seniors
Staff. The Doctors Book of Home Remedies for Seniors.
Emmaus, PA: Rodale Press, Inc., 2000.
Kirchheimer, Sid and Prevention Magazine Health Book Edi-
tors. The Doctors Book of Home Remedies II: Over 1,200
New Doctor-Tested Tips and Techniques Anyone Can Use
to Heat Hundreds of Everyday Health Problems. Em-
maus. PA: Rodale Press, Inc., 1993.
OTHER
Alternative Medicine.com. http://www.alternativemedicine.com
MotherNature.com. http://www.mothernature.com.
Patience Paradox
Cyanocobalamin see Vitamin B 12
Cymatic therapy
Definition
A form of sound therapy that is not applied
through hearing, but by instruments that send audible
sound waves directly into the body through the skin.
Origins
Sound, particularly in the form of music, drumbeats,
or chanting, was used for healing purposes in numerous
ancient traditions. The physiological effects of different
types of music on blood pressure and other bodily indi-
cators were first noticed during the late 1800s. The term
“cymatics” was coined by Hans Jenny, a Swiss scientist
who derived it from the Greek word kyma (a great wave).
Jenny published a book about the structure, dynamics,
and effects of sound vibrations in 1967. Present-day cy-
matic therapy was largely developed by Sir Peter Guy
Manners, an English medical doctor and osteopath, start-
ing in the 1960s.
Benefits
Practitioners of cymatic therapy believe that sound
is capable of rearranging the structure of molecules, and
therefore has unlimited potential as a tool for healing.
They claim to have successfully treated otherwise incur-
able and terminal diseases. At the same time, they ac-
knowledge that some patients seem to be unaffected by
sound therapy. The treatment has been used on patients
with tumors, internal bruises, calcified joints, bacterial
or viral infections, blood diseases, and other problems.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Description
Sound consists of mechanical vibrations that travel
through a medium such as air, water, or in the case of cy-
rnatic therapy, the body. Sound healers believe that all
parts of the body vibrate and therefore produce sound,
either at a healthy, “harmonious” frequency, or at an in-
harmonious, unhealthy frequency. Using a computerized
instrument, cymatic therapists direct healing frequencies
into the body to restore resonance and harmony. The
healing frequencies are related to those emitted by a
healthy organ or body part. In this way, cymatic healers
say, the immune system and other natural regulatory
functions are stimulated. Frequencies may be applied di-
rectly, or transmitted along acupuncture meridians.
Cymatic therapy does not directly heal, practitioners
say. Rather, it creates a near-optimal environment for or-
gans or cells. In such an environment, they say, the body
can heal itself without drugs or surgical intervention.
The instrument produces as many as 800 controlled au-
dible frequencies. The therapy may also be delivered
without such equipment, with the use of instruments
such as tuning forks.
Precautions
Patients with cardiac pacemakers are advised to
avoid this therapy. Because of the controversial nature of
cymatic treatment, a medical doctor should be consulted
in all cases of serious illness.
Side effects
Cymatic therapy is thought to be generally free of
adverse side effects.
Research & general acceptance
The variability with which different body tissues ab-
sorb and reflect sound is universally acknowledged. It is
this variability that makes ultrasound scanning a useful
form of medical imaging. However, few physicians are
convinced that healing can be facilitated by “tuning” a
sound device to a patient’s cellular vibrations. Hence,
medical doctors tend to be highly skeptical about cymat-
ic therapy.
Training & certification
Cymatic devices are used by a variety of alternative
practitioners, including osteopaths, acupuncturists, and
chiropractors. Specific training is needed to operate the
machines. This can be obtained through books, tapes,
seminars, and correspondence courses. In most jurisdic-
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
tions, the field is unregulated and patients must therefore
take care to ensure the competence of their healer.
Resources
ORGANIZATIONS
Brentforton Scientific and Medical Trust. Brentforton Hall,
Vale of Evesharm, Worcs., WR11 5JH England. Tele-
phone: 01386-830537.
Sound Healers Association. P.O. Box 2240 Boulder, CO 80306.
(303) 443-8181. http://www.healingsounds.com.
David Helwig
Cyperus
Description
Cyperus refers to a family of marsh-dwelling grass-
like plants known as sedges. Perhaps the best known
member of this family is the reed, which ancient Egyp-
tians used to make papyrus. However, many other mem-
bers of this family have proved useful as food and medi-
cine. Cyperus articulatus and Cyperus rotundus are the
two species most often associated with healing.
C. articulatus, also called adrue or Guinea rush, is a
tall sedge that mainly grows in Jamaica, Turkey, and
along the Nile River in Egypt. The medicinal part of the
plant is its root or tuber. This part is blackish in color and
shaped like a top. Tubers are usually about 0.7-1 in (1.1-
2.5 cm) long and about 0.5-0. 7 in (1.3-1. 7 cm) in diame-
ter. The tubers may be connected in groups of two or
three by underground stems. They are harvested and
dried for healing. The herb is bitter in taste and aromatic,
similar to lavender.
C. rotundus is used primarily in Asia and Africa but
also grows in Australia, Europe, and North America. It
grows in low, damp places near water. Like C. articula-
tus, the tuber is the part of the plant used in healing. Its
Chinese name is xiang fu and it has been used in tradi-
tional Chinese medicine for thousands of years. C. ro-
tundus is also called tiririca, nutsedge, nut grass, musta,
rnutha, and a host of other local names.
General use
C. articulatus is used mainly for digestive disorders.
It is an antiemetic, meaning that it suppresses vomiting.
This is useful in reducing the symptoms of morning
sickness during pregnancy. Because it gives the body a
general feeling of warmth, C. articulatus is sometimes
used as a sedative, generally in connection with sup-
583
Cyperus
Cyperus
pressing nausea. Cyperus is also used to relieve gas in
the stomach and intestines. In the Peruvian Amazon, na-
tive people use the herb to treat infection and in Africa it
is used to treat epilepsy.
There are few scientific studies of C. articulatus. An
Argentinian study conducted in 1995 looked at the bacte-
ria-killing properties of the herb. It concluded that decoc-
tions of C. articulatus completely inhibited the growth of
one species of Staphylococcus bacteria and partially in-
hibited the growth in one species of Pseudominas bacte-
ria. Both of these bacteria strains are capable of causing
severe, and sometimes fatal, infections. It was ineffective
against five other infection-causing organisms tested.
Another study published in the Journal of Ethno-
pharmacology in 1996 by Swiss investigators found that ex-
tracts of C. articulatus reduced certain types of spontaneous
neuron firings in the brains of rats. These scientists suggest-
ed that this suppression might be the basis for C. articula-
tus’ s effectiveness in treating headache and epilepsy.
C. rotundus is used in Chinese medicine and Japanese
Kampo formulations. It is rarely used alone and can be
found in formulas that relieve pain, especially pain associ-
ated with menstruation. It is also used in formulas for
stomachache and diarrhea, to improve menstrual function,
to treat impotence or heighten sexual potency, to treat bac-
terial infections, dry or tired eyes, and in tonics for general
wellness, in other Asian and African countries, C. rotundus
is also used as a diuretic and to treat high blood pressure. It
is also spread on the skin as a bactericide and a fungicide
to prevent infection of wounds, but these properties have
not been studied extensively in the laboratory. In two stud-
ies, one done in Thailand and the other in Tanzania, com-
pounds found in extracts from the root of C. rotundus were
isolated and several were found to have antimalarial prop-
erties. A recent Japanese study indicates that cyperus ex-
tract acts as an anticoagulant by preventing blood platelets
from clumping together to form clots.
A recent Egyptian study of cyperus lends some sup-
port to the traditional Chinese use of the herb as a reme-
dy for menstrual disorders. The Egyptian researchers
found that cyperus extract has a moderate level of estro-
genic activity.
Preparations
C. articulatus is usually prepared as a decoction or liq-
uid extract to be taken internally. C. rotundus may be pre-
pared two different ways. It can be boiled to make a liquid
to be mixed with other herbs. The tubers can also be ground
into a paste with or without other herbs. The paste can ei-
ther be formed into pills to be taken internally or applied ex-
ternally to wounds or skin rashes. This paste is also some-
times applied directly to the temples to treat headaches.
584
KEY TERMS
Antiemetic — A preparation or medication given to
stop vomiting.
Antimalarial — Any substance that reduces the ef-
fects of the tropical disease malaria.
Bactericide — A substance that kills bacteria.
Decoction — A preparation made by boiling an
herb, then straining the solid material out. The liq-
uid is then taken internally as a drink.
Diuretic — Any substance that increases the pro-
duction of urine.
Fungicide — A substance that kills fungi.
Kampo — Traditional Japanese system of herbal
medicine.
Neuron — A nerve cell that transmits electrical im-
pulses.
Precautions
No particular precautions have been reported as
being necessary in using cyperus.
Side effects
No side effects have been reported in using cyperus.
However, this herb has a long tradition of folk use, but
its effects on humans have not been studied in any struc-
tured way.
Interactions
Cyperus is often used in conjunction with other herbs
in Chinese formulations with no reported interactions.
Cyperus is, however, reported to be mixed with hallucino-
genic plants by certain tribes living in the Brazilian rain for-
est, in order to prolong the action of the hallucinogens. As
of 2002, there are no studies of interactions between cyper-
us and standard Western pharmaceuticals. A recent Korean
report on several new compounds isolated from cyperus,
however, indicates that it inhibits the action of benzodi-
azepine tranquilizers and modifies the effectiveness of sev-
eral neurotransmitters in the central nervous system.
Resources
BOOKS
Molony, David. Complete Guide to Chinese Herbal Medicine.
New York: Berkeley Books, 1998.
PDR for Herbal Medicines. Montvale, NJ: Medical Economics
Company, 1998.
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
Reid, Daniel. Chinese Herbal Medicine. Boston: Shambala,
1996.
PERIODICALS
Ha, J. H., K. Y. Lee. H. C. Choi, et al. “Modulation of Radioli-
gand Binding to the GABA(A)-Benzodiazepine Receptor
Complex by a New Component from Cyperus rotundus.”
Biological and Pharmaceutical Bulletin 25 (January
2002): 128-130.
Makino. T., H. Wakushima, T. Okamoto, et al. “Effects of Kan-
gen-Karyu on Coagulation System and Platelet Aggrega-
tion in Mice.” Biological and Pharmaceutical Bulletin 25
(April 2002): 523-525.
Nassar, M. I., A. F. Abdel-Razik, Eel-D. El-Khrisy, et al. “A
Benzoquinone and Flavonoids from Cyperus a! ope cur -
oides." Phytochemistry 60 (June 2002): 385-387.
ORGANIZATIONS
American Association of Oriental Medicine (AAOM). 433
Front Street, Catasauqua, PA 18032. (610) 266-2433
Centre for International Ethnomedicinal Education and Re-
search (CIEER). <www.cieer.org>.
OTHER
“Tiririca” Rain-Tree, info@rain-tree.com. http://rain-tree.com/
tirirca.htm.
Tish Davidson
Rebecca J. Frey, PhD
Cystitis see Bladder infection
Cysts, ovarian see Ovarian cysts
GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2
585
Cyperus